Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 04 29 1485 1485 Meysam Ghorbanpour Department of Anesthesiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran. Naghmh Ziaie Department of Cardiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran. Shahram Seyfi Department of Anesthesiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran. Roghieh Pourkia Department of Cardiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran. Parviz Amri Maleh Department of Anesthesiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran. 2025 11 14 2025 12 01 Background: Non-invasive ventilation (NIV) is widely used to treat chronic obstructive pulmonary disease and heart failure. This study investigated its effects on cardiac function in patients with acute respiratory failure due to COVID-19. Methods: In this observational cross-sectional study, patients admitted to the ICU of Ayatollah Rouhani Hospital, Babol, who required NIV were evaluated. Heart rate, respiratory rate, arterial blood gas parameters (PaO2, pH, lactate), and echocardiographic indices, including the left ventricular ejection fraction (LVEF), E, tricuspid annular plane systolic excursion (TAPSE), and inferior vena cava diameter (IVCD), were recorded before and 15 minutes after NIV initiation. Data were analyzed using SPSS. Results: 34 patients, 15 (44.1%) men and 19 (55.9%) women, were studied. Their average age was 60.4 ± 12.8 years. NIV significantly improved heart rate, respiratory rate, oxygenation, pH, and lactate levels. Echocardiographic parameters E and TAPSE improved significantly, and IVCD increased compared to baseline. Conclusion: NIV rapidly improves both respiratory and cardiac function in patients with acute respiratory failure due to COVID-19, serving as a potential alternative to invasive ventilation in selected cases. https://aacc.tums.ac.ir/index.php/aacc/article/view/1485