〔Abstract〕 Objective To explore the predictive value of left ventricular spherical index(LVSI) in prognosis of patients with dilated cardiomyopathy(DCM). Methods The DCM patients from hospital were included. All DCM patients were treated with standard anti-heart failure drugs and followed up for six months. They were divided into a good prognosis group according to whether adverse cardiovascular events(MACE) occurred(n=77) and poor prognosis group(n=154). All patients′ age, course of disease, body mass index(BMI), blood pressure, N-terminal fragment of the BNP precursor(NT-proBNP), echocardiogram indicators and other clinical data were collected, and the drug consumption during the follow-up period and the occurrence of MACE events were recorded. Binomial logistic regression was used to analyze the risk factors of MACE events in DCM patients, and receiver operating characteristic(ROC) curves were used to analyze the predictive value of LVSI for MACE events in DCM patients. Results Compared with the good prognosis group, the patients in the poor prognosis group had a longer course of disease, faster heart rate, and increased NT-proBNP, left atrium diameter(LAD), left ventricular end diastolic diameter(LVEDd), and LVSI; systolic blood pressure and left ventricular ejection fraction(LVEF) decreased(P<0.001), and other indicators had no statistical difference. The results of binomial logistic regression analysis showed that the duration of heart failure(OR=1.187,95% CI:1.091-1.290, P<0.001), admission systolic blood pressure(OR=2.089, 95%CI:1.243-3.510,P=0.005), LVEDd(OR=1.241, 95%CI:1.080-1. 426,P = 0. 002),LVEF( OR = 0. 862,95% CI: 0. 771-0. 963,P = 0. 009),LVSI( OR = 1. 462,95% CI:1. 262-1. 693,P<0. 001),NT-proBNP( OR = 1. 001,95% CI: 1. 000-1. 001,P = 0. 002) were independent predictors of MACE in DCM patients. LVSI of 61. 95% was the best critical value for predicting the occurrence of MACE. At this time,the area under the ROC curve was 0. 821( 95% CI: 0. 769-0. 874,P<0. 001),the maximum Youden index was 0. 461,and the sensitivity: 0. 695,specificity: 0. 766. Conclusion LVSI,LVEDd,LVEF,heart failure course,admission systolic blood pressure,NT-proBNP are the prognostic factors of DCM patients. The left ventricular spherical index has a certain predictive effect on the prognosis of DCM patients.