{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:52:51Z","timestamp":1791975171506,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sacubitril\/valsartan (ARNI) improves outcomes in heart failure with reduced ejection fraction (HFrEF). In patients undergoing cardiac resynchronization therapy (CRT), the potential synergy between device\u2010based and pharmacological strategies remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The aim of this study was to assess the effect of ARNI therapy on reverse remodeling, clinical response, and cardiovascular events at 1\u2009year in CRT recipients, in order to clarify the potential synergistic role of pharmacological and device\u2010based strategies. A retrospective cohort of 194 consecutive CRT patients was analyzed, of whom 65 (33.5%) received ARNI. Echocardiographic response was defined as an increase in LVEF &gt;\u20095% or \u2265\u200915% reduction in LV end\u2010systolic volume at 12\u2009months; clinical response as an improvement of at least one NYHA class. The primary endpoint was echocardiographic response. Device\u2010detected remote monitoring heart failure (RM\u2010HF) events were pre\u2010specified as the key time\u2010to\u2010event endpoint, while mortality and HF hospitalization were exploratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable, although systolic blood pressure was higher in ARNI recipients. At 12\u2009months, ARNI therapy was associated with greater reverse remodeling (\u0394LVEF 14.4%\u2009\u00b1\u200910.2% vs. 10.8%\u2009\u00b1\u200911.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Rates of echocardiographic (68% vs. 67%) and clinical response (68% vs. 74%) were similar. Mortality and HF hospitalization did not differ significantly. In contrast, ARNI recipients showed fewer RM\u2010HF events, with higher event\u2010free survival among echocardiographic responders (95.7% vs. 82.6%; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.042) and clinical responders (93.4% vs. 85.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.040).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real\u2010world CRT cohort, ARNI therapy enhanced reverse remodeling and reduced subclinical congestion events detected by remote monitoring. These findings support a synergistic interaction between CRT and ARNI, where resynchronization provides the substrate for pharmacological efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70488","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:45:12Z","timestamp":1791027912000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac Resynchronization as an Enabler of\n                    <scp>ARNI<\/scp>\n                    Efficacy: Insights From a Real\u2010World Cohort"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2629-4372","authenticated-orcid":false,"given":"Amato","family":"Santoro","sequence":"first","affiliation":[{"name":"Interventional Cardiology Azienda Ospedaliera Universitaria Senese  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4914-2605","authenticated-orcid":false,"given":"Laura","family":"Spaccaterra","sequence":"additional","affiliation":[{"name":"Biotechnology Department University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5827-6680","authenticated-orcid":false,"given":"Maurizio","family":"Collantoni","sequence":"additional","affiliation":[{"name":"Biotechnology Department University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Baiocchi","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Azienda Ospedaliera Universitaria Senese  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta Maria","family":"Natali","sequence":"additional","affiliation":[{"name":"Cardiologia Clinico Chirurgica Azienda Ospedaliera Universitaria Senese  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Lunghetti","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Azienda Ospedaliera Universitaria Senese  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Pagliaro","sequence":"additional","affiliation":[{"name":"Cardiologia Clinico Chirurgica Azienda Ospedaliera Universitaria Senese  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6880-3030","authenticated-orcid":false,"given":"Niccol\u00f2","family":"Manetti","sequence":"additional","affiliation":[{"name":"Biotechnology Department University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Morrone","sequence":"additional","affiliation":[{"name":"Biotechnology Department University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7621-1811","authenticated-orcid":false,"given":"Massimo","family":"Fineschi","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Azienda Ospedaliera Universitaria Senese  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6235-984X","authenticated-orcid":false,"given":"Alberto","family":"Palazzuoli","sequence":"additional","affiliation":[{"name":"Malattie Cardiovascolari Azienda Ospedaliera Universitaria Senese  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1755\u20105922.12435"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13547"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.793273"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl099"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euaf050"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euad043"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2023.131391"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euad059"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14082743"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft052"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3310\/PPOH2916"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.15100"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2022.106303"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13801"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14107"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.120.008134"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics15121476"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00380\u2010021\u201001790\u20106"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjdh\/ztac024"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392\u2010019\u201001440\u2010y"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv455"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwaa015"}],"container-title":["Journal 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