{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:11:35Z","timestamp":1753884695570,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T00:00:00Z","timestamp":1732752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiological Reports"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Usual clinical testing rarely reveals cardiac abnormalities persisting after hospitalization for COVID. Such testing may overlook residual changes causing increased adverse cardiac events post\u2010discharge. To clarify status post\u2010hospitalization, we related exercise stress echocardiography (ESE) in 15 recovering patients (RP) age 30\u201363 without myocarditis to matching published data from healthy subjects (HS). RP exercise, average duration 8.2\u2009\u00b1\u20092.2 SD, was halted by dyspnea or fatigue. RP baselines matched HS except for higher heart rate. At peak stress, RP had significantly lower mean left ventricular (LV) ejection fraction (67%\u2009\u00b1\u20097 vs. 73%\u2009\u00b1\u20095, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0017) and higher peak early mitral inflow velocity\/early mitral annular velocity (E\/e\u2019, 9.1\u2009\u00b1\u20092.5 vs. 6.6\u2009\u00b1\u20092.5, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.006) compared with HS performing equal exercise (8.5\u2009\u00b1\u20092.6\u2009min). Thus, when stressed, patients without known cardiac impairment showed diminished systolic contractile function and diastolic LV compliance vs. HS. RP peak heart rate was significantly higher (172\u2009\u00b1\u200918 vs. 153\u2009\u00b1\u200920); peak systolic blood pressure trended higher (192\u2009\u00b1\u200931 vs. 178\u2009\u00b1\u200919). Pulmonary artery systolic pressures among RP remained normal. ESE uniquely identified residual abnormality in cardiac contractile function not evident unstressed, exposing previously unrecognized residual influence of COVID\u201019. This may reflect autonomic dysfunction, microvascular disease, or diffuse interstitial changes; these results may have implications for clinical management and later prognosis.<\/jats:p>","DOI":"10.14814\/phy2.70138","type":"journal-article","created":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T11:21:03Z","timestamp":1732792863000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exercise stress echocardiography shows impaired left ventricular function after hospitalization with COVID\u201019 without overt myocarditis: A pilot study"],"prefix":"10.14814","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1780-6898","authenticated-orcid":false,"given":"Robert E.","family":"Goldstein","sequence":"first","affiliation":[{"name":"Military Cardiovascular Outcomes Research Program Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Walter Reed National Military Medical Center  Bethesda Maryland USA"},{"name":"Henry M. Jackson Foundation  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward A.","family":"Hulten","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas B.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Military Cardiovascular Outcomes Research Program Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Metis Foundation  San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria M.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Military Cardiovascular Outcomes Research Program Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Metis Foundation  San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Heroy","sequence":"additional","affiliation":[{"name":"Military Cardiovascular Outcomes Research Program Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Metis Foundation  San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika N.","family":"Walker","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiko","family":"Fox","sequence":"additional","affiliation":[{"name":"Military Cardiovascular Outcomes Research Program Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Metis Foundation  San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Military Cardiovascular Outcomes Research Program Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Metis Foundation  San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joya","family":"Libbus","sequence":"additional","affiliation":[{"name":"Military Cardiovascular Outcomes Research Program Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Metis Foundation  San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bethelhem","family":"Markos","sequence":"additional","affiliation":[{"name":"Military Cardiovascular Outcomes Research Program Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Metis Foundation  San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen N.","family":"Hood","sequence":"additional","affiliation":[{"name":"Department of Radiology Uniformed Services University of the Health Sciences  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Travis E.","family":"Harrell","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark C.","family":"Haigney","sequence":"additional","affiliation":[{"name":"Military Cardiovascular Outcomes Research Program Uniformed Services University of the Health Sciences  Bethesda Maryland USA"},{"name":"Walter Reed National Military Medical Center  Bethesda Maryland 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