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.
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)
Laura FILIPPETTI
Vandœuvre-lès-Nancy, France
Laura FILIPPETTI, MD, Principal Investigator
CHRU NANCY