{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:32:17Z","timestamp":1772998337517,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T00:00:00Z","timestamp":1770422400000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>COVID\u201019 has been associated with significant cardiovascular complications, yet the long\u2010term cardiovascular consequences and prognostic biomarkers in moderate versus severe disease remain incompletely characterized. This study aimed to evaluate longitudinal cardiovascular changes, identify mortality predictors, and assess the discriminative performance of fractional exhaled nitric oxide (FeNO) and endothelin\u20101 (ET\u20101) in hospitalized COVID\u201019 survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study enrolled 480 hospitalized COVID\u201019 patients (240 moderate, 240 severe by WHO criteria) who survived to discharge between June 2020 and December 2023. Baseline and 1\u2010year echocardiography, inflammatory biomarkers including FeNO and ET\u20101, and clinical outcomes were assessed. Multivariable Cox regression identified mortality predictors, and ROC analysis evaluated biomarker discriminative performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Severe COVID\u201019 patients demonstrated significant baseline right ventricular dysfunction with reduced TAPSE (16.63\u00a0\u00b1\u00a02.43\u00a0vs. 20.36\u00a0\u00b1\u00a03.68\u00a0mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and impaired RVPA coupling (0.60\u00a0\u00b1\u00a00.14\u00a0vs. 0.88\u00a0\u00b1\u00a00.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Progressive cardiovascular deterioration occurred over 1\u00a0year, with pulmonary artery pressure increasing 17.8% in severe versus 7.1% in moderate disease. Two\u2010year mortality was 16.9% overall. Independent mortality predictors included hypertension (HR 3.02), hyperlipidemia (HR 2.51), diabetes (HR 2.23), and left atrial volume index (HR 1.08 per mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). FeNO and ET\u20101 predicted mortality specifically in severe disease (HR 1.028 and 1.035, respectively) and demonstrated excellent discriminative ability (AUC 0.892 and 0.865) for identifying severe COVID\u201019.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Moderate and severe COVID\u201019 survivors exhibit progressive cardiovascular deterioration, particularly affecting right ventricular function. FeNO and ET\u20101 serve as severity\u2010specific prognostic biomarkers and demonstrate excellent discriminative performance, supporting their integration into risk stratification protocols for COVID\u201019 survivors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70407","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T13:44:51Z","timestamp":1770471891000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated Echocardiographic and Biomarker Assessment Reveal Progressive Cardiovascular Injury After Moderate and Severe COVID\u201019"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0108-2824","authenticated-orcid":false,"given":"Cuma","family":"S\u00fcleymano\u011flu","sequence":"first","affiliation":[{"name":"Department of Cardiology Osmaniye Training and Research Hospital  Osmaniye Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuat","family":"Polat","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Educat\u0131on Research Hosp\u0131tal  \u0130stanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deniz","family":"El\u00e7ik","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erciyes University Faculty of Medicine  Kayseri Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5800-7094","authenticated-orcid":false,"given":"Nihat","family":"Kalay","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erciyes University Faculty of Medicine  Kayseri Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,7]]},"reference":[{"key":"e_1_2_15_2_1","volume-title":"WHO Coronavirus (COVID\u201019) 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