{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:16:50Z","timestamp":1790947010875,"version":"4.1.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["32003B_165802"],"award-info":[{"award-number":["32003B_165802"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Swiss Heart Foundation"},{"name":"Biologic Delivery Systems"},{"name":"Division of Biosense Webster a Johnson & Johnson Company"},{"name":"Medical University of Silesia"},{"name":"Anneliese and Mieczys\u0142aw Ko\u0107win Foundation Scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Electromechanical coupling in patients receiving cardiac resynchronization therapy (CRT) is not fully understood. Our aim was to determine the best combination of electrical and mechanical substrates associated with effective CRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Sixty-two patients were prospectively enrolled from two centres. Patients underwent 12-lead electrocardiogram (ECG), cardiovascular magnetic resonance (CMR), echocardiography, and anatomo-electromechanical mapping (AEMM). Remodelling was measured as the end-systolic volume (\u0394ESV) decrease at 6 months. CRT was defined effective with \u0394ESV \u2264 \u221215%. QRS duration (QRSd) was measured from ECG. Area strain was obtained from AEMM and used to derive systolic stretch index (SSI) and total left-ventricular mechanical time. Total left-ventricular activation time (TLVAT) and transeptal time (TST) were derived from AEMM and ECG. Scar was measured from CMR. Significant correlations were observed between \u0394ESV and TST [rho = 0.42; responder: 50 (20\u201358) vs. non-responder: 33 (8\u201344) ms], TLVAT [\u22120.68; 81 (73\u201397) vs. 112 (96\u2013127) ms], scar [\u22120.27; 0.0 (0.0\u20131.2) vs. 8.7 (0.0\u201319.1)%], and SSI [0.41; 10.7 (7.1\u201316.8) vs. 4.2 (2.9\u20135.5)], but not QRSd [\u22120.13; 155 (140\u2013176) vs. 167 (155\u2013177) ms]. TLVAT and SSI were highly accurate in identifying CRT response [area under the curve (AUC) &amp;gt; 0.80], followed by scar (AUC &amp;gt; 0.70). Total left-ventricular activation time (odds ratio = 0.91), scar (0.94), and SSI (1.29) were independent factors associated with effective CRT. Subjects with SSI &amp;gt;7.9% and TLVAT &amp;lt;91 ms all responded to CRT with a median \u0394ESV \u2248 \u221250%, while low SSI and prolonged TLVAT were more common in non-responders (\u0394ESV \u2248 \u22125%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Electromechanical measurements are better associated with CRT response than conventional ECG variables. The absence of scar combined with high SSI and low TLVAT ensures effectiveness of CRT.<\/jats:p><\/jats:sec>","DOI":"10.1093\/europace\/euac157","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T09:00:58Z","timestamp":1663232458000},"page":"546-553","source":"Crossref","is-referenced-by-count":18,"title":["Electromechanical factors associated with favourable outcome in cardiac resynchronization therapy"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7364-3734","authenticated-orcid":false,"given":"Francesco","family":"Maffessanti","sequence":"first","affiliation":[{"name":"Center for Computational Medicine in Cardiology, Universit\u00e0 della Svizzera Italiana , Lugano , Switzerland"},{"name":"Maria Cecilia Hospital, GVM Care and Research , Cotignola , 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Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2248-3456","authenticated-orcid":false,"given":"Giulio","family":"Conte","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Istituto Cardiocentro Ticino , Lugano , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luce","family":"Caputo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Istituto Cardiocentro Ticino , Lugano , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5722-7976","authenticated-orcid":false,"given":"Krzysztof S","family":"Go\u0142ba","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia , Katowice , 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