{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:01:38Z","timestamp":1785175298162,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiac resynchronization therapy (CRT) response in heart failure (HF) patients is multifactorial, with limited data on its association with activities of daily living assessed by the Barthel index (BI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This prospective observational study investigated the predictive value of BI for CRT response and long\u2010term clinical outcomes in non\u2010ischemic HF patients with left bundle branch block (LBBB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 271 consecutive non\u2010ischemic HF patients undergoing CRT with left ventricular ejection fraction (LVEF)\u2009\u2264\u200935% and LBBB were enrolled. BI was evaluated pre\u2010implantation. The primary endpoint was CRT response (absolute LVEF improvement\u2009\u2265\u20095% at 6 months). The secondary composite endpoint included all\u2010cause mortality and HF hospitalization (HFH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 249 patients completing 6\u2010month follow\u2010up, the CRT response rate was 68.67%. Multivariate logistic regression identified BI (per 5\u2010point increment; OR\u2009=\u20091.37, 95% CI:1.12\u22121.67,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) as an independent predictor of CRT response, with an optimal cutoff of 95. Combining BI with left ventricular end\u2010diastolic diameter and left bundle branch area pacing achieved the highest predictive efficacy (AUC\u2009=\u20090.78). Over a median 33.94\u2010month follow\u2010up, BI\u2009&gt;\u200995 was associated with an 88% reduced risk of the composite endpoint (adjusted HR\u2009=\u20090.116,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), driven primarily by marked HFH reduction. A non\u2010significant trend toward lower all\u2010cause mortality was observed, accompanied by sustained LVEF improvement (29.81%\u2009\u00b1\u20095.01% to 51.71%\u2009\u00b1\u200911.30%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BI might be a simple, cost\u2010effective independent predictor for CRT response and improved LVEF and prognosis in non\u2010ischemic HF patients with LBBB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70389","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T14:21:16Z","timestamp":1783606876000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Barthel Index in Predicting Response to Cardiac Resynchronization Therapy and Clinical Outcomes in Patients With Heart Failure"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2784-2721","authenticated-orcid":false,"given":"Kailun","family":"Zhu","sequence":"first","affiliation":[{"name":"Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haojie","family":"Zhu","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7661-0436","authenticated-orcid":false,"given":"Xiaofei","family":"Li","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Chen","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dingkun","family":"Lu","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohan","family":"Fan","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906431"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009540"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.000112"},{"key":"e_1_2_11_5_1","first-page":"1463","article-title":"Avoiding Non\u2010Responders to Cardiac Resynchronization Therapy: A Practical Guide","volume":"38","author":"Daubert C.","year":"2017","journal-title":"European Heart Journal"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.07.019"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.05.006"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.03.007"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2024.03.005"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2025.06.071"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.11.011"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.05.057"},{"key":"e_1_2_11_13_1","first-page":"61","article-title":"Functional Evaluation: The Barthel Index","volume":"14","author":"Mahoney F. 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