{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T01:13:29Z","timestamp":1768007609550,"version":"3.49.0"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T00:00:00Z","timestamp":1626048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Viral\u2010induced cardiac inflammation can induce heart failure with preserved ejection fraction (HFpEF)\u2010like syndromes. COVID\u201019 can lead to myocardial damage and vascular injury. We hypothesised that COVID\u201019 patients frequently develop a HFpEF\u2010like syndrome, and designed this study to explore this.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      Cardiac function was assessed in 64 consecutive, hospitalized, and clinically stable COVID\u201019 patients from April\u2013November 2020 with left ventricular ejection fraction (LVEF) \u226550% (age 56\u2009\u00b1\u200919\u2009years, females: 31%, severe COVID\u201019 disease: 69%). To investigate likelihood of HFpEF presence, we used the HFA\u2010PEFF score. A low (0\u20131 points), intermediate (2\u20134 points), and high (5\u20136 points) HFA\u2010PEFF score was observed in 42%, 33%, and 25% of patients, respectively. In comparison, 64 subjects of similar age, sex, and comorbidity status without COVID\u201019 showed these scores in 30%, 66%, and 4%, respectively (between groups:\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0002). High HFA\u2010PEFF scores were more frequent in COVID\u201019 patients than controls (25% vs. 4%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001). In COVID\u201019 patients, the HFA\u2010PEFF score significantly correlated with age, estimated glomerular filtration rate, high\u2010sensitivity troponin T (hsTnT), haemoglobin, QTc interval, LVEF, mitral E\/A ratio, and H\n                      <jats:sub>2<\/jats:sub>\n                      FPEF score (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). In multivariate, ordinal regression analyses, higher age and hsTnT were significant predictors of increased HFA\u2010PEFF scores. Patients with myocardial injury (hsTnT \u226514\u2009ng\/L: 31%) vs. patients without myocardial injury, showed higher HFA\u2010PEFF scores [median 5 (interquartile range 3\u20136) vs. 1 (0\u20133),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001] and more often showed left ventricular diastolic dysfunction (75% vs. 27%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hospitalized COVID\u201019 patients frequently show high likelihood of presence of HFpEF that is associated with cardiac structural and functional alterations, and myocardial injury. Detailed cardiac assessments including echocardiographic determination of left ventricular diastolic function and biomarkers should become routine in the care of hospitalized COVID\u201019 patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2210","type":"journal-article","created":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T11:30:11Z","timestamp":1619868611000},"page":"1891-1902","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Heart failure with preserved ejection fraction according to the\n                    <scp>HFA\u2010PEFF<\/scp>\n                    score in\n                    <scp>COVID<\/scp>\n                    \u201019 patients: clinical correlates and echocardiographic findings"],"prefix":"10.1093","volume":"23","author":[{"given":"Sara","family":"Hadzibegovic","sequence":"first","affiliation":[{"name":"Department of Cardiology (CBF) Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Lena","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin  Berlin Germany"},{"name":"Division of Cardiology and Metabolism, Department of Cardiology (CVK) Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy W.","family":"Churchill","sequence":"additional","affiliation":[{"name":"Cardiovascular Performance Program Massachusetts General Hospital  Boston MA USA"},{"name":"Echocardiography Laboratory Massachusetts General Hospital  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer E.","family":"Ho","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center Massachusetts General Hospital  Boston MA USA"},{"name":"Cardiology Division, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia","family":"Potthoff","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin  Berlin Germany"},{"name":"Division of Cardiology and Metabolism, Department of Cardiology (CVK) Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinna","family":"Denecke","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Metabolism, Department of Cardiology (CVK) Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"R\u00f6snick","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin  Berlin Germany"},{"name":"Division of Cardiology and Metabolism, Department of Cardiology (CVK) Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin Moira","family":"Heim","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Respiratory Medicine Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malte","family":"Kleinschmidt","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Respiratory Medicine Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leif Erik","family":"Sander","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Respiratory Medicine Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Witzenrath","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Respiratory Medicine Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Suttorp","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Respiratory Medicine Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Krannich","sequence":"additional","affiliation":[{"name":"Clinical Study Center (CSC), Berlin Institute of Health Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Porthun","sequence":"additional","affiliation":[{"name":"Norwegian University of Science and Technology  Gj\u00f8vik Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Friede","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Mississippi State University Jackson Design Center Library  Starkville MS USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ursula","family":"Wilkenshoff","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CBF) Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burkert","family":"Pieske","sequence":"additional","affiliation":[{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Department of Internal Medicine and Cardiology (CVK) Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"German Heart Center  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulf","family":"Landmesser","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CBF) Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin  Berlin Germany"},{"name":"Division of Cardiology and Metabolism, Department of Cardiology (CVK) Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory D.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Medicine Massachusetts General Hospital  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten","family":"Tsch\u00f6pe","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Department of Internal Medicine and Cardiology (CVK) Charit\u00e9\u00a0\u2013\u00a0Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus S.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CBF) Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,7,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1925"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.047164"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa388"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-05991-x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.0950"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1828"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1899"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-020-00435-x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2020.117723"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-020-01464-x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.050757"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004207"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev014"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1741"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.034646"},{"key":"e_1_2_7_20_1","first-page":"66","volume-title":"Breakthroughs in Statistics","author":"Fisher RA","year":"1921"},{"key":"e_1_2_7_21_1","unstructured":"HothornT. R package maxstat \u2010 Maximally Selected Rank Statistics 2017.https:\/\/CRAN.R\u2010project.org\/package=maxstat(10 May 2021)."},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3"},{"key":"e_1_2_7_23_1","unstructured":"World Health Organization. COVID\u201019 clinical management. Living guidance 25 January 2021. Geneva: WHO;2021.https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/338882\/WHO\u20102019\u2010nCoV\u2010clinical\u20102021.1\u2010eng.pdf?sequence=1&isAllowed=y(20 April 2021)."},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.73"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/78.3.691"},{"key":"e_1_2_7_26_1","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J","year":"1988"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000155615.68924.B3"},{"key":"e_1_2_7_29_1","unstructured":"European Society of Cardiology. ESC Guidance for the Diagnosis and Management of CV Disease during the COVID\u201019 Pandemic. Last updated on 10 June 2020.https:\/\/www.escardio.org\/Education\/COVID\u201019\u2010and\u2010Cardiology\/ESC\u2010COVID\u201019\u2010Guidance(10 May 2021)."},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2020.04.024"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30566-3"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30211-7"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2008975"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1614"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeaa178"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.047971"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.039051"},{"key":"e_1_2_7_38_1","first-page":"834","article-title":"The differential diagnosis of dyspnea","volume":"113","author":"Berliner D","year":"2016","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.25809"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa539"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.05.001"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa408"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.3557"},{"key":"e_1_2_7_44_1","first-page":"116","article-title":"Cardiovascular magnetic resonance findings in competitive athletes recovering from COVID\u201019 infection","volume":"6","author":"Rajpal S","year":"2021","journal-title":"JAMA Cardiol"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa664"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12873"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-020-01727-5"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2008.05.008"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.19102\/icrm.2020.110804"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2018.11.024"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.1017"},{"key":"e_1_2_7_52_1","unstructured":"Worldometer. Coronavirus updates.www.worldometers.info(10 May 2021)."},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.11.204"}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejhf.2210","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ejhf.2210","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejhf.2210","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T12:15:05Z","timestamp":1767701705000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ejhf.2210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,12]]},"references-count":52,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1002\/ejhf.2210"],"URL":"https:\/\/doi.org\/10.1002\/ejhf.2210","archive":["Portico"],"relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,12]]},"assertion":[{"value":"2020-11-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}