{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:16:00Z","timestamp":1781223360638,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with heart failure undergoing cardiac resynchronization therapy (CRT) are a heterogenous and complex population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify different clusters of patients with CRT\u2010D and to evaluate the associations with clinical outcomes, using cluster analysis (CAs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three agglomerative hierarchical CAs were performed in CRT\u2010D patients seen between 2010 and 2019 in French hospitals. Associations between clusters and death at 1 year and death during the whole follow\u2010up (FU) were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 23\u2009029 CRT\u2010D patients, who were analyzed in three ways, as follows: the first group was a 50% random sample of all patients (<jats:italic>n<\/jats:italic>\u2009=\u200911\u2009514), the second group included patients who were dead at 1 year (<jats:italic>n<\/jats:italic>\u2009=\u20091604) and the third group included those alive at 3 years FU (<jats:italic>n<\/jats:italic>\u2009=\u200914\u2009228). A CA was performed on each group of patients.<\/jats:p><jats:p>Four clusters were identified: <jats:italic>Cluster 1<\/jats:italic> corresponded to the low\u2010risk phenotype; <jats:italic>Cluster 2<\/jats:italic> to patients with coronary artery disease (CAD) with few cardiovascular (CV) risk factors and comorbidities; <jats:italic>Cluster 3<\/jats:italic> included patients with CV risk factors and comorbidities, but low CAD; <jats:italic>Cluster 4<\/jats:italic> corresponded to clinically complex phenotype (CAD with CV risk factors and comorbidities). Compared with Cluster 1, Clusters 2, 3, and 4 were independently associated with an increased risk of all\u2010cause death at 1\u2010year FU and during the whole FU (Cluster 2: hazard ratio (HR) 1.21, 95% confidence interval (CI) 1.08\u20131.36; Cluster 3: HR 1.15, 95% CI 1.04\u20131.26; and Cluster 4: HR 1.79, 95% CI 1.65\u20131.96).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CAs identified four statistically driven groups of CRT recipients, with specific clinical phenotypes and associated with different risks for all\u2010cause death.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16727","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T06:04:06Z","timestamp":1747721046000},"page":"1619-1631","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Phenotypes in Relation to Outcomes in Heart Failure Patients With Cardiac Resynchronization Therapy and Defibrillators (CRT\u2010D): An Unsupervised Cluster Analysis"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9085-8390","authenticated-orcid":false,"given":"Luigi","family":"Gerra","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University, and Liverpool Heart and Chest Hospital Liverpool UK"},{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia, Policlinico di Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Bucci","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University, and Liverpool Heart and Chest Hospital Liverpool UK"},{"name":"Department of General and Specialized Surgery Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Bisson","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University, and Liverpool Heart and Chest Hospital Liverpool UK"},{"name":"Cardiologie Centre Hospitalier Universitaire Trousseau Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6544-3916","authenticated-orcid":false,"given":"Alexandre","family":"Bodin","sequence":"additional","affiliation":[{"name":"Cardiologie Centre Hospitalier Universitaire Trousseau Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Pierre","sequence":"additional","affiliation":[{"name":"Cardiologie Centre Hospitalier Universitaire Trousseau Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-4815","authenticated-orcid":false,"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia, Policlinico di Modena Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University, and Liverpool Heart and Chest Hospital Liverpool UK"},{"name":"Danish Center for Health Services Research, Department of Clinical Medicine Aalborg University Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Fauchier","sequence":"additional","affiliation":[{"name":"Cardiologie Centre Hospitalier Universitaire Trousseau Tours France"},{"name":"Fran\u00e7ois Rabelais University Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02567-2"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.20.2685"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.08.027"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050496"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009540"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2304542"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_2_10_10_1","first-page":"e895","article-title":"2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"145","author":"Heidenreich P. 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