Journals / Eskisehir Medical Journal / 2026 / Volume: 7 Issue: 1

Effect of COVID-19 Vaccination on Cardiac Electromechanical Functions: Electrocardiographic and Echocardiographic Evaluation in Young Healthy Individuals

COVID-19 Aşılamasının Kardiyak Elektromekanik Fonksiyonlar Üzerine Etkisi: Genç Sağlıklı Bireylerde EKG ve Ekokardiyografik Değerlendirme

Oğuz Kaya(S.B.Ü. ANTALYA EĞİTİM VE ARAŞTIRMA HASTANESİ)0000-0002-0267-5912
Şakir Arslan(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANTALYA SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI)0000-0002-2907-4957
Pages
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Publication Date
2026-02-24
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These findings support the long-term cardiac safety of the vaccine in this population.

📌 3 Key Takeaways

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Objective & Hypothesis:Introduction: The cardiac safety of BNT162b2 mRNA vaccination has been questioned due to rare reports of vaccine-associated myocarditis, particularly in young individuals.
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Key Findings & Data:This study aimed to evaluate the long-term effects of BNT162b2 mRNA vaccination on electrocardiographic repolarization parameters and echocardiographic cardiac function in young healthy adults.
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Conclusion & Impact:These findings support the long-term cardiac safety of the vaccine in this population.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:COVID-19 · mRNA vaccine · QT dispersion

Abstract

Introduction: The cardiac safety of BNT162b2 mRNA vaccination has been questioned due to rare reports of vaccine-associated myocarditis, particularly in young individuals. This study aimed to evaluate the long-term effects of BNT162b2 mRNA vaccination on electrocardiographic repolarization parameters and echocardiographic cardiac function in young healthy adults. Methods: This prospective cross-sectional study included 200 healthy individuals aged 18–45 years. Participants who had received two or three doses of BNT162b2 at least two years prior to enrollment were assigned to the vaccinated group (n=112), while unvaccinated individuals constituted the control group (n=88). Standard 12-lead electrocardiography and transthoracic echocardiography were performed. Electrocardiographic repolarization indices and diastolic function parameters were compared between groups. Given the significant sex imbalance, sex-adjusted analyses were performed using analysis of covariance. Results: P-wave dispersion (46.2 ± 6.8 vs. 45.7 ± 7.1 ms, p=0.61), QT dispersion (38.4 ± 8.9 vs. 38.1 ± 9.3 ms, p=0.86), QTc dispersion (44.9 ± 10.3 vs. 46.8 ± 11.2 ms, p=0.27), and frontal QRS–T angle (33.6 ± 25.0 vs. 30.9 ± 12.2°, p=0.78) did not differ significantly between vaccinated and unvaccinated participants. After adjustment for sex, vaccination status was not independently associated with P-wave dispersion (adjusted p=0.333) or QTc dispersion (adjusted p=0.559). Although lateral e′ velocity (13.20 ± 2.40 vs. 12.23 ± 1.57 cm/s, p=0.008) and deceleration time (203.9 ± 25.9 vs. 194.6 ± 17.9 ms, p=0.017) were higher in the vaccinated group, these differences remained within established physiological reference ranges. Left ventricular systolic function (LVEF: 64.3 ± 2.3% vs. 64.6 ± 2.5%, p=0.23) and other diastolic parameters were largely comparable between groups, with all values remaining within normal physiological reference ranges. Conclusion: In young healthy adults evaluated at least two years after vaccination, BNT162b2 mRNA vaccination was not associated with clinically meaningful long-term alterations in cardiac repolarization or diastolic function. These findings support the long-term cardiac safety of the vaccine in this population.

Özet

Giriş: BNT162b2 mRNA COVID-19 aşısının genç ve sağlıklı erişkinlerde kardiyak elektriksel ve mekanik fonksiyonlar üzerindeki etkisi tam olarak bilinmemektedir. Bu çalışma, en az iki doz BNT162b2 aşısı yapılmış bireyler ile hiç aşılanmamış sağlıklı bireylerde elektrokardiyografik repolarizasyon indeksleri ve transtorasik ekokardiyografi parametrelerinin karşılaştırılmasını amaçlamaktadır. Yöntem: Prospektif kesitsel tasarımda yürütülen çalışmaya 18–45 yaş arası 200 gönüllü dahil edildi (112 aşılı, 88 aşısız). Tüm EKG kayıtları Nihon Kohden ECG-1250K cihazı ile, ekokardiyografik incelemeler Philips EPIQ 7 cihazı ile gerçekleştirildi. P dispersiyonu, QT/QTc dispersiyonu ve frontal QRS-T açısı değerlendirildi. Ekokardiyografide LVEF, sol ventrikül çapları, mitral akım parametreleri, doku Doppler (septal/lateral e′), E/e′, IVRT, DT, LA çapı ve TAPSE ölçüldü. Bulgular: Elektrokardiyografik repolarizasyon indeksleri iki grup arasında anlamlı farklılık göstermedi. LVEF her iki grupta da normaldi. Aşılı grupta lateral e′ (p=0.008) ve DT (p=0.017) değerleri istatistiksel olarak daha yüksek saptandı; ancak tüm parametreler fizyolojik normal aralıklar içerisindeydi. Diğer tüm diyastolik fonksiyon göstergeleri benzerdi. Sonuç: BNT162b2 mRNA aşılaması genç sağlıklı bireylerde ventriküler repolarizasyon veya diyastolik fonksiyon üzerinde klinik açıdan anlamlı bir etkilenmeye yol açmamaktadır.

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Cite This Article

Kaya, O., Arslan, Ş. (2026). Effect of COVID-19 Vaccination on Cardiac Electromechanical Functions: Electrocardiographic and Echocardiographic Evaluation in Young Healthy Individuals. Eskisehir Medical Journal, Volume: 7 Issue: 1. https://doi.org/10.48176/esmj.2026.232

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References (29)

  1. Polack FP, Thomas SJ, Kitchin N, et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med. 2020 Dec 31;383(27):2603–15.
  2. Baden LR, El Sahly HM, Essink B, et al. Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. N Engl J Med. 2021 Feb 4;384(5):403–16.
  3. Barda N, Dagan N, Ben-Shlomo Y, et al. Safety of the BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting. N Engl J Med. 2021 Sept 16;385(12):1078–90.
  4. Mevorach D, Anis E, Cedar N, et al. Myocarditis after BNT162b2 mRNA Vaccine against Covid-19 in Israel. N Engl J Med. 2021 Dec 2;385(23):2140–9.
  5. Witberg G, Barda N, Hoss S, et al. Myocarditis after Covid-19 Vaccination in a Large Health Care Organization. N Engl J Med. 2021 Dec 2;385(23):2132–9.
  6. Diaz GA, Parsons GT, Gering SK, Meier AR, Hutchinson IV, Robicsek A. Myocarditis and Pericarditis After Vaccination for COVID-19. JAMA. 2021 Sept 28;326(12):1210.
  7. Gargano JW, Wallace M, Hadler SC, et al. Use of mRNA COVID-19 Vaccine After Reports of Myocarditis Among Vaccine Recipients: Update from the Advisory Committee on Immunization Practices — United States, June 2021. MMWR Morb Mortal Wkly Rep. 2021 July 9;70(27):977–82.
  8. Fronza M, Thavendiranathan P, Karur GR, et al. Cardiac MRI and Clinical Follow-up in COVID-19 Vaccine–associated Myocarditis. Radiology. 2022 Sept;304(3):E48–9.
  9. Simone A, Herald J, Chen A, et al. Acute Myocarditis Following COVID-19 mRNA Vaccination in Adults Aged 18 Years or Older. JAMA Intern Med. 2021 Dec 1;181(12):1668.
  10. Truong DT, Dionne A, Muniz JC, et al. Clinically Suspected Myocarditis Temporally Related to COVID-19 Vaccination in Adolescents and Young Adults: Suspected Myocarditis After COVID-19 Vaccination. Circulation. 2022 Feb;145(5):345–56.
  11. Malik M, Batchvarov VN. Measurement, interpretation and clinical potential of QT dispersion. J Am Coll Cardiol. 2000 Nov;36(6):1749–66.
  12. Brown RA, Schlegel TT. Diagnostic utility of the spatial versus individual planar QRS-T angles in cardiac disease detection. J Electrocardiol. 2011 July;44(4):404–9.
  13. Rautaharju PM, Surawicz B, Gettes LS. AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part IV: The ST Segment, T and U Waves, and the QT Interval: A Scientific Statement From the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: Endorsed by the International Society for Computerized Electrocardiology. Circulation [Internet]. 2009 Mar 17 [cited 2026 Jan 9];119(10). Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.108.191096
  14. Lanza GA, De Vita A, Ravenna SE, et al. Electrocardiographic findings at presentation and clinical outcome in patients with SARS-CoV-2 infection. EP Eur. 2021 Jan 27;23(1):123–9.
  15. Bhatla A, Mayer MM, Adusumalli S, et al. COVID-19 and cardiac arrhythmias. Heart Rhythm. 2020 Sept;17(9):1439–44.
  16. Carpenter A, Chambers OJ, El Harchi A, et al. COVID-19 Management and Arrhythmia: Risks and Challenges for Clinicians Treating Patients Affected by SARS-CoV-2. Front Cardiovasc Med. 2020 May 5;7:85.
  17. Szekely Y, Lichter Y, Taieb P, et al. Spectrum of Cardiac Manifestations in COVID-19: A Systematic Echocardiographic Study. Circulation. 2020 July 28;142(4):342–53.
  18. Sud K, Vogel B, Bohra C, et al. Echocardiographic Findings in Patients with COVID-19 with Significant Myocardial Injury. J Am Soc Echocardiogr. 2020 Aug;33(8):1054–5.
  19. Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016 Apr;29(4):277–314.
  20. Kuznetsova T, Thijs L, Knez J, et al. Longitudinal Changes in Left Ventricular Diastolic Function in a General Population. Circ Cardiovasc Imaging. 2015 Apr;8(4):e002882.
  21. Redfield MM, Jacobsen SJ, Burnett JC, Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of Systolic and Diastolic Ventricular Dysfunction in the Community: Appreciating the Scope of the Heart Failure Epidemic. JAMA. 2003 Jan 8;289(2):194.
  22. Kaya OK, Dagli N, Yildiz M, et al. The Effect of Acute Allergic Reactions on Diastolic Heart Function. Clin Invest Med. 2014 Apr 1;37(2):E70–6.
  23. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015 Jan;28(1):1-39.e14.
  24. Okura H, Takada Y, Yamabe A, et al. Age- and Gender-Specific Changes in the Left Ventricular Relaxation: A Doppler Echocardiographic Study in Healthy Individuals. Circ Cardiovasc Imaging. 2009 Jan;2(1):41–6.
  25. Shim CY, Park S, Choi D, et al. Sex Differences in Central Hemodynamics and Their Relationship to Left Ventricular Diastolic Function. J Am Coll Cardiol. 2011 Mar;57(10):1226–33.
  26. Hsu WF, Hsu CH, Jeng MJ. Echocardiographic function evaluation in adolescents following BNT162b2 Pfizer-BioNTech mRNA vaccination: A preliminary prospective study. J Chin Med Assoc. 2024 Jan;87(1):88–93.
  27. Karimi R, Norozirad M, Esmaeili F, Mansourian M, Marateb HR. COVID-19 Vaccination and Cardiovascular Events: A Systematic Review and Bayesian Multivariate Meta-Analysis of Preventive Benefits and Risks. Int J Prev Med [Internet]. 2025 Mar [cited 2026 Jan 9];16. Available from: https://journals.lww.com/10.4103/ijpvm.ijpvm_260_24
  28. Hala Ahmed Mohamed Ahmed Wahdan, Reda Biomy Bastwisy, Wael Anwer Haseeb. Echocardiographic assessment of left ventricular function after COVID-19 vaccination in adults. J Pak Med Assoc. 2023 May 25;73(4):S238–41.
  29. Küp A, Çelik M, Uslu A, vd. Is there any effect of COVID-19 mRNA vaccination on electrocardiographic parameters in patients without apparent cardiovascular disease? Troia Med J. 2022;3(3):96-9.