eprintid: 10203289
rev_number: 13
eprint_status: archive
userid: 699
dir: disk0/10/20/32/89
datestamp: 2025-02-27 09:31:14
lastmod: 2025-02-27 09:31:14
status_changed: 2025-02-27 09:31:14
type: thesis
metadata_visibility: show
sword_depositor: 699
creators_name: Artico, Jessica
title: Cardiovascular phenotyping in COVID-19: understanding disease and transforming imaging pathways
ispublished: unpub
divisions: UCL
divisions: B02
divisions: D14
abstract: The Covid-19 pandemic caused millions of deaths and hospitalisations worldwide. SARS-CoV2 has been proven to affect multiple organs. Early studies suggested significant cardiac involvement with COVID 19 with suspected myocarditis. However, subsequent studies produced contrasting results and the cardiovascular implications of COVID 19 were unclear. During my PhD I worked in 3 domains:
1. Mild COVID: I investigated in an unbiased way the cardiovascular effects of COVID-19 in patients with prior (at 6 months) mild, non-hospitalised disease, using Cardiovascular Magnetic Resonance (CMR) I demonstrated that any long-lasting impact on myocardial structure, function and tissue characterisation is either non-existent or rare.
2. Severe Troponin Positive COVID:
Convalescence: I studied the cardiovascular effects of COVID-19 in hospitalised patients with severe disease (troponin+), in a large, multi-centre prospective longitudinal CMR dataset (COVID-Heart – an Urgent Public Health Study) and demonstrated that patients with severe Covid-19 infection have more ventricular impairment and myocardial scar. However, scar pathogenesis is diverse, with a low prevalence of myocarditis but a newly described pattern of microinfarction (likely thrombotic).
Interval change: I demonstrated that at 6 months, acute myocardial injury and tissue changes largely resolve and are non-progressive. At 12-months, patients had a low incidence of major adverse cardiovascular events, demonstrated good cardiac function without further inflammatory change, and reported improved quality of life.
3. Service Impact and recovery: I developed new CMR protocols that improved the services and reduced post-COVID diagnostic delays using accelerated “rapid CMR” protocols in two particular patients’ cohorts: i) patients with possible ischaemia (focus on adenosine perfusion) where rapid perfusion protocols performed in a mean time of 22 minutes with dynamic booking slot increase of +3scans/day, and ii)cardio-oncology patients (no stress, focus on ejection fraction and tissue characterisation) where scans using the new rapid protocol could be completed within 13 minutes.
date: 2025-01-28
date_type: published
thesis_class: doctoral_md_only
thesis_award: Ph.D
language: eng
verified: verified_manual
elements_id: 2352419
lyricists_name: Artico, Jessica
lyricists_id: JARTI49
actors_name: Artico, Jessica
actors_name: Allington-Smith, Dominic
actors_id: JARTI49
actors_id: DAALL44
actors_role: owner
actors_role: impersonator
full_text_status: none
pages: 195
institution: UCL (University College London)
department: Institute of Cardiovascular Science
thesis_type: Doctoral
citation:        Artico, Jessica;      (2025)    Cardiovascular phenotyping in COVID-19: understanding disease and transforming imaging pathways.                   Doctoral thesis  (Ph.D), UCL (University College London).