Prevalence of Myocardial Scars on CMR After COVID-19 Infection

NCT ID: NCT04636320

Last Updated: 2023-03-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

231 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-13

Study Completion Date

2022-04-04

Brief Summary

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The aim of this study is to assess the prevalence and arrhythmogenic role of occult myocardial scars on Cardiac Magnetic Resonance (CMR) in a population of patients with history of laboratory-proven symptomatic COVID-19 infection managed without hospitalization, as compared to a population of age- and sex-matched healthy volunteers.

Detailed Description

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Multiple large series conducted in hospitalized patients have reported high rates of myocardial injuries in the acute stage of COVID-19 infection. These findings have raised concerns regarding potential long term consequences of the pandemic on cardiovascular diseases (heart failure and sudden cardiac deaths due to scar-related arrhythmias). However, the prevalence of silent myocardial injuries in the general population who presented a COVID-19 infection managed without hospitalization are unknown. In addition, the propensity of these scars to generate arrhythmias have not been thoroughly studied. COVID CMR will include 120 patients with history of laboratory-proven symptomatic COVID-19 infection managed without hospitalization and 120 age- and sex-matched controls. At day 1, all subjects will undergo a 12-lead electrocardiogram, a contrast-enhanced CMR study including advanced methods to detect silent myocardial scars, and a blood sample to look for markers of inflammation and cardiac injury, and to assess the COVID-19 serological status at the time of the CMR study. The prevalence of myocardial scars on CMR will be compared between the 2 groups. In a second visit at 3 months, patients showing myocardial scar on CMR will be matched to healthy volunteers showing no such scars, and these 2 population subsets will undergo exercise electrocardiogram (ECG) and 24 hour Holter ECG to characterize the arrhythmogenic role of silent myocardial scars.

Conditions

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COVID-19 Virus Disease

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Single-centre case-control study
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Patient group COVID-19

120 patients with history of laboratory-proven symptomatic COVID-19 infection managed without hospitalization

Group Type EXPERIMENTAL

Contrast-enhanced CMR

Intervention Type DEVICE

Cardiac Magnetic Resonance Imaging (MRI) examinations will be performed at Day 0 visit on clinical systems 1.5 equipped with specific antennas for cardiac imaging. The imaging protocol will last approximately 50 minutes.

Exercise test ECG

Intervention Type DIAGNOSTIC_TEST

A treadmill exercise test with 12 lead ECG monitoring will be performed at M3 visit.

Maximum expected enrollment 30 MRI+ patients and 30 healthy volunteers MRI- matched controls.

Blood sample

Intervention Type BIOLOGICAL

A blood sample will be taken at Day 0 visit for COVID-19 serology, hematocrit measurement, ultra-high sensitive troponin test, low grade markers of inflammation, genetic profiling.

An other blood sample will be taken at M3 visit for a control COVID-19 serology for 30 healthy volunteers.

Resting 12 lead ECG

Intervention Type DIAGNOSTIC_TEST

A resting 12 lead ECG will be performed at Day 0 visit.

24 hour Holter ECG

Intervention Type DIAGNOSTIC_TEST

A 24 hour Holter ECG will be performed at M3 visit. Maximum expected enrollment 30 MRI+ patients and 30 healthy volunteers MRI- matched controls.

Healthy volunteer group

120 healthy volunteers. Age- and sex-matched controls

Group Type ACTIVE_COMPARATOR

Contrast-enhanced CMR

Intervention Type DEVICE

Cardiac Magnetic Resonance Imaging (MRI) examinations will be performed at Day 0 visit on clinical systems 1.5 equipped with specific antennas for cardiac imaging. The imaging protocol will last approximately 50 minutes.

Exercise test ECG

Intervention Type DIAGNOSTIC_TEST

A treadmill exercise test with 12 lead ECG monitoring will be performed at M3 visit.

Maximum expected enrollment 30 MRI+ patients and 30 healthy volunteers MRI- matched controls.

Blood sample

Intervention Type BIOLOGICAL

A blood sample will be taken at Day 0 visit for COVID-19 serology, hematocrit measurement, ultra-high sensitive troponin test, low grade markers of inflammation, genetic profiling.

An other blood sample will be taken at M3 visit for a control COVID-19 serology for 30 healthy volunteers.

Resting 12 lead ECG

Intervention Type DIAGNOSTIC_TEST

A resting 12 lead ECG will be performed at Day 0 visit.

24 hour Holter ECG

Intervention Type DIAGNOSTIC_TEST

A 24 hour Holter ECG will be performed at M3 visit. Maximum expected enrollment 30 MRI+ patients and 30 healthy volunteers MRI- matched controls.

Interventions

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Contrast-enhanced CMR

Cardiac Magnetic Resonance Imaging (MRI) examinations will be performed at Day 0 visit on clinical systems 1.5 equipped with specific antennas for cardiac imaging. The imaging protocol will last approximately 50 minutes.

Intervention Type DEVICE

Exercise test ECG

A treadmill exercise test with 12 lead ECG monitoring will be performed at M3 visit.

Maximum expected enrollment 30 MRI+ patients and 30 healthy volunteers MRI- matched controls.

Intervention Type DIAGNOSTIC_TEST

Blood sample

A blood sample will be taken at Day 0 visit for COVID-19 serology, hematocrit measurement, ultra-high sensitive troponin test, low grade markers of inflammation, genetic profiling.

An other blood sample will be taken at M3 visit for a control COVID-19 serology for 30 healthy volunteers.

Intervention Type BIOLOGICAL

Resting 12 lead ECG

A resting 12 lead ECG will be performed at Day 0 visit.

Intervention Type DIAGNOSTIC_TEST

24 hour Holter ECG

A 24 hour Holter ECG will be performed at M3 visit. Maximum expected enrollment 30 MRI+ patients and 30 healthy volunteers MRI- matched controls.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Man or woman ≥ 18 years old
* Affiliated to a health insurance program
* Providing free, informed, written and signed consent to participate (at the latest on the day of inclusion and before any research procedure is initiated)
* Effective contraception if women in the age to procreate
* In the patient group : history of COVID-19 infection with either a positive Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test on nasopharyngeal swab or a positive COVID-19 serology in the acute stage. Presence of all following symptoms in the acute stage: fever\>38°C, asthenia, arthromyalgia, associated with at least 2 of the following: coughing and/or spitting, dyspnea and/or chest discomfort, anosmia and/or ageusia.

Exclusion Criteria

* age \< 18 years old
* History of cardiac disease or acute coronary syndrome associated with troponin rise
* History of allergic reaction to gadolinium-based contrast agents
* History of severe renal failure
* Presence of a pacemaker, implantable defibrillator, intra-orbital metallic material, intra-cranial surgical clip, valve prosthesis Star-Edwards pre 6000, neurostimulator or implantable insulin pump
* Claustrophobia or inability to lay on the back for 50 min
* Pregnant or breast feeding women
* Inability to express informed consent
* Person deprived of liberty by judicial or administrative decision
* Person under legal protection
* In the healthy volunteer group:

* Symptoms suggestive of COVID-19 infection over the epidemic period (after February 1st 2020)
* Person not willing to be informed of potential incidental CMR findings
* In the patient group:

* Hospitalization for infectious syndrome suggestive of COVID-19.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Grant Agreement ERC n°715093

UNKNOWN

Sponsor Role collaborator

University of Bordeaux

OTHER

Sponsor Role collaborator

University Hospital, Bordeaux

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hubert COCHET, MD-PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Bordeaux

Locations

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Bordeaux University Hospital

Pessac, , France

Site Status

Countries

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France

Other Identifiers

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CHUBX 2020/22

Identifier Type: -

Identifier Source: org_study_id

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