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Background In March 2009, novel 2009 influenza A (H1N1) was first reported in the southwest 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 It was a retrospective study.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 were recruited.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 those 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 with2009 influenza A (H 1N 1) had injury and dilation of the heart, which may be a potential cause of death.