{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T17:11:09Z","timestamp":1776705069925,"version":"3.51.2"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1729,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,3,27]],"date-time":"2021-03-27T00:00:00Z","timestamp":1616803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"APHP"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Myocardial injury is frequently observed in patients hospitalized with coronavirus disease 2019 (COVID-19) pneumonia. Different cardiac abnormalities have been reported during the acute COVID-19 phase, ranging from infra-clinic elevations of myocardial necrosis biomarkers to acute cardiac dysfunction and myocarditis. There is limited information on late cardiac sequelae in patients who have recovered from acute COVID-19 illness. We aimed to document the presence and quantify the extent of myocardial functional alterations in patients hospitalized 6 months earlier for COVID-19 infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We conducted a prospective echocardiographic evaluation of 48 patients (mean age 58 \u00b1 13 years, 69% male) hospitalized 6 \u00b1 1 month earlier for a laboratory-confirmed and symptomatic COVID-19. Thirty-two (66.6%) had pre-existing cardiovascular risks factors (systemic hypertension, diabetes, or dyslipidaemia), and three patients (6.2%) had a known prior myocardial infarction. Sixteen patients (33.3%) experienced myocardial injury during the index COVID-19 hospitalization as identified by a rise in cardiac troponin levels. Six months later, 60.4% of patients still reported clinical symptoms including exercise dyspnoea for 56%. Echocardiographic measurements under resting conditions were not different between patients with versus without myocardial injury during the acute COVID-19 phase. In contrast, low-level exercise (25W for 3 min) induced a significant increase in the average E\/e\u2032 ratio (10.1 \u00b1 4.3 vs. 7.3 \u00b1 11.5, P = 0.01) and the systolic pulmonary artery pressure (33.4 \u00b1 7.8 vs. 25.6 \u00b1 5.3 mmHg, P = 0.02) in patients with myocardial injury during the acute COVID-19 phase. Sensitivity analyses showed that these alterations of left ventricular diastolic markers were observed regardless of whether of cardiovascular risk factors or established cardiac diseases indicating SARS-CoV-2 infection as a primary cause.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Six months after the acute COVID-19 phase, significant cardiac diastolic abnormalities are observed in patients who experienced myocardial injury but not in patients without cardiac involvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13315","type":"journal-article","created":{"date-parts":[[2021,3,27]],"date-time":"2021-03-27T05:46:04Z","timestamp":1616823964000},"page":"2232-2239","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Cardiac Performance in Patients Hospitalized with COVID-19: A 6 Month Follow-Up Study"],"prefix":"10.1093","volume":"8","author":[{"given":"Antoine","family":"Fayol","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Paris, INSERM, PARCC , 56 Rue Leblanc, Paris, F-75015 ,","place":["France"]},{"name":"CIC1418 and DMU CARTE, AP-HP, H\u00f4pital Europ\u00e9en Georges-Pompidou , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marine","family":"Livrozet","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, INSERM, PARCC , 56 Rue Leblanc, Paris, F-75015 ,","place":["France"]},{"name":"CIC1418 and DMU CARTE, AP-HP, H\u00f4pital Europ\u00e9en Georges-Pompidou , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Boutouyrie","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, INSERM, PARCC , 56 Rue Leblanc, Paris, F-75015 ,","place":["France"]},{"name":"Department of Pharmacology and DMU CARTE, AP-HP, H\u00f4pital Europ\u00e9en Georges-Pompidou , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakim","family":"Khettab","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and DMU CARTE, AP-HP, H\u00f4pital Europ\u00e9en Georges-Pompidou , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen","family":"Betton","sequence":"additional","affiliation":[{"name":"CIC1418 and DMU CARTE, AP-HP, H\u00f4pital Europ\u00e9en Georges-Pompidou , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Tea","sequence":"additional","affiliation":[{"name":"Department of Cardiology and DMU CARTE, AP-HP, H\u00f4pital Europ\u00e9en Georges-Pompidou , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Blanchard","sequence":"additional","affiliation":[{"name":"CIC1418 and DMU CARTE, AP-HP, H\u00f4pital Europ\u00e9en Georges-Pompidou , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa-Maria","family":"Bruno","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, INSERM, PARCC , 56 Rue Leblanc, Paris, F-75015 ,","place":["France"]},{"name":"Department of Pharmacology and DMU CARTE, AP-HP, H\u00f4pital Europ\u00e9en Georges-Pompidou , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-S\u00e9bastien","family":"Hulot","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, INSERM, PARCC , 56 Rue Leblanc, Paris, F-75015 ,","place":["France"]},{"name":"CIC1418 and DMU CARTE, AP-HP, H\u00f4pital Europ\u00e9en Georges-Pompidou , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"French COVID cohort study group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,27]]},"reference":[{"key":"2026012114031634000_ehf213315-bib-0001","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1016\/j.jacc.2020.08.069","article-title":"Characterization of myocardial injury in patients with Covid-19","volume":"76","author":"Giustino","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2026012114031634000_ehf213315-bib-0002","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1001\/jamacardio.2020.3538","article-title":"Association of troponin levels with mortality in italian patients hospitalized with coronavirus disease 2019: results of a multicenter study","volume":"5","author":"Lombardi","year":"2020","journal-title":"JAMA Cardiol"},{"key":"2026012114031634000_ehf213315-bib-0003","doi-asserted-by":"crossref","first-page":"2393","DOI":"10.1161\/CIRCULATIONAHA.120.050434","article-title":"Myocardial injury in adults hospitalized with Covid-19","volume":"142","author":"Smilowitz","year":"2020","journal-title":"Circulation"},{"key":"2026012114031634000_ehf213315-bib-0004","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.pcad.2020.05.013","article-title":"Special article\u2014Acute myocardial injury in patients hospitalized with Covid-19 infection: a review","volume":"63","author":"Bavishi","year":"2020","journal-title":"Prog Cardiovasc Dis"},{"key":"2026012114031634000_ehf213315-bib-0005","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1001\/jamacardio.2020.3557","article-title":"Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (Covid-19)","volume":"5","author":"Puntmann","year":"2020","journal-title":"JAMA Cardiol"},{"key":"2026012114031634000_ehf213315-bib-0006","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1161\/01.CIR.0000094737.21775.32","article-title":"Left ventricular performance in patients with severe acute respiratory syndrome: a 30-day echocardiographic follow-up study","volume":"108","author":"Li","year":"2003","journal-title":"Circulation"},{"key":"2026012114031634000_ehf213315-bib-0007","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1093\/ehjci\/jew082","article-title":"Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the EuropeanAssociation of Cardiovascular Imaging","volume":"17","author":"Nagueh","year":"2016","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026012114031634000_ehf213315-bib-0008","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026012114031634000_ehf213315-bib-0009","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1007\/s00392-016-1039-0","article-title":"Low level exercise echocardiography helps diagnose early stage heart failure with preserved ejection fraction: a study of echocardiography versus catheterization","volume":"106","author":"Hammoudi","year":"2017","journal-title":"Clin Res Cardiol"},{"key":"2026012114031634000_ehf213315-bib-0010","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/S0735-1097(00)01056-1","article-title":"Hemodynamic determinants of the mitral annulus diastolic velocities by tissue Doppler","volume":"37","author":"Nagueh","year":"2001","journal-title":"J Am Coll Cardiol"},{"key":"2026012114031634000_ehf213315-bib-0011","doi-asserted-by":"crossref","first-page":"3297","DOI":"10.1093\/eurheartj\/ehz641","article-title":"How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)","volume":"40","author":"Pieske","year":"2019","journal-title":"Eur Heart J"},{"key":"2026012114031634000_ehf213315-bib-0012","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1002\/ejhf.1406","article-title":"Towards better definition, quantification and treatment of fibrosis in heart failure. A scientific roadmap by the Committee of Translational Research of the Heart Failure Association (HFA) of the European Society of Cardiology","volume":"21","author":"de Boer","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2026012114031634000_ehf213315-bib-0013","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/j.jacc.2010.10.024","article-title":"Diastolic tissue Doppler indexes correlate with the degree of collagen expression and cross-linking in heart failure and normal ejection fraction","volume":"57","author":"Kasner","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2026012114031634000_ehf213315-bib-0014","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1161\/CIRCULATIONAHA.116.024822","article-title":"Role of diastolic stress testing in the evaluation for heart failure with preserved ejection fraction: a simultaneous invasive-echocardiographic study","volume":"135","author":"Obokata","year":"2017","journal-title":"Circulation"},{"key":"2026012114031634000_ehf213315-bib-0015","doi-asserted-by":"crossref","first-page":"101","DOI":"10.4103\/jcecho.jcecho_57_17","article-title":"Reference ranges and physiologic variations of left E\/e' ratio in healthy adults: clinical and echocardiographic correlates","volume":"28","author":"D'Andrea","year":"2018","journal-title":"J Cardiovasc Echogr"},{"key":"2026012114031634000_ehf213315-bib-0016","doi-asserted-by":"crossref","first-page":"2207","DOI":"10.1093\/cvr\/cvaa267","article-title":"SARS-CoV-2 infects and induces cytotoxic effects in human cardiomyocytes","volume":"116","author":"Bojkova","year":"2020","journal-title":"Cardiovasc Res"},{"key":"2026012114031634000_ehf213315-bib-0017","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1056\/NEJMoa2015432","article-title":"Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19","volume":"383","author":"Ackermann","year":"2020","journal-title":"N Engl J Med"},{"key":"2026012114031634000_ehf213315-bib-0018","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1016\/S0140-6736(20)30937-5","article-title":"Endothelial cell infection and endotheliitis in COVID-19","volume":"395","author":"Varga","year":"2020","journal-title":"Lancet"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13315","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/3\/2232\/65798205\/eschf_8_3_2232.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/3\/2232\/65798205\/eschf_8_3_2232.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:03:26Z","timestamp":1769022206000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/8\/3\/2232\/8363490"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,27]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,27]]},"published-print":{"date-parts":[[2021,6,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13315","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,6]]},"published":{"date-parts":[[2021,3,27]]},"assertion":[{"value":"2021-01-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}