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CMR Findings in COVID-19 Patients Presenting With Myocardial Infarction

18. juli 2022 opdateret af: Mohamed Ahmed Abdallah Hamada, Assiut University
To compare myocardial injury in COVID 19 patients presented with myocardial infarction and non COVID Patients presented with myocardial infarction evaluated with CMR

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Coronavirus disease 2019 (COVID-19) is a global pandemic affecting 185 countries and >3 000 000 patients worldwide as of April 28, 2020. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2,. Among patients with COVID-19, there is a high prevalence of cardiovascular disease, and >7% of patients experience myocardial injury from the infection (22% of critically ill patients). Although angiotensin-converting enzyme 2 serves as the portal for infection, the role of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers requires further investigation.

However, much like any other respiratory tract infection, pre-existing cardiovascular disease (CVD) and CV risk factors enhance vulnerability to COVID-19. Further, COVID-19 can worsen underly- ing CVD and even precipitate de novo cardiac complications.

Preliminary reports suggest that haemostatic abnormalities, including disseminated intravascular coagulation (DIC), occur in patients affected by COVID-19. Additionally, the severe inflammatory response, critical illness, and underlying traditional risk factors may all predispose to thrombotic events, similar to prior virulent zoonotic coronavirus outbreaks CMR is the reference non-invasive standard for cardiac function and tissue characterization and may offer an effective and efficient diagnostic imaging choice to obtain critical information for clinical decision-making.

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

60

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 80 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Included patients will be randomly divided in a 1:1 pattern into two groups. The 1st group are COVID 19 patients and the 2nd group are non COVID 19 patients as a control.

All patients will be subjected to:

A. Full history taking: including age, sex, history of DM, HTN, Smoking, dyslipidemia, symptoms of COVID 19 infection, chest pain analysis.

B. Thorough physical examination:

  • General examination including Systolic and diastolic blood pressure, heart rate assessment and O2 Saturation
  • Cardiac examination C. Twelve lead ECG: to search for STEMI criteria according to ECS guidelines of STEMI 2017.5 D. lab investigation: Cardiac enzymes, Renal function, Liver function, CBC, CRP, Lipid profile, RBG, Serum ferritin, ESR, D-Dimer, PCR.

E.MSCT chest: to detect finding suggestive of COVID 19 infection.

F.CMR:

Beskrivelse

Inclusion Criteria:

  1. Patients presenting with symptoms and ECG indicative of acute MI (both STEMI & NSTEMI) AND confirmed COVID-19.
  2. Patients admitted with acute MI (both STEMI & NSTEMI) who develop COVID-19 symptoms during hospital admission & are confirmed by RT-PCR to have COVID-19

Exclusion Criteria:

  1. History of previous diagnosis of STEMI or myocarditis.
  2. History of previous PCI in infarcted related artery or NSTEMI
  3. Severe respiratory distress that precludes lying supine in the CMR scanner.
  4. Acute kidney injury with rapidly declining GFR or GFR that is persistently below 30 ml/min/1.73 m2 (contraindication for Gadopentetate dimeglumine contrast).

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: Kohorte
  • Tidsperspektiver: Tværsnit

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
COVID-19 patients presented with myocardial infarction
Stråling: cardiac magnetic resonance

o CMR protocol:

  • Cine imaging to assess regional & global ventricular function according to the AHA 16-segment model.
  • T2-weighted imaging to detect extent & distribution of myocardial edema.
  • Early Gd enhancement imaging to detect extent & distribution of myocardial hyperemia.
  • Late Gd enhancement imaging to detect extent & distribution of myocardial necrosis.
  • Single-short sequences & other acceleration techniques will be used as appropriate in patients with poor ability to hold their breath.
  • Post-processing analysis will be done on a dedicated workstation
Non-COVID-19 patients presented with myocardial infarction
Stråling: cardiac magnetic resonance

o CMR protocol:

  • Cine imaging to assess regional & global ventricular function according to the AHA 16-segment model.
  • T2-weighted imaging to detect extent & distribution of myocardial edema.
  • Early Gd enhancement imaging to detect extent & distribution of myocardial hyperemia.
  • Late Gd enhancement imaging to detect extent & distribution of myocardial necrosis.
  • Single-short sequences & other acceleration techniques will be used as appropriate in patients with poor ability to hold their breath.
  • Post-processing analysis will be done on a dedicated workstation

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
comparison between COVID-19 and COVID-19 presented with myocardial infarction
Tidsramme: baseline
Distribution and Extent of myocardial injury in COVID 19 patients presented with myocardial infarction and non COVID Patients presented with myocardial infarction evaluated with CMR.
baseline

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Assiut University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. januar 2021

Primær færdiggørelse (Forventet)

1. oktober 2022

Studieafslutning (Forventet)

1. oktober 2023

Datoer for studieregistrering

Først indsendt

12. november 2020

Først indsendt, der opfyldte QC-kriterier

12. november 2020

Først opslået (Faktiske)

13. november 2020

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

20. juli 2022

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

18. juli 2022

Sidst verificeret

1. juli 2022

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • CMR in myocardial infarction

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Myokardieinfarkt

Kliniske forsøg med cardiac magnetic resonance

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Sponsorer og samarbejdspartnere

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Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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