{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T06:09:27Z","timestamp":1779170967732,"version":"3.51.4"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004061","name":"Oesterreichische Nationalbank","doi-asserted-by":"publisher","award":["15974"],"award-info":[{"award-number":["15974"]}],"id":[{"id":"10.13039\/501100004061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008497","name":"Boston Scientific Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008497","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Data on the effects of conventional cardiac resynchronization therapy (CRT) upgrading by implantation of a left ventricular lead via the coronary sinus on functional mitral regurgitation (MR) in patients with pacing-induced cardiomyopathy are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This analysis of the UPGRADE study, an investigator-initiated randomized controlled trial to evaluate the effect of conventional CRT on central sleep apnea, evaluated the significance of CRT on MR in all included patients. Differences in all-cause mortality were assessed in patients with significant MR during long-term follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 54 patients were included in the trial. MR was found in the majority of patients [mild:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930 (55.6%), moderate:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915 (27.8%), severe:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096 (11.1%)], while \u201cnone\/trace\u201d MR was observed in only three (5.6%) patients. CRT was associated with a significant reduction in MR [\u201cnone\/trace\u201d:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095 (9.6%), mild:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200937 (71.2%), moderate:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096 (11.5%), severe:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094 (7.7%);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035)] after 3\u20135 months, with all patients either having an improvement in MR grading or it remaining unchanged. Notably, only two patients with severe MR improved to either a mild or moderate level. CRT upgrading was linked to a significant amelioration of vena contracta width [2\u2005mm (1.0\u20134.3) at baseline versus 2\u2005mm (1.0\u20133.0) post-CRT; r\u2009=\u20090.73, 95% CI 0.53\u20130.85,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001]. The presence of significant MR at baseline was associated with impaired survival during long-term follow-up [MR\u2009&amp;lt;\u20092:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914 (42.4%), MR\u2009\u2265\u20092:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919 (90.5%); hazard ratio 0.25 (95% CI 0.12\u20130.54); log rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Conventional CRT upgrading in patients with pacing-induced cardiomyopathy was associated with significant improvement in MR grading. The presence of moderate or severe MR at baseline was associated with impaired outcomes during long-term follow-up, suggesting that these patients represent a high-risk cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1758374","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:43:53Z","timestamp":1779169433000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Conventional cardiac resynchronization therapy upgrading and its effect on functional mitral regurgitation in patients with pacing-induced cardiomyopathy"],"prefix":"10.3389","volume":"13","author":[{"given":"Agne","family":"Adukauskaite","sequence":"first","affiliation":[{"name":"University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck","place":["Innsbruck, 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Erich","family":"Pfeifer","sequence":"additional","affiliation":[{"name":"Institute of Clinical Epidemiology, Tirol Kliniken","place":["Innsbruck, Austria"]},{"name":"Institute of Electrical and Biomedical Engineering, University for Health Sciences, Medical Informatics and Technology (UMIT)","place":["Hall in Tirol, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Hintringer","sequence":"additional","affiliation":[{"name":"University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck","place":["Innsbruck, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Dichtl","sequence":"additional","affiliation":[{"name":"University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck","place":["Innsbruck, 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