{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:29:25Z","timestamp":1789662565302,"version":"4.0.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Genetic testing is routinely recommended in dilated cardiomyopathy (DCM), yet the prevalence and implications of pathogenic\/likely pathogenic (P\/LP) variants in patients with DCM and left bundle branch block (LBBB) remain unclear. We therefore investigated the electromechanical profile of genotyped patients with DCM and LBBB, and its relationship with cardiac resynchronization therapy (CRT) response and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with LBBB were selected from a multicentre cohort of 1206 consecutive DCM patients undergoing genetic testing. All underwent sequencing of 20 clinically validated DCM-related genes (ClinGen) and comprehensive electro- and echocardiographic phenotyping, including speckle-tracking strain analysis, categorizing septal strain curves into five stages (LBBB-0 to LBBB-4). CRT response was assessed as end-systolic volume (ESV) reduction and left ventricular ejection fraction (LVEF) improvement. The clinical endpoints were a composite of all-cause mortality, heart transplantation\/left ventricular assist device implantation, and heart failure hospitalization (HFH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 347 DCM patients with LBBB (median age 60 [53\u201368], median LVEF 31% [23\u201339]), 22 (6%) exhibited P\/LP variants. Genotype-positive patients less frequently fulfilled strict LBBB criteria (Strauss: P &amp;lt; .001) and exhibited less mechanical dyssynchrony (predominantly LBBB-0\/1; P &amp;lt; .001). They showed attenuated reverse remodelling after CRT (\u0394LVEF 1% [\u22126\u20136] vs 14% [7\u201322]; P &amp;lt; .001) and worse clinical outcomes (both composite outcome and HFH; P &amp;lt; .001). Conversely, advanced LBBB stages excluded an underlying rare genetic variant. P\/LP variant status, LVEF, and LBBB stage independently predicted CRT response and composite outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Genetic testing has a low diagnostic yield in patients with DCM and LBBB. Genotype-positive variants exhibit a distinct electromechanical profile, characterized by atypical electrocardiographic features and markedly reduced mechanical dyssynchrony, poor CRT response, and worse long-term outcomes. Integrating genetic and electromechanical phenotyping may improve individualized risk stratification and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag239","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:36:44Z","timestamp":1784633804000},"source":"Crossref","is-referenced-by-count":1,"title":["Electromechanical profiling in genotyped dilated cardiomyopathy with left bundle branch block"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6701-7818","authenticated-orcid":false,"given":"Thomas","family":"Van Overmeiren","sequence":"first","affiliation":[{"name":"Department of Cardiology, Ghent University Hospital , Corneel Heymanslaan 10, Ghent 9000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University , Maastricht ,","place":["The Netherlands"]},{"name":"European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max F G H M","family":"Venner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University , Maastricht ,","place":["The Netherlands"]},{"name":"European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Vanderheyden","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, AZORG-Clinic , Aalst ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonius","family":"Van Stipdonk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Luzzi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University , Maastricht ,","place":["The Netherlands"]},{"name":"European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid B M","family":"Heymans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University , Maastricht ,","place":["The Netherlands"]},{"name":"European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1196-3016","authenticated-orcid":false,"given":"Philippe","family":"Debonnaire","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital , Brugge ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"Trenson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital , Brugge ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik","family":"Van Durme","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Glorieux , Ronse ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J","family":"Coucke","sequence":"additional","affiliation":[{"name":"Center for Medical Genetics Ghent, Ghent University , Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofie","family":"Symoens","sequence":"additional","affiliation":[{"name":"Center for Medical Genetics Ghent, Ghent University , Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"De Pooter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ghent University Hospital , Corneel Heymanslaan 10, Ghent 9000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Job A J","family":"Verdonschot","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University , Maastricht ,","place":["The Netherlands"]},{"name":"European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart , Maastricht ,","place":["The Netherlands"]},{"name":"Department of Clinical Genetics, Maastricht University Medical Center , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Calle","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ghent University Hospital , Corneel Heymanslaan 10, Ghent 9000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane R B","family":"Heymans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University , Maastricht ,","place":["The Netherlands"]},{"name":"European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart , Maastricht ,","place":["The Netherlands"]},{"name":"Department of Cardiovascular Sciences, Centre for Vascular and Molecular Biology, KU Leuven , Leuven 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