{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:12:21Z","timestamp":1791832341650,"version":"4.3.4"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,8,25]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Reduced left ventricular (LV) ejection fraction increases the risk of ventricular arrhythmias; however,\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              ejection fraction has a low sensitivity to predict ventricular arrhythmias. LV dilatation and mass may be useful to further risk\u2010stratify for ventricular arrhythmias.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Patients from the Genetic Risk of Assessment of Defibrillator Events (\n              <jats:styled-content style=\"fixed-case\">GRADE<\/jats:styled-content>\n              ) study (N=930), a study of heart failure subjects with defibrillators, were assessed for appropriate implantable cardioverter\u2010defibrillator shock and death, heart transplant, or ventricular assist device placement by\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              diameter and mass.\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              mass was divided into normal, mild, moderate, and severe classifications. Severe\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              end\u2010diastolic diameter had worse shock\u2010free survival than normal and mild\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              end\u2010diastolic diameter (\n              <jats:italic>P<\/jats:italic>\n              =0.0002 and 0.0063, respectively; 2\u2010year shock free, severe 74%, moderate 80%, mild 91%, normal 88%; 4\u2010year shock free, severe 62%, moderate 69%, mild 72%, normal 81%) and freedom from death, transplant, or ventricular assist device compared with normal and moderate LV end\u2010diastolic diameter (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001 and 0.0441, respectively; 2\u2010year survival: severe 78%, moderate 85%, mild 82%, normal 89%; 4\u2010year survival: severe 55%, moderate 64%, mild 63%, normal 74%). Severe\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              mass had worse shock\u2010free survival than normal and mild LV mass (\n              <jats:italic>P<\/jats:italic>\n              =0.0370 and 0.0280, respectively; 2\u2010year shock free: severe 80%, moderate 81%, mild 91%, normal 87%; 4\u2010year shock free: severe 68%, moderate 73%, mild 76%, normal 76%) but no association with death, transplant, or ventricular assist device (\n              <jats:italic>P<\/jats:italic>\n              =0.1319). In a multivariable Cox proportional hazards analysis adjusted for\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              ejection fraction,\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              end\u2010diastolic diameter was associated with appropriate implantable cardioverter\u2010defibrillator shocks (hazard ratio 1.22,\n              <jats:italic>P<\/jats:italic>\n              =0.020).\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              end\u2010diastolic diameter was associated with time to death, transplant, or ventricular assist device (hazard ratio 1.29,\n              <jats:italic>P<\/jats:italic>\n              =0.0009).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">LV dilatation may complement ejection fraction to predict ventricular arrhythmias.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT02045043.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.114.001566","type":"journal-article","created":{"date-parts":[[2015,8,1]],"date-time":"2015-08-01T02:20:05Z","timestamp":1438395605000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Left Ventricular Dilatation Increases the Risk of Ventricular Arrhythmias in Patients With Reduced Systolic Function"],"prefix":"10.1161","volume":"4","author":[{"given":"Ryan G.","family":"Aleong","sequence":"first","affiliation":[{"name":"University of Colorado, Denver, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Mulvahill","sequence":"additional","affiliation":[{"name":"University of Colorado, Denver, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indrani","family":"Halder","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichole E.","family":"Carlson","sequence":"additional","affiliation":[{"name":"University of Colorado, Denver, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhurmeet","family":"Singh","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather L.","family":"Bloom","sequence":"additional","affiliation":[{"name":"Emory University and Atlanta VA Medical Center, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel C.","family":"Dudley","sequence":"additional","affiliation":[{"name":"Lifespan Cardiovascular Institute and the Warren Alpert School of Medicine at Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick T.","family":"Ellinor","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Shalaby","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, PA"},{"name":"Pittsburgh VA Healthcare System, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Weiss","sequence":"additional","affiliation":[{"name":"Ohio State University, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Gutmann","sequence":"additional","affiliation":[{"name":"University of Iowa, Iowa City, IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William H.","family":"Sauer","sequence":"additional","affiliation":[{"name":"University of Colorado, Denver, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumar","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumeet S.","family":"Chugh","sequence":"additional","affiliation":[{"name":"Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Saba","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"London","sequence":"additional","affiliation":[{"name":"University of Iowa, Iowa City, 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