{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T06:30:27Z","timestamp":1769581827618,"version":"3.49.0"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100010816","name":"Anhui Provincial Department of Science and Technology","doi-asserted-by":"publisher","award":["202427b10020101"],"award-info":[{"award-number":["202427b10020101"]}],"id":[{"id":"10.13039\/501100010816","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010814","name":"Anhui Provincial Department of Education","doi-asserted-by":"publisher","award":["2024AH040113"],"award-info":[{"award-number":["2024AH040113"]}],"id":[{"id":"10.13039\/501100010814","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Population\u2010based evidence on the predictive role of left ventricular ejection fraction (LVEF) in incident Cardiac Conduction Dysfunction (CCD) and the mediating effects of electrophysiological parameters remains understudied. This study aimed to characterize the relationship between LVEF and incident CCD and explore the potential mediating effects of electrophysiological parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study included 32,398 participants (96.6% White ethnicity) from the UK Biobank with analyzable LVEF and electrocardiogram data. Incident CCD was defined as the first occurrence of atrioventricular block, left bundle branch block, or other conduction disorders. Stepwise backward Cox regression and sensitivity analyses evaluated the association between LVEF and CCD. Additionally, mediation analysis was performed to examine QRS duration, PQ interval, and corrected QT interval as potential mediators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a mean follow\u2010up of 6.96\u2009\u00b1\u20091.63\u2009years, 484 incident CCD cases were identified. LVEF was an independent predictor of incident CCD, with each 1\u2010standard deviation increase in LVEF associated with a 17% reduction in risk (adjusted hazard ratio, 0.83; 95% confidence interval, 0.77\u20130.89;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Sensitivity analyses across LVEF thresholds, competing risks, and exclusion of early events confirmed the robustness of these findings. Mediation analysis showed that PQ interval mediated 6% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), QRS duration mediated 17% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and corrected QT interval mediated \u22123% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) of the total effect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LVEF is independently associated with incident CCD, with electrophysiological parameters potentially explaining part of this association. These findings underscore the clinical relevance of myocardial mechano\u2010electrical coupling in large\u2010scale population settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anec.70146","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T01:47:59Z","timestamp":1766972879000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Left Ventricular Ejection Fraction and Incident Cardiac Conduction Dysfunction: Exploring the Mediating Effects of Electrophysiological Parameters"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4886-3343","authenticated-orcid":false,"given":"Qie","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiology, National Cardiovascular Disease Regional Center for Anhui The First Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0958-6090","authenticated-orcid":false,"given":"Feilong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Cardiovascular Disease Regional Center for Anhui The First Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhao","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Cardiovascular Disease Regional Center for Anhui The First Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinfeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Cardiovascular Disease Regional Center for Anhui The First Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinlin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Cardiovascular Disease Regional Center for Anhui The First Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhou","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Cardiovascular Disease Regional Center for Anhui The First Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuting","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Research The First Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiran","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Cardiovascular Disease Regional Center for Anhui The First Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7212-6203","authenticated-orcid":false,"given":"Ronghui","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Cardiovascular Disease Regional Center for Anhui The First Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00423.2005"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/415198a"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/26.7.671"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.03.342"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/HPC.0000000000000171"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.888"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.01009"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.003980"},{"issue":"7373","key":"e_1_2_12_10_1","article-title":"Prevalence of Left Ventricular Systolic Dysfunction and Heart Failure in High Risk Patients: Community Based Epidemiological Study","volume":"325","author":"Davis R. 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