{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:16:48Z","timestamp":1790947008898,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Siemens Healthcare","award":["U01 AG024904"],"award-info":[{"award-number":["U01 AG024904"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Sudden cardiac death (SCD) risk estimation in patients referred for cardiac resynchronization therapy (CRT) remains a challenge. By CRT-mediated improvement of left ventricular ejection fraction (LVEF), many patients loose indication for primary prevention implantable cardioverter-defibrillator (ICD). Increasing evidence shows the importance of myocardial scar for risk prediction. The aim of this study was to investigate the prognostic impact of myocardial scar depending on the echocardiographic response in patients undergoing CRT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Patients with indication for CRT were prospectively enrolled. Decision about ICD or pacemaker implantation was based on clinical criteria. All patients underwent delayed-enhancement cardiac magnetic resonance imaging. Median follow-up duration was 45 (24\u201375) months. Primary outcome was a composite of sustained ventricular arrhythmia, appropriate ICD therapy, or SCD. A total of 218 patients with LVEF 25.5\u2009\u00b1\u20096.6% were analysed [158 (73%) male, 64.9\u2009\u00b1\u200910.7\u2009years]. Myocardial scar was observed in 73 patients with ischaemic cardiomyopathy (ICM) (95% of ICM patients); in 62 with non-ischaemic cardiomyopathy (45% of these patients); and in all but 1 of 36 (17%) patients who reached the primary outcome. Myocardial scar was the only significant predictor of primary outcome [odds ratio 27.7 (3.8\u2013202.7)], independent of echocardiographic CRT response. A total of 55 (25%) patients died from any cause or received heart transplant. For overall survival, only a combination of the absence of myocardial scar with CRT response was associated with favourable outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Malignant arrhythmic events and SCD depend on the presence of myocardial scar but not on CRT response. All-cause mortality improved only with the combined absence of myocardial scar and CRT response.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaa142","type":"journal-article","created":{"date-parts":[[2020,9,4]],"date-time":"2020-09-04T19:14:10Z","timestamp":1599246850000},"page":"1391-1400","source":"Crossref","is-referenced-by-count":25,"title":["Ventricular arrhythmia risk is associated with myocardial scar but not with response to cardiac resynchronization therapy"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4840-6192","authenticated-orcid":false,"given":"Markus","family":"Linhart","sequence":"first","affiliation":[{"name":"Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Cl\u00ednic and IDIBAPS (Institut d\u2019Investigaci\u00f3 Agust\u00ed Pi i Sunyer), University of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelina","family":"Doltra","sequence":"additional","affiliation":[{"name":"Non-Invasive Cardiac Imaging Section, Cardiology Department, Thorax Institute, Hospital Cl\u00ednic and IDIBAPS (Institut d\u2019Investigaci\u00f3 Agust\u00ed Pi i Sunyer), University of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Acosta","sequence":"additional","affiliation":[{"name":"Unidad de Cardiolog\u00eda y Cirug\u00eda Cardiovascular, Hospital Universitario Virgen del Roc\u00edo, Av. Manuel Siurot, S\/n, 41013 Sevilla, Spain"},{"name":"CIBERCV, Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabell\u00f3n 11, Planta 0 28029, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Borr\u00e0s","sequence":"additional","affiliation":[{"name":"Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Cl\u00ednic and IDIBAPS (Institut d\u2019Investigaci\u00f3 Agust\u00ed Pi i Sunyer), University of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain"},{"name":"CIBERCV, Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabell\u00f3n 11, Planta 0 28029, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"J\u00e1uregui","sequence":"additional","affiliation":[{"name":"Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Cl\u00ednic and IDIBAPS (Institut d\u2019Investigaci\u00f3 Agust\u00ed Pi i Sunyer), University of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain"},{"name":"Cardiology Department, Heart Institute, Teknon Medical Center, C\/Vilana, 12, 08022 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Fern\u00e1ndez-Armenta","sequence":"additional","affiliation":[{"name":"CIBERCV, Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5. Pabell\u00f3n 11, Planta 0 28029, Madrid, Spain"},{"name":"Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta del Mar, Av. Ana de Viya, 21, 11009 C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignasi","family":"Anguera","sequence":"additional","affiliation":[{"name":"Cardiology Department, Heart Disease Institute, Bellvitge Biomedical Research Institute IDIBELL, Bellvitge Hospital, University of Barcelona, Carrer de la Feixa Llarga, s\/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Bisbal","sequence":"additional","affiliation":[{"name":"Heart Institute (iCor), University Hospital Germans Trias i Pujol, Carretera de Canyet, s\/n, 08916 Badalona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Mart\u00ed-Almor","sequence":"additional","affiliation":[{"name":"Electrophysiology Unit, Cardiovascular Division, Department of Medicine, Hospital del Mar, Universitat Aut\u00f2noma de Barcelona, Passeig Mar\u00edtim 25-29, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose M","family":"Tolosana","sequence":"additional","affiliation":[{"name":"Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Cl\u00ednic and IDIBAPS (Institut d\u2019Investigaci\u00f3 Agust\u00ed Pi i Sunyer), University of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Penela","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ospedale Guglielmo da Saliceto, Via Taverna Giuseppe, 49, 29121 Piacenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Soto-Iglesias","sequence":"additional","affiliation":[{"name":"Cardiology Department, Heart Institute, Teknon Medical Center, C\/Vilana, 12, 08022 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Villuendas","sequence":"additional","affiliation":[{"name":"CIBERCV, Instituto de Salud Carlos III, Av. 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Pabell\u00f3n 11, Planta 0 28029, Madrid, Spain"},{"name":"Heart Institute (iCor), University Hospital Germans Trias i Pujol, Carretera de Canyet, s\/n, 08916 Badalona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario J","family":"Perea","sequence":"additional","affiliation":[{"name":"Radiology Department, Hospital Clinic, University of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose T","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Cl\u00ednic and IDIBAPS (Institut d\u2019Investigaci\u00f3 Agust\u00ed Pi i Sunyer), University of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Bosch","sequence":"additional","affiliation":[{"name":"Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Cl\u00ednic and IDIBAPS (Institut d\u2019Investigaci\u00f3 Agust\u00ed Pi i Sunyer), University of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Auricchio","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Fondazione Cardiocentro Ticino, Via Tesserete 48. 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