{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:58:29Z","timestamp":1790211509964,"version":"4.1.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1560,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,9,12]],"date-time":"2021-09-12T00:00:00Z","timestamp":1631404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Although increasingly recognized as a distinct pathological entity, left bundle branch block-induced cardiomyopathy (LBBB-ICMP) is not included among the possible aetiologies of acquired dilated cardiomyopathies (DCM). While diagnostic criteria have been proposed, its recognition remains principally retrospective, in the presence of clinical and instrumental red flags. We aimed to assess the prevalence and clinical and instrumental features of LBBB-ICMP in a large cohort of patients with DCM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We analysed a cohort of 242 DCM patients from a two-centre registry. Inclusion criteria were age &amp;gt; 18, non-ischaemic or non-valvular DCM, and LBBB on electrocardiogram. LBBB-ICMP was defined according to previously proposed diagnostic criteria: (i) neither family history nor clinically identifiable potential causes for DCM; (ii) negative genetic testing; (iii) echocardiographic features including non-severe chamber dilation, normal absolute and relative wall thickness, marked dyssynchrony, and normal right ventricular function; and (iv) absence of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR). From the entire cohort, we identified 30 subjects (similar in terms of New York Heart Association class I or II in 80% vs. 75%, P = 0.56; QRS width of 150 \u00b1 22 vs. 151 \u00b1 24 ms, P = 0.82; and cardiac remodelling of baseline end-diastolic diameter 66 \u00b1 8 vs. 65 \u00b1 10 mm, P = 0.53) with a comprehensive dataset including CMR and genetic testing, required to verify the presence of the diagnostic criteria proposed for LBBB-ICMP. The main characteristics of this subgroup were 73% males, age 45 \u00b1 13 years, left ventricular ejection fraction (LVEF) 30 \u00b1 10%, LGE in 38% of patients, and QRS complex of 150 \u00b1 22 ms. Patients were under guideline-directed medical therapy, and 57% of them were treated with cardiac resynchronization therapy (CRT). Two patients (6.67%, 50% males, age 53 \u00b1 13 years) fulfilled the diagnostic criteria proposed for LBBB-ICMP. After a follow-up of 44 (12\u201376) months, LVEF was normal and QRS width significantly reduced (from 154 \u00b1 25 to 116 \u00b1 52 ms) in patients with LBBB-ICMP. Both patients were under optimal medical treatment, and one was implanted with CRT-D. Neither of the two patients experienced death, malignant ventricular arrhythmia, or heart failure hospitalization at follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Left bundle branch block-induced cardiomyopathy emerges as a distinct pathological entity, promptly identifiable in a minority but not negligible proportion of patients with newly diagnosed DCM and LBBB, using a series of diagnostic criteria including CMR and genetic testing. Further studies are needed to better elucidate the clinical course of LBBB-ICMP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13568","type":"journal-article","created":{"date-parts":[[2021,9,12]],"date-time":"2021-09-12T13:59:11Z","timestamp":1631455151000},"page":"5589-5593","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Prevalence, Clinical and Instrumental Features of Left Bundle Branch Block-Induced Cardiomyopathy: The CLIMB Registry"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3357-0961","authenticated-orcid":false,"given":"Giuseppe D.","family":"Sanna","sequence":"first","affiliation":[{"name":"Clinical and Interventional Cardiology, Sassari University Hospital , Via Enrico De Nicola, Sassari, 07100 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"De Bellis","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Zecchin","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Beccu","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Experimental Sciences, University of Sassari \u00a0","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Carta","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Experimental Sciences, University of Sassari \u00a0","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Moccia","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Experimental Sciences, University of Sassari \u00a0","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario E.","family":"Canonico","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Experimental Sciences, University of Sassari \u00a0","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Parodi","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Experimental Sciences, University of Sassari \u00a0","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Sinagra","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Merlo","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,12]]},"reference":[{"key":"2026012114195152300_ehf213568-bib-0001","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.eupc.2005.06.005","article-title":"Evaluation of left bundle branch block as a reversible cause of non-ischaemic dilated cardiomyopathy with severe heart failure. 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