{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:01:40Z","timestamp":1784552500989,"version":"3.55.0"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context:<\/jats:title>\n                    <jats:p>Total atrio-ventricular block is a lethal condition and is an indication of permanent pacemaker (PPM) implantation. Although PPM is lifesaving, patients frequently develop left ventricular dysfunction (LVd) which is traditionally detected with left ventricular ejection fraction (LVEF). Global longitudinal strain (GLS) may detect LVd before a decrease in LVEF. Cellular mechanisms of LVd following PPM implantation remain poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>This study aimed to evaluate biomarker changes associated with the development of LVd following PPM implantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings and Design:<\/jats:title>\n                    <jats:p>This quasi-experimental study was conducted on adult patients undergoing PPM implantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods:<\/jats:title>\n                    <jats:p>Echocardiography parameters and blood samples were obtained before PPM implantation (P0), at 1 month (P1) and at 3 months (P3). Patients divided into two groups (decreased GLS vs. unchanged GLS group) based on Delta P1 to P3 GLS. Biomarkers (miR-155, sTNFR-2, MMP-9, N-Cad, and ZO-1) concentration at P0 are compared to P1 and P3 between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Analysis Used:<\/jats:title>\n                    <jats:p>Data were evaluated using nonparametric and parametric tests, repeated-measures analyses, and multivariate modeling as appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 42 patients were included. There is a significant difference of P1 sTNFR-2 concentration between decreased GLS group and unchanged GLS group (1947.75 [standard deviation (SD) 103.80] vs. 1778.01 [SD 237.16];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      : 0.003). Moreover, general linier model showed a higher concentration of sTNFR-2 in patients with GLS decreased compared to unchanged GLS, although the difference is insignificant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      : 0.340). There was no statistically significant difference of other biomarkers in the study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>STNFR-2 may represent an early inflammatory signal associated with relative GLS deterioration following permanent pacemaker implantation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcecho.jcecho_176_25","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T21:02:44Z","timestamp":1784322164000},"page":"304-312","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Mechanism of Left Ventricular Dysfunction due to Permanent Pacemaker: An Analysis of miR-155, sTNFR-2, MMP-9, N-Cad, and ZO-1"],"prefix":"10.4103","volume":"36","author":[{"given":"Sidhi","family":"Laksono","sequence":"first","affiliation":[{"name":"Doctoral Program in Medical Sciences, Faculty of Medicine, University of Indonesia, West Jakarta City, Jakarta, Indonesia"},{"name":"Department of Medical Education, Faculty of Medicine, Prof. Dr. Hamka Muhammadiyah University, Tangerang City, Banten, Indonesia"},{"name":"Division of Interventional Cardiology and Structural Heart Disease, Siloam Diagram Hospital, Depok City, West Java, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoga","family":"Yuniadi","sequence":"additional","affiliation":[{"name":"Doctoral Program in Medical Sciences, Faculty of Medicine, University of Indonesia, West Jakarta City, Jakarta, Indonesia"},{"name":"Harapan Kita National Cardiovascular Center, West Jakarta City, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amiliana M.","family":"Soesanto","sequence":"additional","affiliation":[{"name":"Doctoral Program in Medical Sciences, Faculty of Medicine, University of Indonesia, West Jakarta City, Jakarta, Indonesia"},{"name":"Harapan Kita National Cardiovascular Center, West Jakarta City, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunu B.","family":"Raharjo","sequence":"additional","affiliation":[{"name":"Doctoral Program in Medical Sciences, Faculty of Medicine, University of Indonesia, West Jakarta City, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irwan S.","family":"Angkasa","sequence":"additional","affiliation":[{"name":"Division of Interventional Cardiology and Structural Heart Disease, Siloam Diagram Hospital, Depok City, West Java, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cliffian","family":"Hosanna","sequence":"additional","affiliation":[{"name":"Division of Interventional Cardiology and Structural Heart Disease, Siloam Diagram Hospital, Depok City, West Java, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"R1-20260720","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1161\/CIRCULATIONAHA.110.942284","article-title":"The cardiac conduction system","volume":"123","author":"Park","year":"2011","journal-title":"Circulation"},{"key":"R2-20260720","doi-asserted-by":"crossref","first-page":"e283","DOI":"10.1161\/CIR.0b013e318276ce9b","article-title":"2012 ACCF\/AHA\/HRS focused update incorporated into the ACCF\/AHA\/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities","volume":"127","author":"Epstein","year":"2013","journal-title":"Circulation"},{"key":"R3-20260720","doi-asserted-by":"crossref","first-page":"3427","DOI":"10.1093\/eurheartj\/ehab364","article-title":"2021 ESC guidelines on cardiac pacing and cardiac resynchronization therapy","volume":"42","author":"Glikson","year":"2021","journal-title":"Eur Heart J"},{"key":"R4-20260720","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1016\/j.jacc.2012.07.017","article-title":"Trends in permanent pacemaker implantation in the United States from 1993 to 2009: Increasing complexity of patients and procedures","volume":"60","author":"Greenspon","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"R5-20260720","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1161\/01.CIR.0000016183.07898.90","article-title":"Cardiology patient pages. 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