title: Cardiac injury in patients with pandemic 2009 influenza A (H1N1) infection.
abstract: BACKGROUND
  In March 2009, the novel 2009 influenza A (H1N1) was first reported in the southwest of Mexico, and rapidly spread worldwide. We investigated the clinical features of cardiovascular involvement of patients infected with the 2009 influenza A (H1N1) virus in China.
  
  
  METHODS
  This retrospective study recruited one hundred and seventy-two patients with 2009 influenza A (H1N1) of different severity (non-severe, severe, critically severe) and 21 patients who were influenza A (H1N1)-negative but who had an influenza-like illness. Blood was obtained for measurement of the concentration of creatine kinase (CK), creatine kinase-MB (CK-MB) and high sensitivity C-reactive protein (hs-CRP) in plasma. Chest radiography was also undertaken to calculate the cardiothoracic ratio (CTR).
  
  
  RESULTS
  influenza A (H1N1) caused more illness in middle-aged people. The patients in the non-severe group were younger than in the severe group (P < 0.05) and the non-influenza A (H1N1) group (P < 0.01). The level of CK, CK-MB, hs-CRP and the CTR was higher in the critically severe group than in the other three groups (P < 0.001, P < 0.05, P < 0.01, P < 0.01, respectively).
  
  
  CONCLUSIONS
  Myocardial injury was quite serious in severe infection by the influenza A (H1N1) virus, particularly in critically severe patients. Patients with 2009 influenza A (H1N1) had injury and dilation of the heart, which may be a potential cause of death.
authors: Department of Emergency, First People's Hospital of Hangzhou, Zhejiang Province, People's Republic of China.
authors: Ziying
authors: Z
authors: Ni
authors: Zhidong
authors: Z
authors: Guo
authors: Xi
authors: X
authors: Chen
authors: Qiqi
authors: Q
authors: Wang
authors: Yuangang
authors: Y
authors: Qiu
authors: Tao
authors: T
authors: Wu
authors: Yida
authors: Y
authors: Yang
authors: Lili
authors: L
authors: Zhao
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000097:blood / Q000150:complications*; D008297:Male; D058873:Pandemics; D012189:Retrospective Studies; D019210:Troponin I / Q000097:blood
chemical_list: D019210:Troponin I; D002097:C-Reactive Protein; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form