{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:42:47Z","timestamp":1786725767861,"version":"build-2736575974"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context:<\/jats:title>\n                    <jats:p>Subclinical myocardial dysfunction may follow mild COVID-19, highlighting the importance of early detection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>To evaluate cardiac involvement in recently recovered COVID-19 patients using two-dimensional speckle-tracking echocardiography (2D-STE) and four-dimensional-transthoracic echocardiography (4D-TTE), comparing symptomatic and asymptomatic groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings and Design:<\/jats:title>\n                    <jats:p>This study involves a prospective observational cohort study at a tertiary cardiac center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods:<\/jats:title>\n                    <jats:p>Ninety-four adults (mean age 37 \u00b1 7.5 years) post-COVID-19 recovery underwent echocardiographic evaluation at 1 and 3 months. Assessments included left and right ventricular (RV) function, myocardial strain using 2D STE, and left ventricular volumes and ejection fraction using 4D TTE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Analysis:<\/jats:title>\n                    <jats:p>\n                      Paired and independent\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests were applied, with statistical significance set at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Statistically significant improvement was observed over time. Left ventricular end-diastolic volume decreased from 89.3 ml to 84.7 ml, left ventricular end-systolic volume from 31.9 ml to 29.4 ml, left ventricular ejection fraction (LVEF) increased from 64.8% to 66.0%, and left ventricular-global longitudinal strain improved from \u221223.8% to \u221224.7% (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). 4D-TTE confirmed parallel reductions in left ventricular volumes and an LVEF increase from 62.8% to 64.5% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2264 0.002). RV functional parameters improved, RV end-systolic area (6.19 cm\u22125.71 cm), RV-fractional area change (52.1%\u201354.4%), and RV-longitudinal strain (\u221226.5% to \u221227.9%) (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Symptomatic patients had lower LVEF at baseline (63.4% vs. 65.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004) and follow-up (64.3% vs. 66.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.032); these findings should be interpreted cautiously due to the limited subgroup size.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Mild or asymptomatic COVID-19 infections may cause temporary cardiac dysfunction. 2D-STE and 4D-TTE are sensitive tools for early detecting subclinical myocardial involvement and guiding follow-up care.<\/jats:p>\n                  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