[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-436099-105":59,"doc-detail-436099-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","reply-to-to-conclude-that-bnt162b2-does-not-worsen-echocardiographic-indices-well-powered-multicenter-studies-are-required","Reply to - “To conclude that BNT162b2 does not worsen echocardiographic indices, well-powered multicenter studies are required”","","Letter to the editor provides point-by-point responses to comments on a study evaluating echocardiographic function in adolescents following BNT162b2 Pfizer-BioNTech mRNA vaccination. Authors address limitations from small sample size, explain possible reasons for observed changes in systolic function and left ventricular internal diameters, and acknowledge lack of direct myocardial damage evidence. They also discuss absence of autonomic measurements, suggest future multicenter and international research, and emphasize the need for comprehensive biochemical and autonomic assessment to confirm and extend findings.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/reply-to-to-conclude-that-bnt162b2-does-not-worsen-echocardiographic-indices-well-powered-multicenter-studies-are-required/436099/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/reply-to-to-conclude-that-bnt162b2-does-not-worsen-echocardiographic-indices-well-powered-multicenter-studies-are-required/436099.png","ImageObject",300,407,{"name":92,"@type":93},"Ezra","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"How do the authors respond to concerns about the study’s small sample size?","Question",{"text":113,"@type":114},"They acknowledge the limited sample size due to constraints from the government’s unified vaccination program and difficulties recruiting additional participants. They agree that multicenter and international collaborations are needed, and state that future larger studies will provide more definitive conclusions.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What explanations are offered for the increase in systolic function after vaccination?",{"text":118,"@type":114},"They note the steady postvaccination increase and discuss hypotheses such as enhanced self-care or a compensatory mechanism in response to subclinical myocardial stress. They also emphasize that, without concrete evidence of myocardial damage or a direct vaccination link, these interpretations remain speculative.",{"name":120,"@type":111,"acceptedAnswer":121},"Why was autonomic function not measured in the study?",{"text":122,"@type":114},"The authors state that, due to the limited time interval between participant enrollment and vaccination, they did not measure sympathetic activation markers such as urinary catecholamines or serum norepinephrine. They suggest these measurements would support a more comprehensive understanding and represent a future research direction.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},436099,1791276294,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":81,"preview_page_count":4},1099514068035,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","J Chin MedAssoc  \nLetter to the editor  \nReply to: “To conclude that BNT162b2 does not worsen echocardiographic indices, well-powered multicenter studies are required”  \nWan-Fu Hsua,b, Chih‐Hsiung Hsuc,d, Mei-Jy Jengb,e,f,*  \naDepartment of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; bInstitute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cSchool of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC; dHealth Service and Readiness Section, Armed Forces Taoyuan General Hospital, Taoyuan, Taiwan, ROC; eDepartment of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; fDepartment of Pediatrics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC  \nDEAR EDITOR,  \nWe thank Dr. Josef Finsterer and Claudia Stollberger C for the valuable comments and questions on our study named“Echocardiographic function evaluation in adolescents following BNT162b2 Pfizer-BioNTech mRNA vaccination: a preliminary prospective study” published in Journal of the Chinese Medical Association in October 2023.1 We acknowledge the concerns raised and provide the following responses to address these points.  \nSmall group size: We acknowledge the limitation of the small sample size in our study, attributed primarily to constraints imposed by the government’s unified vaccination program and challenges in recruiting additional participants for this particular investigation. We concur with the suggestion of multicenter and international collaborations to expand the cohort and enhance the robustness of our findings. Future studies with larger, more diverse populations are indeed warranted to provide more definitive conclusions.  \nExplanation of the increase in systolic function: The observed steady increase in systolic function postvaccination raises important questions. Although we hypothesized that this maybe attributable to heightened self-care postvaccination or a compensatory mechanism in response to subclinical myocardial stress, we acknowledge that without concrete evidence of myocardial damage or a direct link to vaccination, these interpretations remain speculative. The referenced study on isolated rat cardiomyocytes provides valuable insights, suggesting possible cellular mechanisms that warrant further investigation in humans.2  \nAnalysis of autonomic function: We appreciate the suggestion to include autonomic function in our analysis. Due to the limited time interval between participant enrollment and vaccination,  \n* Address correspondence. Dr. Mei-Jy Jeng, Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, 155, Section 2, Linong Street, Taipei 112, Taiwan, ROC. E-mail address: mjjeng@ [nycu.edu.tw](nycu.edu.tw) (M.-J. Jeng).  \nConflicts of interest: Dr. Mei-Jy Jeng, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2024) 87: 243.  \ndoi: 10. 1097/JCMA.0000000000001048  \nCopyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \ninfluenced by government policy during the Coronavirus Disease 2019 (COVID-19) pandemic, our study did not measure sympathetic activation levels, such as urinary catecholamines or serum norepinephrine. These measurements could indeed provide amore comprehensive understanding of the vaccine’s impact on cardiac function and represent an interesting avenue for future research.  \nExplanation of decreased Le","cbCaiv2L49dybuAr","https://ap.wps.com/l/cbCaiv2L49dybuAr","pdf",253031,"English","# Letter to the editor\n## Small group size\n## Explanation of systolic function increase\n## Analysis of autonomic function\n## Decreased LVIDs in females on day 2\n## Conflicts of interest and publication information","[{\"question\":\"How do the authors respond to concerns about the study’s small sample size?\",\"answer\":\"They acknowledge the limited sample size due to constraints from the government’s unified vaccination program and difficulties recruiting additional participants. They agree that multicenter and international collaborations are needed, and state that future larger studies will provide more definitive conclusions.\"},{\"question\":\"What explanations are offered for the increase in systolic function after vaccination?\",\"answer\":\"They note the steady postvaccination increase and discuss hypotheses such as enhanced self-care or a compensatory mechanism in response to subclinical myocardial stress. They also emphasize that, without concrete evidence of myocardial damage or a direct vaccination link, these interpretations remain speculative.\"},{\"question\":\"Why was autonomic function not measured in the study?\",\"answer\":\"The authors state that, due to the limited time interval between participant enrollment and vaccination, they did not measure sympathetic activation markers such as urinary catecholamines or serum norepinephrine. They suggest these measurements would support a more comprehensive understanding and represent a future research direction.\"}]","Reply to - “To conclude that BNT162b2 does not worsen echocardiographic indices, well-powered multicenter studies are required” | PDF",1790676788]