{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T21:47:09Z","timestamp":1775771229332,"version":"3.50.1"},"reference-count":62,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">COVID\u201019 has been linked to cardiovascular complications, but its long\u2010term impact on left ventricular (LV) function is unclear. We investigated whether SARS\u2010CoV\u20102 infection is associated with increased risk of LV ejection fraction (LVEF) decline and whether vaccination mitigates this risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this retrospective study, we included patients with COVID\u201019, normal baseline LVEF (\u226550%), and at least one follow\u2010up echocardiogram from 2016 to 2024. Outcomes were LVEF dropping &lt;50%, 40%, and 30%. Multivariable Cox models adjusted for demographics, comorbidities, vaccination status, and baseline LVEF. Associations with acute\u2010phase blood biomarkers were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 2853 patients who were COVID+ and 3963 patients who were COVID\u2212 (baseline LVEF \u226550%), patients with COVID\u201019 had lower mean follow\u2010up LVEF (60.65% versus 61.53%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.005) and higher rates of LVEF decline &lt;50%, 40%, and 30%. Both hospitalized (adjusted hazard ratio [aHR], 1.57 [1.30\u20131.91]) and non\u2010hospitalized (aHR, 1.48 [1.18\u20131.85]) patients with COVID\u201019 had greater risk of LVEF &lt;50% versus controls; only hospitalized patients had significantly increased risk of LVEF&lt;40% (aHR, 1.81 [1.35\u20132.43]) and &lt;30% (aHR, 2.79 [1.72\u20134.54]). Vaccination was not significantly associated with LVEF decline. Baseline LVEF, older age, male sex, history of heart failure, myocardial infarction, and chronic kidney disease were associated with greater risk. Elevated troponin, B\u2010type natriuretic peptide, D\u2010dimer, and thrombocytopenia predicted greater risk in hospitalized patients with COVID\u201019.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">SARS\u2010CoV\u20102 infection is associated with long\u2010term LVEF declines, especially in hospitalized patients. Vigilant cardiac surveillance may be needed in survivors of COVID\u201019 to mitigate progressive dysfunction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043976","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T12:26:54Z","timestamp":1760444814000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Elevated Risk of Long\u2010Term Decline in Left Ventricular Ejection Fraction After COVID\u201019"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2231-0172","authenticated-orcid":false,"given":"Roham","family":"Hadidchi","sequence":"first","affiliation":[{"name":"Montefiore Health System and Albert Einstein College of Medicine","place":["Bronx, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9448-2871","authenticated-orcid":false,"given":"Ekram","family":"Ali","sequence":"additional","affiliation":[{"name":"Montefiore Health System and Albert Einstein College of Medicine","place":["Bronx, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Piskun","sequence":"additional","affiliation":[{"name":"Montefiore Health System and Albert Einstein College of Medicine","place":["Bronx, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6471-4569","authenticated-orcid":false,"given":"Sonya","family":"Henry","sequence":"additional","affiliation":[{"name":"Montefiore Health System and Albert Einstein College of Medicine","place":["Bronx, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9341-5832","authenticated-orcid":false,"given":"Lili","family":"Zhang","sequence":"additional","affiliation":[{"name":"Montefiore Health System and Albert Einstein College of Medicine","place":["Bronx, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6403-2827","authenticated-orcid":false,"given":"Tim Q","family":"Duong","sequence":"additional","affiliation":[{"name":"Montefiore Health System and Albert Einstein College of Medicine","place":["Bronx, USA"]},{"name":"Montefiore Health System and Albert Einstein College of Medicine","place":["Bronx, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","volume-title":"StatPearls","author":"Kosaraju A","year":"2025","unstructured":"Kosaraju A, Goyal A, Grigorova Y, Makaryus AN. 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