ArticleHeart rhythm O22026
Survival prediction after cardiac resynchronization therapy: Clinical scores vs left ventricular ejection fraction.
Article in Heart rhythm O2, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Beyond ejection fraction: Rethinking response and prognostication after cardiac resynchronization therapy.Heart rhythm O2 · 2026Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Left ventricular ejection fraction (LVEF) is commonly used to characterize remodeling and estimate prognosis after cardiac resynchronization therapy (CRT). Clinical scores assessed at follow-up may provide complementary prognostic information. Objective: This study compared the predictive value of LVEF and clinical scores, measured at 6 months after CRT, for long-term survival. Methods: This prospective cohort study enrolled 528 patients undergoing CRT between May 2016 and June 2022. Clinical scores, including the 6-minute walk distance, gait speed, the timed up-and-go test, the Study of Osteoporotic Fractures frailty index, and the 5-level EuroQol-5 dimension score, were evaluated at 6 months after CRT alongside LVEF. The primary end point was event-free survival, defined as survival without left ventricular assist device implantation, heart transplantation, or death. Using a nested model approach, Cox proportional hazards models assessed predictive accuracy using the concordance index (C-index). Results: Over a mean follow-up of 3.73 years, 127 patients (24%) reached the primary end point. In models adjusted for baseline covariates, LVEF at 6 months was associated with event-free survival (C-index 0.732), whereas several clinical scores showed higher discrimination (C-index: 6-minute walk distance 0.767; Study of Osteoporotic Fractures frailty index 0.754; timed up-and-go test 0.749; 5-level EuroQol-5-dimension score 0.740). Findings were consistent when using clinically relevant cut points. In LVEF-adjusted models, high-performing clinical measures provided incremental prognostic value beyond LVEF. Conclusion: Although LVEF remains a valuable metric, a multidimensional approach incorporating clinical scores alongside LVEF may improve long-term survival prediction after CRT. Their integration into clinical practice could enhance personalized care and risk stratification for CRT recipients.
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