{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:14:37Z","timestamp":1793103277768,"version":"4.5.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,6,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Studies have reported that female sex predicts superior cardiac resynchronization therapy (CRT) response. One theory is that this association is related to smaller female heart size, thus increased relative dyssynchrony at a given QRS duration (QRSd). Our objective was to investigate the mechanisms of sex\u2010specific CRT response relating to heart size, relative dyssynchrony, cardiomyopathy type, QRS morphology, and other patient characteristics.<\/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                      This is a post hoc analysis of the MORE\u2010CRT MPP (More Response on Cardiac Resynchronization Therapy with Multipoint Pacing)\u00a0\u00a0trial (n=3739, 28% women), with a subgroup analysis of patients with nonischemic cardiomyopathy and left bundle\u2010branch block (n=1308, 41% women) to control for confounding characteristics. A multivariable analysis examined predictors of response to 6 months of conventional CRT, including sex and relative dyssynchrony, measured by QRSd\/left ventricular end\u2010diastolic volume (LVEDV). Women had a higher CRT response rate than men (70.1% versus 56.8%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0001). In subgroup analysis, regression analysis of the nonischemic cardiomyopathy left bundle\u2010branch block subgroup identified QRSd\/LVEDV, but not sex, as a modifier of CRT response (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0039). QRSd\/LVEDV was significantly higher in women (0.919) versus men (0.708,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). CRT response was 78% for female patients with QRSd\/LVEDV greater than the median value, compared with 68%\u2009with QRSd\/LVEDV less than the median value (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.012). The association between CRT response and QRSd\/LVEDV was strongest at QRSd &lt;150\u2009ms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In the nonischemic cardiomyopathy left bundle\u2010branch block population, increased relative dyssynchrony in women, who have smaller heart sizes than their male counterparts, is a driver of sex\u2010specific CRT response, particularly at QRSd &lt;150\u2009ms. Women may benefit from CRT at a QRSd &lt;130\u2009ms, opening the debate on whether sex\u2010specific QRSd cutoffs or QRS\/LVEDV measurement should be incorporated into clinical guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.035279","type":"journal-article","created":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T22:52:39Z","timestamp":1718491959000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Heart Size Difference Drives Sex\u2010Specific Response to Cardiac Resynchronization Therapy: A Post Hoc Analysis of the MORE\u2010MPP CRT Trial"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7893-0708","authenticated-orcid":false,"given":"Nadeev","family":"Wijesuriya","sequence":"first","affiliation":[{"name":"King\u2019s College London","place":["London, UK"]},{"name":"Guy\u2019s and St Thomas\u2019s NHS Foundation Trust","place":["London, 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UK"]},{"name":"Guy\u2019s and St Thomas\u2019s NHS Foundation Trust","place":["London, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4612-6982","authenticated-orcid":false,"given":"Steven A.","family":"Niederer","sequence":"additional","affiliation":[{"name":"King\u2019s College London","place":["London, UK"]},{"name":"Imperial College London","place":["London, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4393-5338","authenticated-orcid":false,"given":"Haran","family":"Burri","sequence":"additional","affiliation":[{"name":"University Hospital of Geneva","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Sperzel","sequence":"additional","affiliation":[{"name":"Kerckhoff\u2014Klinik Heart Center","place":["Bad Nauheim, 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