{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:28:27Z","timestamp":1761060507324,"version":"3.37.3"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,2,14]],"date-time":"2018-02-14T00:00:00Z","timestamp":1518566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Systolic dyssynchrony index (SDI) using three\u2010dimensional echocardiography (3DE) was shown to be a reliable measure of left ventricular (LV) dyssynchrony. However, the prognostic value of SDI on long\u2010term outcomes after cardiac resynchronization therapy (CRT) remains unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>A total of 414 patients (mean age 67 \u00b1 10 years, 60% ischemic etiology) with 3DE evaluation before CRT implantation were included. SDI was evaluated as continuous value and in quartiles. The study endpoint was combined all\u2010cause mortality, heart transplantation, and LV assist device implantation.<\/jats:p><jats:p>At baseline, median SDI was 8.0% (IQR 5.6\u201311.3%). During a median follow\u2010up of 45 months (IQR 25\u201359 months), the endpoint was observed in 94 (23%) patients. SDI was independently associated with the endpoint together with ischemic etiology, diabetes, and renal function (HR 0.914, P\u00a0=\u00a00.003) after adjustment for age, atrial fibrillation, hemoglobin level, NYHA functional class, and posterolateral LV lead position. Patients from the 1st, 2nd, and 3rd SDI quartiles showed similar survival and superior as compared to the 4th quartile with the lowest SDI values (\u22645.5%; \u03c7\u00b2: 30.4, log\u2010rank P\u00a0&lt;\u00a00.001). From receiver operating characteristic curve analysis, the optimal SDI cut\u2010off value associated with the endpoint was\u00a0&gt;6.8% (area under the curve 0.634). Finally, a subgroup analysis (293 patients) demonstrated that a more pronounced reduction in SDI immediately after CRT (resynchronization) was independently associated with superior survival (HR 0.461, P\u00a0=\u00a00.011) after adjustment for prognostic relevant parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SDI is independently associated with long\u2010term prognosis after CRT and might therefore be important to optimize risk\u2010stratification in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13445","type":"journal-article","created":{"date-parts":[[2018,1,29]],"date-time":"2018-01-29T22:14:51Z","timestamp":1517264091000},"page":"780-787","source":"Crossref","is-referenced-by-count":6,"title":["Assessment of left ventricular dyssynchrony by three\u2010dimensional echocardiography: Prognostic value in patients undergoing cardiac resynchronization therapy"],"prefix":"10.1111","volume":"29","author":[{"given":"Ulas","family":"H\u00f6ke","sequence":"first","affiliation":[{"name":"Department of Cardiology Leiden University Medical Centre  Leiden The Netherlands"},{"name":"Interuniversity Cardiology Institute of The Netherlands  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeroen J.","family":"Bax","sequence":"additional","affiliation":[{"name":"Department of Cardiology Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Delgado","sequence":"additional","affiliation":[{"name":"Department of Cardiology Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7208-5769","authenticated-orcid":false,"given":"Nina","family":"Ajmone Marsan","sequence":"additional","affiliation":[{"name":"Department of Cardiology Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,2,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.08.016"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-011-9274-y"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.954404"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2009.08.012"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jes041"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.04.023"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2008.05.021"},{"key":"e_1_2_6_11_1","first-page":"1070","article-title":"2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: The Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). 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