Multimodal IMAgery Characterization of Cardiac Damage and Severity After COVID-19 Infection

Study Overview
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Brief Summary
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Coronavirus Disease 2019 (COVID-19) is an infection caused by Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), which affects multiple organ system particularly the lung and heart. Indeed, SARS CoV-2 has various cardiac manifestations which are associated with higher mortality and morbidity. Cardiac involvement, based on elevated levels of myocardial enzymes, have been described in 20 to 30% of COVID-19 infection. However, the physiopathological mechanisms of myocardial injury remains unclear. Main hypothesis include inflammation and cytokine storm, hypercoagulability and vascular thrombosis, inflammation or stress leading to coronary plaque rupture (type I myocardial infarction), supply-demand mismatch and hypoxemia resulting in myocardial damage (type II myocardial infarction) ... Two patterns can be identified : ischemic or non-ischemic pattern including myocarditis, stress induced cardiomyopathy, thrombo-embolic disease. However, the consequences of myocardial damage after confirmed COVID-19 infection are unknown at medium to long term prognosis. Data are needed to identify myocardial damage and to guide effective therapies and follow-up (use of ACE inhibitor, beta-blockers, steroids...? ) In this study, the investigators proposed to collect multimodal cardiac imaging including MRI (Magnetic Resonance Imaging) and TTE (Transthoracic echocardiogram) in order to identify and characterize cardiac injury as ischemic or non-ischemic pattern, to better assess risk stratification and to guide effective therapies if necessary.

Official Title
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Multimodal IMAgery (Echocardiography and Cardiac MRI) Characterization of Cardiac Damage and Severity After COVID-19 Infection

Conditions
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COVID-19 Virus Disease, Cardiac Complication

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cardiac involvement confirmed : increase troponin level > 50pg/ml or left ventricular dysfunction assessed by echocardiography during hospitalization for confirmed COVID-19 infection Absence of severe renal failure (CKD EPI > 30ml/min/1.73m²) Cardic imaging (MRI and TTE) performed during 4 months from COVID-19 infection Exclusion Criteria: Cardiovascular history (ischemic or valvular disease, dilated cardiomyopathy, cardiac surgery...) Vulnerable patient (pregnancy, adult under legal protection)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 79 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To Characterize cardiac involvement by cardiac TTE imaging during 4 months after confirmed COVID-19 infection | Cardiac TTE imaging is performed during 4 months after COVID-19 infection in patients with suspected cardiac involvement (increase troponin level>50ng/ml or left ventricular dysfunction during hospitalisation for COVID-19 infection) in order to determine tissular characterization, in particular the presence of ischemic or non-ischemic pattern. | 1 to 4 months after COVID 19 infection | 
| To Characterize cardiac involvement by cardiac MRI during 4 months after confirmed COVID-19 infection | Cardiac MRI is performed during 4 months after COVID-19 infection in patients with suspected cardiac involvement (increase troponin level>50ng/ml or left ventricular dysfunction during hospitalisation for COVID-19 infection) in order to determine tissular characterization, in particular the presence of ischemic or non-ischemic pattern. | 1 to 4 months after COVID 19 infection | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To characterize cardiac evolution at 12 +/-2 months from COVID-19 infection | Cardiac imaging are performed 12 +/-2 months after COVID-19 infection | 12 +/- 2 months | 
| To evaluate Cardiac events at 12 +/-2 months from COVID-19 infection | Follow-up at 12+/-2 months from COVID-19 infection : - medical consultation to collect cardiac events (heart failure, arrythmias, chest pain). | 12+/-2 months | 
| To evaluate all cause deaths at 12 +/-2 months from COVID-19 infection | Follow-up at 12+/-2 months from COVID-19 infection : - status (dead or alive) | 12+/-2 months |