{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:59:49Z","timestamp":1791907189367,"version":"4.3.4"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009687","name":"Uniwersytet Medyczny Im. Piast\u00f3w Slaskich we Wroclawiu","doi-asserted-by":"publisher","award":["SUBZ.E264.23.039"],"award-info":[{"award-number":["SUBZ.E264.23.039"]}],"id":[{"id":"10.13039\/501100009687","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of the study was to compare the assessment of left ventricular ejection fraction (LVEF) performed using echocardiography, cardiac computed tomography (CCT) and cardiac magnetic resonance (CMR) in patients after SARS-CoV2 infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>The study group consisted of 108 patients (54.17 \u00b1 8.11 years, 52% women and 48% men) with a history of SARS-CoV-2 infection. In all patients, echocardiography, CCT and CMR examinations were performed based on the guidelines of scientific societies. In echocardiography, LVEF (LVEF<jats:sub>ECHO<\/jats:sub>) was determined from the apical 4-chamber and 2-chamber views, with the biplane Simpson\u2019s method. In CCT, LVEF was assessed based on the contours of the left ventricular endocardium and epicardium in multiplanar reconstructions (MPR) from the multiphase of the entire cardiac cycle, which was part of the protocol of coronary computed tomography angiography performed with retrospective ECG gating with radiation dose modulation (LVEF<jats:sub>CCT1<\/jats:sub>). Additionally, in CCT, LVEF was assessed based on the left ventricular blood pool in the above reconstructions (LVEF<jats:sub>CCT2<\/jats:sub>). For the assessment of LVEF in CMR (LVEF<jats:sub>CMR<\/jats:sub>), a standard volumetric method was used using CINE sequence images in the 2-chamber projection in the long axis and in the short axis of the left ventricle. The coefficient of variation of measurements (CV) was calculated for each pair of LVEF measurements, as well as for all LVEF measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean LVEF measurement values in the study group were 59.72% \u00b1 7.39% for LVEF<jats:sub>ECHO<\/jats:sub>, 63.36% \u00b1 9.32% for LVEF<jats:sub>CCT1<\/jats:sub>, 64.5% \u00b1 9.79% for LVEF<jats:sub>CCT2<\/jats:sub>, and 60.84% \u00b1 9.29% for LVEF<jats:sub>CMR<\/jats:sub>. LVEF<jats:sub>ECHO<\/jats:sub> was statistically significantly lower than LVEF<jats:sub>CCT1<\/jats:sub> and LVEF<jats:sub>CCT2<\/jats:sub>. LVEF<jats:sub>CMR<\/jats:sub> was also statistically significantly lower than LVEF<jats:sub>CCT1<\/jats:sub> and LVEF<jats:sub>CCT2<\/jats:sub>. CV for all LVEF measurements was 4.61% \u00b1 1.73%. When comparing pairs of LVEF measurements, the lowest CV was observed for LVEF<jats:sub>CCT1<\/jats:sub> and LVEF<jats:sub>CCT2<\/jats:sub> (2.97% \u00b1 2.64%), while the highest CV was observed for LVEF<jats:sub>ECHO<\/jats:sub> and LVEF<jats:sub>CCT2<\/jats:sub> (6.04% \u00b1 3.39%). When comparing LVEF to the gold standard of assessment, i.e., LVEF<jats:sub>CMR<\/jats:sub>, the most consistent measurements were obtained for LVEF<jats:sub>ECHO<\/jats:sub> (CV 3.00% \u00b1 2.01%), while the least consistent measurements were obtained for CCT2 (4.65% \u00b1 3.24%). A positive correlation was found between body mass index and CV of LVEF measurements (r = 0.44, p &amp;lt; 0.05), as well as between heart rate (during CCT) and CV of LVEF measurements (r = 0.37, p &amp;lt; 0.05). Furthermore, a negative correlation existed between LVEF measured by ECHO and CV of LVEF measurements in this group of patients (r = - 0.27, p &amp;lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There are statistically significant differences in left ventricular ejection fraction measurements in patients with a history of SARS-CoV-2 infection using different cardiac imaging modalities. Cardiac computed tomography overestimates LVEF compared to echocardiography and cardiac magnetic resonance imaging. Patients with abnormal body mass, suboptimal heart rate and reduced left ventricular systolic function are subgroups with increased variability of LVEF measurements in different cardiac imaging modalities.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphys.2025.1629065","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T05:41:14Z","timestamp":1758692474000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Multimodal assessment of the left ventricular ejection fraction by echocardiography, cardiac computed tomography and cardiac magnetic resonance in patients after SARS-CoV2 infection"],"prefix":"10.3389","volume":"16","author":[{"given":"Pawe\u0142","family":"Ga\u0107","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Wysocki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewelina","family":"Beck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Por\u0119ba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafa\u0142","family":"Por\u0119ba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1001\/jama.2021.0107","article-title":"Researchers investigate what COVID-19 does to the heart","volume":"325","author":"Abbasi","year":"2021","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1161\/CIRCULATIONAHA.122.060632","article-title":"Myocardial involvement after hospitalization for COVID-19 complicated by troponin elevation: a prospective, multicenter, observational study","volume":"147","author":"Artico","year":"2023","journal-title":"Circulation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"143","DOI":"10.24969\/hvt.2019.165","article-title":"Looking beyond ejection fraction: what we have in echocardiography","volume":"3","author":"Baysan","year":"2019","journal-title":"Heart, Vessels Transplant."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2177","DOI":"10.1002\/ejhf.3043","article-title":"Impact of COVID-19 in patients with heart failure with mildly reduced or preserved ejection fraction enrolled in the DELIVER trial","volume":"25","author":"Bhatt","year":"2023","journal-title":"Eur. 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