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We hypothesized that clinical dengue virus (DENV) infection could induce myocardial alterations of the left ventricle (LV) and that these changes could be detected by transthoracic echocardiography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology\/Principal findings<\/jats:title>\n                    <jats:p>We examined individuals from Acre in the Amazon Basin of Brazil in 2020 as part of the Malaria Heart Study. By questionnaires we collected information on self-reported prior dengue infection. All individuals underwent transthoracic echocardiography, analysis of left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). We included 521 persons (mean age 40\u00b115 years, 39% men, 50% urban areas) of which 253 (49%) had a history of dengue infection. In multivariable models adjusted for clinical and sociodemographic data, a history of self-reported dengue was significantly associated with lower LVEF (\u03b2 = -2.37, P &lt; 0.01) and lower GLS (\u03b2 = 1.08, P &lt; 0.01) in men, whereas no significant associations were found in women (P &gt; 0.05). In line with these findings, men with a history of dengue had higher rates of LV systolic dysfunction (LVEF &lt; 50% = 20%; GLS &lt; 16% = 17%) than those without a history of dengue (LVEF &lt; 50% = 7%; GLS &lt; 16% = 8%; P &lt; 0.01 and 0.06, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions\/Significance<\/jats:title>\n                    <jats:p>The findings of this study suggest that a clinical infection by dengue virus could induce myocardial alterations, mainly in men and in the LV, which could be detected by conventional transthoracic echocardiography. Hence, these results highlight a potential role of echocardiography for screening LV dysfunction in participants with a history of dengue infection. Further larger studies are warranted to validate the findings of this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0276725","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T13:29:20Z","timestamp":1668778160000},"page":"e0276725","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Potential role of transthoracic echocardiography for screening LV systolic dysfunction in patients with a history of dengue infection. A cross-sectional and cohort study and review of the literature"],"prefix":"10.1371","volume":"17","author":[{"given":"Molly D.","family":"Kaagaard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alma","family":"Wegener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7161-0098","authenticated-orcid":true,"given":"Laura C.","family":"Gomes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna E.","family":"Holm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karine O.","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luan O.","family":"Matos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle V. M.","family":"Vieira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo Medeiros","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasse S.","family":"Vestergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio Romero Farias","family":"Marinho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1309-5366","authenticated-orcid":true,"given":"Fl\u00e1via Barreto","family":"Dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tor","family":"Biering-S\u00f8rensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odilson M.","family":"Silvestre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6880-0424","authenticated-orcid":true,"given":"Philip","family":"Brainin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"key":"pone.0276725.ref001","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1038\/nature12060","article-title":"The global distribution and burden of dengue","volume":"496","author":"Samir Bhatt","year":"2013","journal-title":"Nature"},{"key":"pone.0276725.ref002","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1056\/NEJMra1110265","volume":"366","author":"PC Simmons","year":"2012","journal-title":"N Engl J Med"},{"key":"pone.0276725.ref003","first-page":"1","article-title":"Monitoramento dos casos de Arboviroses urbanas transmitidas pelo Aedes (dengue, chikungunya e Zika).","volume":"50","author":"Secretaria de Vigil\u00e2ncia em Sa\u00fade","year":"2019","journal-title":"Bol Epidemiol\u00f3gico Arboviroses"},{"key":"pone.0276725.ref004","article-title":"Review Article Dengue and the heart","author":"D Araiza-Garaygordobil","year":"2021","journal-title":"Cardiovasc J Afr"},{"key":"pone.0276725.ref005","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.ihj.2013.04.017","article-title":"Left ventricular myocardial performance in patients with dengue hemorrhagic fever and thrombocytopenia as assessed by two-dimensional speckle tracking echocardiography","volume":"65","author":"SP Sengupta","year":"2013","journal-title":"Indian Heart J"},{"key":"pone.0276725.ref006","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1097\/CCM.0b013e318232d966","article-title":"Cardiac function in Vietnamese patients with different dengue severity grades","volume":"40","author":"S Yacoub","year":"2012","journal-title":"Crit Care Med"},{"key":"pone.0276725.ref007","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.eimce.2020.02.014","article-title":"Cardiovascular disorders in hospitalized patients with dengue infection","volume":"39","author":"JO Cabrera-Rego","year":"2021","journal-title":"Enfermedades Infecc y Microbiol Clin (English ed)"},{"key":"pone.0276725.ref008","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1017\/S0950268816002004","article-title":"Influence of demographics on clinical outcome of dengue: A cross-sectional study of 6703 confirmed cases in Vit\u00f3ria, Esp\u00edrito Santo State, Brazil","volume":"145","author":"CR Vicente","year":"2017","journal-title":"Epidemiol Infect"},{"key":"pone.0276725.ref009","first-page":"1","article-title":"Monitoramento dos casos de arboviroses urbanas causados por v\u00edrus transmitidos por Aedes (dengue, chikungunya e zika), semanas epidemiol\u00f3gicas 1 a 53, 2020","volume":"52","author":"Minist\u00e9rio da Sa\u00fade","year":"2021","journal-title":"Bol Epidemiol\u00f3gico"},{"key":"pone.0276725.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0228346","article-title":"Spatial and temporal distribution of dengue in Brazil, 1990\u20132017","volume":"15","author":"D Andrioli","year":"2020","journal-title":"PLoS One"},{"key":"pone.0276725.ref011","first-page":"1","article-title":"The Challenges Imposed by Dengue, Zika, and Chikungunya to Brazil","volume":"9","author":"P Marinho","year":"2018","journal-title":"Front Immunol"},{"key":"pone.0276725.ref012","author":"Panamerican Health Organization","year":"2016","journal-title":"Report on the Situation of Malaria in the Americas, 2000\u20132015"},{"key":"pone.0276725.ref013","unstructured":"Minas. 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