{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:05:16Z","timestamp":1785470716224,"version":"3.56.0"},"reference-count":16,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T00:00:00Z","timestamp":1636848000000},"content-version":"unspecified","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Northwick Park Cardiac Research Charity"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2021,10,19]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine the prevalence of cardiac abnormalities and their relationship to markers of myocardial injury and mortality in patients admitted to hospital with COVID-19.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective and prospective observational study of inpatients referred for transthoracic echocardiography for suspected cardiac pathology due to COVID-19 within a London NHS Trust. Echocardiograms were performed to assess left ventricular (LV), right ventricular (RV) and pulmonary variables along with collection of patient demographics, comorbid conditions, blood biomarkers and outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Result<\/jats:title>\n                  <jats:p>In the predominant non-white (72%) population, RV dysfunction was the primary cardiac abnormality noted in 50% of patients, with RV fractional area change &lt;35%\u2009being the most common marker of this RV dysfunction. By comparison, LV systolic dysfunction occurred in 18% of patients. RV dysfunction was associated with LV systolic dysfunction and the presence of a D-shaped LV throughout the cardiac cycle (marker of significant pulmonary artery hypertension). LV systolic dysfunction (p=0.002, HR 3.82, 95% CI 1.624 to 8.982), pulmonary valve acceleration time (p=0.024, HR 0.98, 95% CI 0.964 to 0.997)\u2014marker of increased pulmonary vascular resistance, age (p=0.047, HR 1.027, 95%\u2009CI 1.000 to 1.055) and an episode of tachycardia measured from admission to time of echo (p=0.004, HR 6.183, 95% CI 1.772 to 21.575) were independently associated with mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this predominantly non-white population hospitalised with COVID-19, the most common cardiac pathology was RV dysfunction which is associated with both LV systolic dysfunction and elevated pulmonary artery pressure. The latter two, not RV dysfunction, were associated with mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2021-001833","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T11:15:23Z","timestamp":1636974923000},"page":"e001833","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Prevalence of cardiac pathology and relation to mortality in a multiethnic population hospitalised with COVID-19"],"prefix":"10.1136","volume":"8","author":[{"given":"Gabriel","family":"Bioh","sequence":"first","affiliation":[{"name":"Department of Cardiology, Northwick Park Hospital, Harrow, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Botrous","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northwick Park Hospital, Harrow, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northwick Park Hospital, Harrow, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northwick Park Hospital, Harrow, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinette","family":"Hampson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northwick Park Hospital, Harrow, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6579-7039","authenticated-orcid":false,"given":"Roxy","family":"Senior","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northwick Park Hospital, Harrow, London, UK"},{"name":"Royal Brompton Hospital, London, UK"},{"name":"National Heart and Lung Institute, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"2025081710554383000_8.2.e001833.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"2025081710554383000_8.2.e001833.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30211-7"},{"key":"2025081710554383000_8.2.e001833.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00059-020-04909-z"},{"key":"2025081710554383000_8.2.e001833.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-05991-x"},{"key":"2025081710554383000_8.2.e001833.5","doi-asserted-by":"crossref","unstructured":"Hu H , Ma F , Xin Wei YF . Coronavirus fulminant myocarditis saved with glucocorticoid and human immunoglobulin. Eur Heart J 2020;1307800.","DOI":"10.1093\/eurheartj\/ehaa190"},{"key":"2025081710554383000_8.2.e001833.6","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1001\/jamacardio.2020.1096","article-title":"Cardiac involvement in a patient with coronavirus disease 2019 (COVID-19)","volume":"5","author":"Inciardi","year":"2020","journal-title":"JAMA Cardiol"},{"key":"2025081710554383000_8.2.e001833.7","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1016\/j.jcmg.2020.05.010","article-title":"Right ventricular dilation in hospitalized patients with COVID-19 infection","volume":"13","author":"Argulian","year":"2020","journal-title":"JACC Cardiovasc Imaging"},{"key":"2025081710554383000_8.2.e001833.8","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.047971"},{"key":"2025081710554383000_8.2.e001833.9","first-page":"1203","article-title":"Echocardiographic findings in patients with COVID-19 pneumonia","volume":"36","author":"Mahmoud-Elsayed","year":"2020","journal-title":"Can J Cardiol"},{"key":"2025081710554383000_8.2.e001833.10","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s10554-020-01968-5","article-title":"Evaluation of biventricular function in patients with COVID-19 using speckle tracking echocardiography","volume":"37","author":"Baycan","year":"2021","journal-title":"Int J Cardiovasc Imaging"},{"key":"2025081710554383000_8.2.e001833.11","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1001\/jamacardio.2020.0950","article-title":"Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China","volume":"5","author":"Shi","year":"2020","journal-title":"JAMA Cardiol"},{"key":"2025081710554383000_8.2.e001833.12","unstructured":"Ingram T , Augustine D , Colebourn C . COVID-19 clinical guidance, 2020. Available: https:\/\/bsecho.org\/covid19 [Accessed 29 Oct 2020]."},{"key":"2025081710554383000_8.2.e001833.13","doi-asserted-by":"crossref","unstructured":"Lang RM , Badano LP , Mor-Avi V . Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging. 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