{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:14:48Z","timestamp":1791231288985,"version":"4.1.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Septal strain patterns measured by echocardiography reflect the severity of left bundle branch block (LBBB)-induced left ventricular (LV) dysfunction. We investigated whether these LBBB strain stages predicted the response to cardiac resynchronization therapy in an observational study and developed a sheep model of LBBB-induced cardiomyopathy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The clinical study enrolled cardiac resynchronization therapy patients who underwent echocardiographic examination with speckle-tracking strain analysis before cardiac resynchronization therapy implant. In an experimental sheep model with pacing-induced dyssynchrony, LV remodeling and strain were assessed at baseline, at 8 and 16 weeks. Septal strain curves were classified into 5 patterns (LBBB-0 to LBBB-4).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              The clinical study involved 250 patients (age 65 [58; 72] years; 79% men; 89% LBBB) with a median LV ejection fraction of 25 [21; 30]%. Across the stages, cardiac resynchronization therapy resulted in a gradual volumetric response, ranging from no response in LBBB-0 patients (\u0394LV end-systolic volume 0 [\u221212; 15]%) to super-response in LBBB-4 patients (\u0394LV end-systolic volume \u221244 [\u221264; \u221218]%) (\n              <jats:italic toggle=\"yes\">P&lt;<\/jats:italic>\n              0.001). LBBB-0 patients had a less favorable long-term outcome compared with those in stage LBBB\u22651 (log-rank\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.003). In 13 sheep, acute right ventricular pacing resulted in LBBB-1 (23%) and LBBB-2 (77%) patterns. Over the course of 8\u221216 weeks, continued pacing resulted in progressive LBBB-induced dysfunction, coincident with a transition to advanced strain patterns (92% LBBB-2 and 8% LBBB-3 at week 8; 75% LBBB-3 and 25% LBBB-4 at week 16) (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.023).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The strain-based LBBB classification reflects a pathophysiological continuum of LBBB-induced remodeling over time and is associated with the extent of reverse remodeling in observational cardiac resynchronization therapy-eligible patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.122.014296","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T09:00:36Z","timestamp":1667552436000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Clinical and Experimental Evidence for a Strain-Based Classification of Left Bundle Branch Block-Induced Cardiac Remodeling"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8895-5343","authenticated-orcid":true,"given":"Simon","family":"Calle","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Hospital Ghent, Belgium (S.C., M.D.B., J.D.P., F.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0221-5753","authenticated-orcid":true,"given":"J\u00fcrgen","family":"Duchenne","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven, Belgium (J.D., A.S.B., I.S., A.P., J.-U.V.)."},{"name":"Department of Cardiovascular Diseases, University Hospital Leuven, Belgium (J.D., A.P., J.-U.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0517-7000","authenticated-orcid":true,"given":"Ahmed S.","family":"Beela","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven, Belgium (J.D., A.S.B., I.S., A.P., J.-U.V.)."},{"name":"Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht, the Netherlands (A.S.B.)."},{"name":"Department of Cardiovascular Diseases, Suez Canal University, Egypt (A.S.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Stankovic","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven, Belgium (J.D., A.S.B., I.S., A.P., J.-U.V.)."},{"name":"Clinical Hospital Centre Zemun, Faculty of Medicine, University of Belgrade, Serbia (I.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9454-7706","authenticated-orcid":true,"given":"Alexis","family":"Puvrez","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven, Belgium (J.D., A.S.B., I.S., A.P., J.-U.V.)."},{"name":"Department of Cardiovascular Diseases, University Hospital Leuven, Belgium (J.D., A.P., J.-U.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Winter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Vinzenz Hospital, Germany (S.W., W.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8087-5736","authenticated-orcid":true,"given":"Wolfgang","family":"Fehske","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Vinzenz Hospital, Germany (S.W., W.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marit","family":"Aarones","sequence":"additional","affiliation":[{"name":"Department of Medicine, Diakonhjemmet Hospital, Norway (M.A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1277-1083","authenticated-orcid":true,"given":"Marc","family":"De Buyzere","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Ghent, Belgium (S.C., M.D.B., J.D.P., F.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"De Pooter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Ghent, Belgium (S.C., M.D.B., J.D.P., F.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0575-1888","authenticated-orcid":true,"given":"Jens-Uwe","family":"Voigt","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, KU Leuven, Belgium (J.D., A.S.B., I.S., A.P., J.-U.V.)."},{"name":"Department of Cardiovascular Diseases, University Hospital Leuven, Belgium (J.D., A.P., J.-U.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Timmermans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Ghent, Belgium (S.C., M.D.B., J.D.P., F.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2018.10.012"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeaa003"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.069"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2019.03.008"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2021.02.019"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev288"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.07.013"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.5603\/CJ.a2018.0007"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.118.007224"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jex325"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.119.007393"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi008"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-020-01791-y"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.cj-10-1268"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.111.962704"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.01.004"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew289"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.11.030"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.020"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa603"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2021.01.019"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.051"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2020.07.025"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2020.11.010"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv264"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht290"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.25225"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2019.03.012"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-014-0403-2"}],"container-title":["Circulation: Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCIMAGING.122.014296","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T13:07:12Z","timestamp":1749042432000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCIMAGING.122.014296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":29,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1161\/CIRCIMAGING.122.014296"],"URL":"https:\/\/doi.org\/10.1161\/circimaging.122.014296","relation":{},"ISSN":["1941-9651","1942-0080"],"issn-type":[{"value":"1941-9651","type":"print"},{"value":"1942-0080","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11]]},"assertion":[{"value":"2022-04-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}