{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T11:31:23Z","timestamp":1792409483094,"version":"4.4.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T00:00:00Z","timestamp":1629417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018625","name":"Science and Technology Innovation Plan Of Shanghai Science and Technology Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018625","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Little is known about the efficacy of permanent left bundle branch area pacing (LBBAP) in delivering cardiac resynchronization therapy (CRT). This study aimed to evaluate the effect of LBBAP on mechanical synchronization and myocardial work (MW) in heart failure (HF) patients and to compare LBBAP with biventricular pacing (BVP).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    This is a multicenter, prospective cohort study. From February 2018 to January 2021, 62 consecutive HF patients with reduced ejection fraction (LVEF \u2264 35%) and complete left bundle branch block (CLBBB) who underwent LBBAP or BVP were enrolled in this study. Echocardiograms and electrocardiograms and were conducted before and 3\u20136 months after implantation. Intra- and interventricular synchronization were assessed using two-dimensional speckle tracking imaging (2D-STI). The left ventricular pressure-strain loop was obtained by combining left ventricular strain with non-invasive blood pressure to evaluate mechanical efficiency.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The echocardiographic response rates were 68.6 and 88.9% in the BVP and LBBAP groups, respectively. Left bundle branch area pacing resulted in significant QRS narrowing (from 177.1 \u00b1 16.7 to 113.0 \u00b1 18.4 ms,\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.001) and improvement in LVEF (from 29.9 \u00b1 4.8 to 47.1 \u00b1 8.3%,\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.001). The global wasted work (GWW) (410.3 \u00b1 166.6 vs. 283.0 \u00b1 129.6 mmHg%,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.001) and global work efficiency (GWE) (64.6 \u00b1 7.8 vs. 80.5 \u00b1 5.7%,\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.001) were significantly improved along with shorter peak strain dispersion (PSD) (143.4 \u00b1 45.2 vs. 92.6 \u00b1 35.1 ms,\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.001) and interventricular mechanical delay (IVMD) (56.4 \u00b1 28.5 vs. 28.9 \u00b1 19.0 ms,\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.001), indicating its efficiency in improving mechanical synchronization. In comparison with BVP, LBBAP delivered greater improvement of QRS narrowing (\u221264.1 \u00b1 18.9 vs. \u221232.5 \u00b1 22.3 ms,\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.001) and better mechanical synchronization and efficiency.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Left bundle branch area pacing was effective in improving cardiac function, mechanical synchronization, and mechanical efficiency and may be a promising alternative cardiac resynchronization therapy.\n                  <\/jats:p>","DOI":"10.3389\/fcvm.2021.727611","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T03:05:51Z","timestamp":1629428751000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":37,"title":["Mechanical Synchrony and Myocardial Work in Heart Failure Patients With Left Bundle Branch Area Pacing and Comparison With Biventricular 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