Skip to content
DraconiticResearch
Search Sources API
197,768 studies31 sourcesUpdated 30 min ago
Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Global Myocardial Work Efficiency and Left Ventricular Ejection Fraction After Left Bundle Branch Area Pacing Versus Right Ventricular Pacing: Extended Follow-Up of a Prospective Cohort

  • Georgios Leventopoulos1
  • Maria Bozika1
  • Panagiotis Chronopoulos1
  • Eleni Papastavrou1
  • Christos Kyriazis1
  • Kassiani-Maria Nastouli1
  • Georgios Boliaris1
  • Panagiotis Patrinos1
  • Angelos Perperis1
  • Rafail Koros1
  • Ioanna Koniari1,2
  • Georgia Xygka1
7 more authors
  • Efthimia Kapsali1
  • Anastasios Apostolos3,4
  • Nikolaos Vythoulkas-Biotis5
  • Alexandros Dedes1
  • Anastasia Efraimoglou1
  • Athanasios Moulias1
  • Periklis Davlouros1
5 affiliations
  1. 1Department of Medicine, Division of Cardiology, University Hospital of Patras, 265 04 Patras, Greece
  2. 2Liverpool Centre for Cardiovascular Science, Liverpool L14 3PE, UK
  3. 3Department of Cardiology, Royal Brompton and Harefield Hospitals, Part of Guy’s and St Thomas’ NHS Foundation Trust, London SW3 6NP, UK
  4. 4Faculty of Medicine, Imperial College London, London SW7 2AZ, UK
  5. 5Third Department of Cardiology, “Sotiria” Chest Diseases Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
Open at sourceDOICite

Abstract

Background/Objectives: Evidence on myocardial-work indices beyond 12 months after left bundle branch area pacing (LBBAP) remains limited. We compared global myocardial work efficiency (GWE) and the left ventricular ejection fraction (LVEF) after LBBAP and right ventricular mid-septal pacing (RVP). Methods: This prospective, non-randomised cohort included 63 patients with advanced atrioventricular block and preserved pre-implantation LVEF: 34 assigned to an LBBAP strategy and 29 to RVP. Ventricular pacing burden was 100%. GWE was the primary endpoint; LVEF was the principal adjusted secondary endpoint. Analyses adjusted for age, sex, hypertension and atrial fibrillation. Follow-up averaged approximately two years, with an individual range of 0.64–4.23 years. Results: GWE was higher with LBBAP (85.23 ± 6.82% versus 80.00 ± 9.41%; p = 0.016), with an adjusted difference of +4.96 percentage points (95% CI 0.87 to 9.04; p = 0.018). The adjusted LVEF difference was +5.73 percentage points (95% CI 2.77 to 8.68; p < 0.001). Exploratory within-patient LVEF analyses showed mean changes of +1.20 percentage points with LBBAP (95% CI −1.25 to +3.65) and −6.15 with RVP (95% CI −9.16 to −3.14), with an unadjusted between-group difference of +7.35 percentage points (95% CI 3.55 to 11.16; p < 0.001). Conclusions: LBBAP was associated with higher GWE and LVEF at extended follow-up, although some propensity-score GWE confidence intervals included zero. LVEF-change findings are exploratory and do not estimate a common-time trajectory. These observational findings do not establish causality or clinical benefit.

Related

  1. Myocardial Work Index Dispersion as a Potential Predictor of Ventricular Arrhythmias in Patients with Heart Failure with Reduced Ejection Fraction
    Martyna Dąbrowska, Magdalena Potapowicz-Krysztofiak, Patrycja Życzkowska +6
    BiomedicinesPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  2. Association of Haptoglobin Genotype with Cardiovascular Disease and Left Ventricular Ejection Fraction in Kidney Transplant Recipients
    Zeynep Ural, Ozant Helvacı, Berfu Korucu +3
    Journal of clinical medicinePeer-reviewedCC BYFull textGeneral medicineEurope PMC
  3. Delayed left ventricular remodelling in patients with heart failure and reduced ejection fraction: a systematic review.
    Laurence Whittaker, Visvesh Jeyalan, Matthew Dewhurst +5
    Open heartPeer-reviewedCC BY-NCFull textCardiovascular medicineEurope PMC
  4. Recurrent Large‐Vessel Occlusive Stroke Requiring Repeated Mechanical Thrombectomy in Severe Dilated Cardiomyopathy With Extremely Low Left Ventricular Ejection Fraction and HIV Screening Positivity: A Case Report
    Jing Xu, Liangxu Xiang, Yanghua Tian
    Clinical case reportsPeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMC
  5. Perioperative temporary microaxial left ventricular assist device support in patients with low ejection fraction undergoing coronary artery bypass grafting
    Allyson Howard-Green, Deevya Raman, Mark Cordell +9
    Frontiers in cardiovascular medicinePeer-reviewedCC BYFull textCardiovascular medicineEurope PMC

Cite

BibTeXRIS
BibTeX
@article{leventopoulos2026global,
  title = {{Global Myocardial Work Efficiency and Left Ventricular Ejection Fraction After Left Bundle Branch Area Pacing Versus Right Ventricular Pacing: Extended Follow-Up of a Prospective Cohort}},
  author = {Georgios Leventopoulos and Maria Bozika and Panagiotis Chronopoulos and Eleni Papastavrou and Christos Kyriazis and Kassiani-Maria Nastouli and Georgios Boliaris and Panagiotis Patrinos and Angelos Perperis and Rafail Koros and Ioanna Koniari and Georgia Xygka and Efthimia Kapsali and Anastasios Apostolos and Nikolaos Vythoulkas-Biotis and Alexandros Dedes and Anastasia Efraimoglou and Athanasios Moulias and Periklis Davlouros},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218224},
  url = {https://www.mdpi.com/2077-0383/15/21/8224},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Global Myocardial Work Efficiency and Left Ventricular Ejection Fraction After Left Bundle Branch Area Pacing Versus Right Ventricular Pacing: Extended Follow-Up of a Prospective Cohort
AU  - Georgios Leventopoulos
AU  - Maria Bozika
AU  - Panagiotis Chronopoulos
AU  - Eleni Papastavrou
AU  - Christos Kyriazis
AU  - Kassiani-Maria Nastouli
AU  - Georgios Boliaris
AU  - Panagiotis Patrinos
AU  - Angelos Perperis
AU  - Rafail Koros
AU  - Ioanna Koniari
AU  - Georgia Xygka
AU  - Efthimia Kapsali
AU  - Anastasios Apostolos
AU  - Nikolaos Vythoulkas-Biotis
AU  - Alexandros Dedes
AU  - Anastasia Efraimoglou
AU  - Athanasios Moulias
AU  - Periklis Davlouros
PY  - 2026
DA  - 2026/10/22
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218224
UR  - https://www.mdpi.com/2077-0383/15/21/8224
AB  - Background/Objectives: Evidence on myocardial-work indices beyond 12 months after left bundle branch area pacing (LBBAP) remains limited. We compared global myocardial work efficiency (GWE) and the left ventricular ejection fraction (LVEF) after LBBAP and right ventricular mid-septal pacing (RVP). Methods: This prospective, non-randomised cohort included 63 patients with advanced atrioventricular block and preserved pre-implantation LVEF: 34 assigned to an LBBAP strategy and 29 to RVP. Ventricular pacing burden was 100%. GWE was the primary endpoint; LVEF was the principal adjusted secondary endpoint. Analyses adjusted for age, sex, hypertension and atrial fibrillation. Follow-up averaged approximately two years, with an individual range of 0.64–4.23 years. Results: GWE was higher with LBBAP (85.23 ± 6.82% versus 80.00 ± 9.41%; p = 0.016), with an adjusted difference of +4.96 percentage points (95% CI 0.87 to 9.04; p = 0.018). The adjusted LVEF difference was +5.73 percentage points (95% CI 2.77 to 8.68; p < 0.001). Exploratory within-patient LVEF analyses showed mean changes of +1.20 percentage points with LBBAP (95% CI −1.25 to +3.65) and −6.15 with RVP (95% CI −9.16 to −3.14), with an unadjusted between-group difference of +7.35 percentage points (95% CI 3.55 to 11.16; p < 0.001). Conclusions: LBBAP was associated with higher GWE and LVEF at extended follow-up, although some propensity-score GWE confidence intervals included zero. LVEF-change findings are exploratory and do not estimate a common-time trajectory. These observational findings do not establish causality or clinical benefit.
SN  - 2077-0383
ER  -