{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T02:20:15Z","timestamp":1785550815888,"version":"3.56.0"},"reference-count":41,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T00:00:00Z","timestamp":1743811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Electrical and mechanical dyssynchrony (MD) underlies left ventricular (LV) contractile dysfunction in patients with heart failure (HF) and left bundle branch block (LBBB). In some cases, cardiac resynchronization therapy (CRT) almost completely reverses LV contractile dysfunction. The LBBB electrocardiographic Strauss criteria and MD assessment were proposed to improve CRT response. However, using these techniques separately does not improve LV contraction in 20\u201340% of patients after CRT device implantation. We aimed to evaluate whether the combined use of electrocardiography (ECG), speckle-tracking echocardiography (STE) and cardiac scintigraphy could improve the prognosis of CRT super-response in patients with HF and Strauss LBBB criteria during a 6-month follow-up period. The study prospectively included patients with HF, classified as New York Heart Association (NYHA) functional class (FC) II\u2013III in sinus rhythm with Strauss LBBB criteria and reduced left ventricular ejection fraction (LVEF). Before and 6 months after CRT device implantation, ECG, STE and cardiac scintigraphy were performed. The study\u2019s primary endpoint was the NYHA class improvement \u2265 1 and left ventricle end systolic volume decrease &gt; 30% or LVEF improvement &gt; 15% after 6 months of CRT. Based on collected data, we developed a prognostic model regarding the CRT super-response. Out of 54 (100.0%) patients, 39 (72.2%) had a CRT super-response. Patients with CRT super-response were likelier to have a greater S wave amplitude in V2 lead (p = 0.004), higher rates of global longitudinal strain (GLS) (p = 0.001) and interventricular delay (IVD) (p = 0.005). Only three indicators (S wave amplitude in V2 lead, GLS and IVD) were independently associated with CRT super-response in univariable and multivariable logistic regression. We created a prognostic model based on the logistic equation and calculated a cut-off value (&gt;0.73). The resulting ROC curve revealed a discriminative ability with an AUC of 0.957 (sensitivity 87.2%; specificity 100.0%). The electrical and mechanical dyssynchrony assessment using ECG, STE and cardiac scintigraphy is useful in the prediction of CRT super-response in patients with HF and Strauss LBBB criteria during a 6-month follow-up period. Our prognostic model can identify patients who are super-responders to CRT.<\/jats:p>","DOI":"10.3390\/life15040605","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T07:41:51Z","timestamp":1744270911000},"page":"605","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Prospective Pilot Study for Prognosis of Cardiac Resynchronization Therapy Super-Response Using Electrical and Mechanical Dyssynchrony Assessment in Patients with Heart Failure and Strauss Left Bundle Branch Block Criteria"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-4142","authenticated-orcid":false,"given":"Tariel","family":"Atabekov","sequence":"first","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, Tomsk 634012, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrey","family":"Smorgon","sequence":"additional","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, Tomsk 634012, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Mishkina","sequence":"additional","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, Tomsk 634012, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8121-8287","authenticated-orcid":false,"given":"Sergey","family":"Krivolapov","sequence":"additional","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, Tomsk 634012, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2799-3260","authenticated-orcid":false,"given":"Svetlana","family":"Sazonova","sequence":"additional","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, Tomsk 634012, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9885-5204","authenticated-orcid":false,"given":"Mikhail","family":"Khlynin","sequence":"additional","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, Tomsk 634012, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Batalov","sequence":"additional","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, Tomsk 634012, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Popov","sequence":"additional","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, Tomsk 634012, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.amjcard.2010.11.010","article-title":"Defining left bundle branch block in the era of cardiac resynchronization therapy","volume":"107","author":"Strauss","year":"2011","journal-title":"Am. J. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1007\/s12350-018-1204-0","article-title":"Relationships between electrical and mechanical dyssynchrony in patients with left bundle branch block and healthy controls","volume":"26","author":"Lipponen","year":"2019","journal-title":"J. Nucl. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1054\/jelc.2000.20330","article-title":"Hemodynamic implications of left bundle branch block","volume":"33","author":"Littmann","year":"2000","journal-title":"J. Electrocardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1161\/CIRCRESAHA.113.300270","article-title":"Electromechanical dyssynchrony and resynchronization of the failing heart","volume":"113","author":"Kirk","year":"2013","journal-title":"Circ. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3427","DOI":"10.1093\/eurheartj\/ehab364","article-title":"ESC Scientific Document Group. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy","volume":"42","author":"Glikson","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/s43044-022-00308-3","article-title":"Role of Strauss ECG criteria as predictor of response in patients undergoing cardiac resynchronization therapy","volume":"74","author":"Shoman","year":"2022","journal-title":"Egypt. Heart J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1253\/circj.CJ-10-1268","article-title":"Non-responders to cardiac resynchronization therapy: The magnitude of the problem and the issues","volume":"75","author":"Auricchio","year":"2011","journal-title":"Circ. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1253\/circj.CJ-14-0842","article-title":"The speckle tracking imaging for the assessment of cardiac resynchronization therapy (START) study","volume":"79","author":"Maruo","year":"2015","journal-title":"Circ. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e003882","DOI":"10.1161\/JAHA.116.003882","article-title":"Incremental value of speckle tracking echocardiography to predict cardiac resynchronization therapy (CRT) responders","volume":"5","author":"Seo","year":"2016","journal-title":"J. Am. Heart Assoc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1253\/circj.CJ-15-0953","article-title":"Combined global longitudinal strain and intraventricular mechanical dyssynchrony predicts long-term outcome in patients with systolic heart failure","volume":"80","author":"Chan","year":"2016","journal-title":"Circ. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12947-018-0148-5","article-title":"Speckle tracking echocardiography analyses of myocardial contraction efficiency predict response for cardiac resynchronization therapy","volume":"16","author":"Fulati","year":"2018","journal-title":"Cardiovasc. Ultrasound"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2608","DOI":"10.1161\/CIRCULATIONAHA.107.743120","article-title":"Results of the predictors of response to CRT (PROSPECT) trial","volume":"117","author":"Chung","year":"2008","journal-title":"Circulation"},{"key":"ref_13","first-page":"720","article-title":"Prognostic implications of left ventricular global longitudinal strain in heart failure patients with narrow QRS complex treated with cardiac resynchronization therapy: A subanalysis of the randomized EchoCRT trial","volume":"38","author":"Bax","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1007\/s12350-020-02414-8","article-title":"Clinical and gated SPECT MPI parameters associated with super-response to cardiac resynchronization therapy","volume":"29","author":"Mesquita","year":"2022","journal-title":"J. Nucl. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s12350-018-01589-5","article-title":"Value of intraventricular dyssynchrony assessment by gated-SPECT myocardial perfusion imaging in the management of heart failure patients undergoing cardiac resynchronization therapy (VISION-CRT)","volume":"28","author":"Peix","year":"2021","journal-title":"J. Nucl. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1111\/pace.12506","article-title":"Clinical characteristics and predictors of super response to cardiac resynchronization therapy: A combination of predictive factors","volume":"37","author":"Yanagisawa","year":"2014","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3856294","DOI":"10.1155\/2020\/3856294","article-title":"A predictive model for super-response to cardiac resynchronization therapy: The QQ-LAE score","volume":"2020","author":"Liu","year":"2020","journal-title":"Cardiol. Res. Pract."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Guo, Z., Liu, X., Liu, C., Yang, J., Cheng, X., Chen, Y., Li, P., He, Y., and Wang, J. (2019). Heart failure duration combined with left atrial dimension predicts super-response and long-term prognosis in patients with cardiac resynchronization therapy implantation. BioMed Res. Int., 2019.","DOI":"10.1155\/2019\/2983752"},{"key":"ref_19","first-page":"e876","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure: Executive summary: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"145","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"key":"ref_20","first-page":"100636","article-title":"QTc evaluation in patients with bundle branch block","volume":"30","author":"Bogossian","year":"2020","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jacc.2019.02.027","article-title":"2019 ACC\/AHA\/ASE key data elements and definitions for transthoracic echocardiography: A report of the American College of Cardiology\/American Heart Association task force on clinical data standards (writing committee to develop cardiovascular endpoints data standards) and the American Society of Echocardiography","volume":"74","author":"Douglas","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1007\/s12350-015-0214-4","article-title":"Radiation reduction and faster acquisition times with SPECT gated blood pool scans using a high-efficiency cardiac SPECT camera","volume":"23","author":"Duvall","year":"2016","journal-title":"J. Nucl. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e220","DOI":"10.1016\/j.hrthm.2019.02.034","article-title":"2019 HRS\/EHRA\/APHRS\/LAHRS focused update to 2015 expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing","volume":"17","author":"Stiles","year":"2020","journal-title":"Heart Rhythm"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.cardfail.2014.03.001","article-title":"Predictors and outcomes of \u201csuper-response\u201d to cardiac resynchronization therapy","volume":"20","author":"Killu","year":"2014","journal-title":"J. Card. Fail."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e12525","DOI":"10.1111\/anec.12525","article-title":"Relation between electrical and mechanical dyssynchrony in patients with left bundle branch block: An electro- and vectorcardiographic study","volume":"23","author":"Kamoen","year":"2018","journal-title":"Ann. Noninvasive Electrocardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1007\/s10741-021-10094-w","article-title":"Global longitudinal strain predicts responders after cardiac resynchronization therapy-a systematic review and meta-analysis","volume":"27","author":"Bazoukis","year":"2022","journal-title":"Heart Fail. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1002\/ejhf.167","article-title":"Development of a multiparametric score to predict left ventricular remodeling and prognosis after cardiac resynchronization therapy","volume":"16","author":"Kydd","year":"2014","journal-title":"Eur. J. Heart Fail."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1093\/eurjhf\/hfn010","article-title":"Effects of global longitudinal strain and total scar burden on response to cardiac resynchronization therapy in patients with ischaemic dilated cardiomyopathy","volume":"11","author":"Caso","year":"2009","journal-title":"Eur. J. Heart Fail."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1161\/CIRCHEARTFAILURE.111.962902","article-title":"Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy Investigators. Dyssynchrony, contractile function, and response to cardiac resynchronization therapy","volume":"4","author":"Knappe","year":"2011","journal-title":"Circ. Heart Fail."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kadoglou, N.P.E., Bouwmeester, S., de Lepper, A.G.W., de Kleijn, M.C., Herold, I.H.F., Bouwman, A.R.A., Korakianitis, I., Simmers, T., Bracke, F., and Houthuizen, P. (2024). The Prognostic Role of Global Longitudinal Strain and NT-proBNP in Heart Failure Patients Receiving Cardiac Resynchronization Therapy. J. Pers. Med., 14.","DOI":"10.3390\/jpm14020188"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s10840-018-0363-x","article-title":"Cardiac resynchronization therapy response in heart failure patients with different subtypes of true left bundle branch block","volume":"52","author":"Kreidieh","year":"2018","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.ijcard.2018.07.060","article-title":"The definition of left bundle branch block influences the response to cardiac resynchronization therapy","volume":"269","author":"Caputo","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1111\/pace.13104","article-title":"Stricter criteria for left bundle branch block diagnosis do not improve response to CRT","volume":"40","author":"Bertaglia","year":"2017","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"149","DOI":"10.29001\/2073-8552-2022-756","article-title":"Association of cardiac mechanical dyssynchrony indices with data of dynamic single-photon emission computed tomography of the myocardium: The role of the time interval between the stress test and recording","volume":"39","author":"Shipulin","year":"2024","journal-title":"Sib. J. Clin. Exp. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"88","DOI":"10.4103\/ijnm.IJNM_165_18","article-title":"Equilibrium radionuclide angiography in evaluation of left ventricular mechanical dyssynchrony in patients with dilated cardiomyopathy: Comparison with electrocardiographic parameters and speckle-tracking echocardiography","volume":"34","author":"Singhal","year":"2019","journal-title":"Indian. J. Nucl. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1093\/europace\/euv145","article-title":"Quantitative assessment of cardiac mechanical dyssynchrony and prediction of response to cardiac resynchronization therapy in patients with non-ischaemic dilated cardiomyopathy using equilibrium radionuclide angiography","volume":"18","author":"Mukherjee","year":"2016","journal-title":"Europace"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e19296","DOI":"10.1097\/MD.0000000000019296","article-title":"Equilibrium radionuclide angiography compared with tissue doppler imaging for detection of right ventricular dyssynchrony and prediction of acute response to cardiac resynchronization therapy","volume":"99","author":"Chen","year":"2020","journal-title":"Medicine"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1007\/s12350-017-1072-z","article-title":"The role of nuclear medicine in assessments of cardiac dyssynchrony","volume":"25","author":"Naya","year":"2018","journal-title":"J. Nucl. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1880","DOI":"10.2967\/jnumed.116.174789","article-title":"Utility of Equilibrium Radionuclide Angiogram-Derived Measures of Dyssynchrony to Predict Outcomes in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy","volume":"57","author":"Badhwar","year":"2016","journal-title":"J. Nucl. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1161\/CIRCULATIONAHA.110.014324","article-title":"MADIT-CRT Executive Committee. Predictors of response to cardiac resynchronization therapy in the Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy (MADIT-CRT)","volume":"124","author":"Goldenberg","year":"2011","journal-title":"Circulation"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/europace\/euw445","article-title":"Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodeling: Results from the Markers and Response to CRT (MARC) study","volume":"20","author":"Maass","year":"2018","journal-title":"Europace"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/4\/605\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:10:46Z","timestamp":1760029846000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/4\/605"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,5]]},"references-count":41,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["life15040605"],"URL":"https:\/\/doi.org\/10.3390\/life15040605","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,5]]}}}