{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T01:42:07Z","timestamp":1777254127743,"version":"3.51.4"},"reference-count":17,"publisher":"Radcliffe Medical Media Ltd","license":[{"start":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T00:00:00Z","timestamp":1590537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/legalcode"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Cardiol"],"abstract":"<jats:p>Multiple lines of evidence have shown that elevated blood troponin is strongly associated with poor prognosis in patients with the novel coronavirus disease 2019 (COVID-19). Possible mechanisms of myocardial injury in COVID-19 include ischaemia due to circulatory and respiratory failure, epicardial or intramyocardial small coronary artery thrombotic obstruction due to increased coagulability, and myocarditis caused by systemic inflammation or direct binding of the virus to its receptor, angiotensin-converting enzyme-2 (ACE2), which is abundantly expressed in the heart. It is postulated that persistent immune activation upon viral infection increases the risk of developing dilated cardiomyopathy in COVID-19 patients.<\/jats:p>","DOI":"10.15420\/ecr.2020.17","type":"journal-article","created":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T10:29:25Z","timestamp":1591007365000},"source":"Crossref","is-referenced-by-count":17,"title":["Dilated Cardiomyopathy Risk in Patients with Coronavirus Disease 2019: How to Identify and Characterise it Early?"],"prefix":"10.15420","volume":"15","author":[{"given":"Maki","family":"Komiyama","sequence":"first","affiliation":[{"name":"Division of Translational Research, National Hospital Organization Kyoto Medical Center, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Division of Translational Research, National Hospital Organization Kyoto Medical Center, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Matsumori","sequence":"additional","affiliation":[{"name":"Division of Translational Research, National Hospital Organization Kyoto Medical Center, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6096","published-online":{"date-parts":[[2020,5,27]]},"reference":[{"key":"ref0","unstructured":"WHO. 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Information on COVID-19 for specific groups: the elderly, patients with chronic diseases, people with immunocompromising condition and pregnant women. https:\/\/www.ecdc.europa.eu\/en\/news-events\/information-covid-19-specific-groups-elderly-patients-chronic-diseases-people (accessed 9 May 2020)."},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Lukassen S, Chua RL, Trefzer T, et al. SARS-CoV-2 receptor ACE2 and TMPRSS2 are primarily expressed in bronchial transient secretory cells. EMBO J 2020. https:\/\/doi.org\/10.15252\/embj.20105114; PMID: 32246845; epub ahead of press.","DOI":"10.15252\/embj.20105114"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Guo T, Fan Y, Chen M, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). 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An SH-dependent reduction of its expression and myocardial injury. J Clin Invest 1993;91:2727\u201333. https:\/\/doi.org\/10.1172\/JCI116513; PMID: 8390488.","DOI":"10.1172\/jci116513"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Tanaka A, Matsumori A, Wang W, Sasayama S. An angiotensin II receptor antagonist reduces myocardial damage in an animal model of myocarditis. Circulation 1994;90:2051\u20135. https:\/\/doi.org\/10.1161\/01.cir.90.4.2051; PMID: 7923693.","DOI":"10.1161\/01.cir.90.4.2051"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020;395:1033\u20134. https:\/\/doi.org\/10.1016\/S0140-6736(20)30628-0; PMID: 32192578.","DOI":"10.1016\/s0140-6736(20)30628-0"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Yang C, Jin Z. 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