Artico, Jessica; (2025) Cardiovascular phenotyping in COVID-19: understanding disease and transforming imaging pathways. Doctoral thesis (Ph.D), UCL (University College London).

Full text not available from this repository.

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.

Type:	Thesis (Doctoral)
Qualification:	Ph.D
Title:	Cardiovascular phenotyping in COVID-19: understanding disease and transforming imaging pathways
Language:	English
UCL classification:	UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
URI:	https://discovery.ucl.ac.uk/id/eprint/10203289

Archive Staff Only

View Item