{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T02:06:49Z","timestamp":1775095609186,"version":"3.50.1"},"reference-count":40,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor babes university of medicine and pharmacy Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Restoring electrical synchrony with cardiac resynchronization therapy (CRT) reverses the heart failure phenotype developed by left-ventricular (LV) dyssynchrony. This study aimed to identify new predictors of response to LV-only fusion pacing CRT. Methods: A select group of patients with CRT-P indications received a right atrium (RA)\/LV DDD pacing system. LV dyssynchrony was assessed via offline TDI timing focusing on the temporal difference between peak septal (E\u2033T) and lateral wall (A\u201cT) motion. CRT effectiveness was evaluated at each follow-up, involving the heart rate recovery index (HRRI) parameter (acceleration\/deceleration time) derived from exercise testing along with the echocardiographic parameters. Patients were classified into super-responders (SR), responders (R), and non-responders (NR). Results: Baseline initial characteristics: 62 patients (35 male) aged 62 \u00b1 11 y.o. with non-ischemic dilated cardiomyopathy (DCM). Ejection fraction (EF) 27 \u00b1 5.2%; QRS 164 \u00b1 18 ms; 29% had type III diastolic dysfunction (DD), 63% type II DD, and 8% type I DD. Average follow-up was 45 \u00b1 19 months: 34% of patients were SR, 61% R, and 5% NR. The E\u2033T decreased from 90 \u00b1 20 ms to 25 \u00b1 10 ms in SR, with a shorter deceleration time (DT) during exercise test compared to NR (109 \u00b1 68 ms vs. 330 \u00b1 30 ms; p &lt; 0.0001). The responders present a higher HRRI (2.87 \u00b1 1.47 vs. 0.98 \u00b1 0.08; p = 0.03) compared to NR and a significantly decrease in E\u201cT and A\u201cT from 76 \u00b1 13 ms to 51 \u00b1 11 ms (p &lt; 0.0001). Prolonged DT was associated with an accentuated LV dyssynchrony and nonoptimal response to CRT. Conclusions: The study identified new parameters for assessing responsiveness to LV-only fusion pacing CRT, which could improve candidate selection and CRT implementation.<\/jats:p>","DOI":"10.3390\/jcm13216365","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T05:47:33Z","timestamp":1729748853000},"page":"6365","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Heart Rate Recovery Index and Improved Diastolic Dyssynchrony in Fusion Pacing Cardiac Resynchronization Therapy"],"prefix":"10.3390","volume":"13","author":[{"given":"Andra","family":"Gurgu","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantin-Tudor","family":"Luca","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"},{"name":"Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Vacarescu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"},{"name":"Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Gai\u021b\u0103","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"},{"name":"Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simina","family":"Cri\u0219an","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"},{"name":"Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adelina-Andreea","family":"Faur-Grigori","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina-Ramona","family":"Cozlac","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7351-741X","authenticated-orcid":false,"given":"Cristina","family":"Tudoran","sequence":"additional","affiliation":[{"name":"Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy \u201cVictor Babes\u201d Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"County Emergency Hospital \u201cPius Brinzeu\u201d, L. Rebreanu, Nr. 156, 300723 Timisoara, Romania"},{"name":"Center of Molecular Research in Nephrology and Vascular Disease, Faculty of the University of Medicine and Pharmacy \u201cVictor Babes\u201d Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2375-2793","authenticated-orcid":false,"given":"M\u0103d\u0103lin-Marius","family":"Margan","sequence":"additional","affiliation":[{"name":"Department of Functional Sciences, Discipline of Public Health, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7378-7787","authenticated-orcid":false,"given":"Dragos","family":"Cozma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"},{"name":"Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1093\/europace\/eup272","article-title":"Pathophysiological mechanisms underlying ventricular dyssynchrony","volume":"11","author":"Cheng","year":"2009","journal-title":"Europace"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Cozma, D., Vacarescu, C., Petrescu, L., Mornos, C., Goanta, E.V., Feier, H., Luca, C.T., Gusetu, G., and Vatasescu, R. 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