{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:18:54Z","timestamp":1791566334796,"version":"4.3.4"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T00:00:00Z","timestamp":1489449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The level of improvement in left ventricular ejection fraction (<jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>) in super\u2010responders to cardiac resynchronization therapy (<jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>) is exceptional. However, the long\u2010term prognosis remains unknown in a large population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Whether super\u2010responders haven good long\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We registered 347 patients with primary <jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>\u2010D indication. Super\u2010response was defined by <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content> &gt;50% at follow\u2010up echocardiogram. Best\u2010subset regression analysis identified predictors of super\u2010response. Endpoints were major adverse cardiac events (<jats:styled-content style=\"fixed-case\">MACE<\/jats:styled-content>; eg, all\u2010cause mortality or heart failure hospitalization, cardiac death, and appropriate <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content> therapy).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010six (16%) patients with <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content> &gt;50% were classified as super\u2010responders. Female sex (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 3.06, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.54\u20106.05), nonischemic etiology (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 2.70, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.29\u20105.68), higher <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content> at baseline (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 1.07, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.02\u20101.13), and wider <jats:styled-content style=\"fixed-case\">QRS<\/jats:styled-content> duration (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 1.17, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.04\u20101.32) were predictors of super\u2010response. Cumulative incidence of <jats:styled-content style=\"fixed-case\">MACE<\/jats:styled-content> at a median of 5.3 years was 18% in super\u2010responders, 22% in responders, and 51% in nonresponders (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). None of super responders died from cardiac death, compared to 9% of responders and 25% of non\u2010responders (<jats:italic>P<\/jats:italic> &lt;\u20090.001). None of super\u2010responders experienced appropriate <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content> therapy, compared with 10% of responders and 21% of non\u2010responders (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). In super\u2010responders, the adjusted hazard ratio was 0.37 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.19\u20100.73) for <jats:styled-content style=\"fixed-case\">MACE<\/jats:styled-content> and 0.44 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.20\u20100.95) for total mortality, compared with non\u2010responders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Female sex, non\u2010ischemic etiology, higher baseline <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>, and wider <jats:styled-content style=\"fixed-case\">QRS<\/jats:styled-content> duration were independently associated with super\u2010response. Super\u2010response was associated with persistent excellent prognosis regarding survival and appropriate <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content> therapy during long\u2010term follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22658","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T21:13:30Z","timestamp":1489526010000},"page":"292-299","source":"Crossref","is-referenced-by-count":31,"title":["Predictors and long\u2010term outcome of super\u2010responders to cardiac resynchronization therapy"],"prefix":"10.1002","volume":"40","author":[{"given":"Abdul","family":"Ghani","sequence":"first","affiliation":[{"name":"Department of Cardiology Isala Heart Centre  Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Paul H.M.","family":"Delnoy","sequence":"additional","affiliation":[{"name":"Department of Cardiology Isala Heart Centre  Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Adiyaman","sequence":"additional","affiliation":[{"name":"Department of Cardiology Isala Heart Centre  Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Paul","family":"Ottervanger","sequence":"additional","affiliation":[{"name":"Department of Cardiology Isala Heart Centre  Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand R.","family":"Ramdat Misier","sequence":"additional","affiliation":[{"name":"Department of Cardiology Isala Heart Centre  Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaap Jan J.","family":"Smit","sequence":"additional","affiliation":[{"name":"Department of Cardiology Isala Heart Centre  Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arif","family":"Elvan","sequence":"additional","affiliation":[{"name":"Department of Cardiology Isala Heart Centre  Zwolle the 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