Manganese-Enhanced Magnetic Resonance Imaging of MyOcardial injuRY in COVID 19 (COVID-19) (MEMORY-COVID)
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ClinicalTrials.gov Identifier: NCT04625075 |
Recruitment Status :
Active, not recruiting
First Posted : November 12, 2020
Last Update Posted : September 29, 2021
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Our understanding of the clinical manifestations of COVID-19 is growing on a daily basis and there is evidence that increased age, cardiovascular risk factors and cardiac comorbidity are strongly associated with poor outcomes. Furthermore, myocardial injury occurs and is associated with a much worse outcome and rapid increase in mortality. There have been several reports of myocarditis and heart failure following infection. The mechanisms of myocardial injury and its consequences are not well understood.
In an ongoing peer-reviewed and funded study, the investigators are evaluating the use of magnetic resonance imaging (MRI) to characterise and to understand the mechanisms of heart failure and myocarditis. Following strong encouragement by the British Heart Foundation, the investigators now propose to extend this investigation to patients who have recovered from COVID-19 infection to understand the mechanisms of myocardial injury that they have experienced. Using gadolinium and manganese-enhanced MRI combined with Computed tomography coronary angiography (CTCA), the investigators will assess the mechanisms and direct impact of myocardial injury in patients who have recovered from COVID-19 infection. This will help the investigators understand how best to manage individuals who demonstrate evidence of myocardial injury and potentially provide insights that could lead to novel treatment interventions to reduce such injury and improve patient outcomes.
Condition or disease | Intervention/treatment |
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Covid19 | Diagnostic Test: Cardiac MRI Diagnostic Test: Cardiac CT Diagnostic Test: Electrocardiogram (ECG) Diagnostic Test: Blood samples |

Study Type : | Observational |
Estimated Enrollment : | 40 participants |
Observational Model: | Case-Control |
Time Perspective: | Retrospective |
Official Title: | Manganese-Enhanced Magnetic Resonance Imaging of MyOcardial injuRY in COVID 19 (MEMORY- COVID) |
Actual Study Start Date : | June 10, 2020 |
Actual Primary Completion Date : | June 10, 2021 |
Estimated Study Completion Date : | June 10, 2022 |

Group/Cohort | Intervention/treatment |
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Healthy Volunteer
Age and sex matched healthy volunteer
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Diagnostic Test: Cardiac MRI
Cardiac MRI with gadolinium and manganese contrast Diagnostic Test: Electrocardiogram (ECG) ECG to assess rhythm Diagnostic Test: Blood samples renal function liver function full blood count, hematocrit glucose |
COVID-19 with myocardial injury
Patients hospitalised with severe COVID-19 infection and evidence of myocardial. Involvement: elevation of plasma cardiac troponin concentration (>99th centile of the upper reference limit), abnormalities on electrocardiography or abnormal echocardiography. Some patients will have suspected myocarditis or takotsubo cardiomyopathy. We will identify subgroups of interest who have left/right ventricular systolic dysfunction ± regional wall motion abnormalities, on echocardiography.
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Diagnostic Test: Cardiac MRI
Cardiac MRI with gadolinium and manganese contrast Diagnostic Test: Cardiac CT Cardiac CT to assess coronaries Diagnostic Test: Electrocardiogram (ECG) ECG to assess rhythm Diagnostic Test: Blood samples renal function liver function full blood count, hematocrit glucose |
COVID-19 without myocardial injury
Patients hospitalised with severe COVID-19 infection but without known elevation of plasma cardiac troponin concentration, clinically significant ECG abnormalities or an abnormal echocardiogram.
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Diagnostic Test: Cardiac MRI
Cardiac MRI with gadolinium and manganese contrast Diagnostic Test: Cardiac CT Cardiac CT to assess coronaries Diagnostic Test: Electrocardiogram (ECG) ECG to assess rhythm Diagnostic Test: Blood samples renal function liver function full blood count, hematocrit glucose |
- MRI with gadolinium [ Time Frame: 2 years ]Measure late gadolinium enhancement
- Extra-cellular volume (ECV) [ Time Frame: 2 years ]Measure T1 values to calculate ECV (%)
- Manganese MRI [ Time Frame: 2 years ]Measure manganese uptake
- CTCA [ Time Frame: 2 years ]Measure degree of coronary disease
- Cardiac biomarkers [ Time Frame: 2 years ]measure troponin profile in patients
- Electrocardiogram [ Time Frame: 2 years ]ECG Rhythm
- Electrocardiogram [ Time Frame: 2 years ]ECG ST segment
- Electrocardiogram [ Time Frame: 2 years ]ECG Rate
- Electrocardiogram [ Time Frame: 2 years ]ECG T wave morphology
- Electrocardiogram [ Time Frame: 2 years ]ECG QT interval

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | Yes |
Sampling Method: | Probability Sample |
Patient cohort:
Patients admitted to hospital with COVID-19 with and without myocardial injury
Healthy volunteer:
Age and sex matched healthy control with no evidence/symptoms of COVID-19
Inclusion Criteria:
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All subjects to be entered must:
- ≥ 18 years of age
- if female, be non-pregnant as evidenced by a urine pregnancy test or postmenopausal or surgically sterile
- provide written informed consent after having received oral and written information about the study
Exclusion Criteria:
have a positive pregnancy test
- women who are breast feeding
- have a history of ongoing drug abuse or alcoholism
- have a history of torsades or prolonged QT/QT corrected interval
- high degree atrioventricular block (AVB, second or third degree)
- atrial fibrillation or flutter
- have New York Heart Failure Association (NYHA) Grade IV heart failure
- have abnormal liver function tests (> x3 ULN) or a history of liver disease
- have a baseline estimated glomerular filtration rate (eGFR) (of <30 mL/min/1.73 m2)
- have uncontrolled hypertension (systolic blood pressure >200 mmHg)
- have any contraindications to MRI, including implanted devices/pacemakers
- be maintained on either a calcium channel blocker or digoxin
- known diagnosis of pheochromocytoma

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04625075
United Kingdom | |
University of Edinburgh | |
Edinburgh, Scotland, United Kingdom, EH146SB |
Responsible Party: | University of Edinburgh |
ClinicalTrials.gov Identifier: | NCT04625075 |
Other Study ID Numbers: |
20/NW/0249 |
First Posted: | November 12, 2020 Key Record Dates |
Last Update Posted: | September 29, 2021 |
Last Verified: | September 2021 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Plan Description: | Individual patient data will not be directly shared with other researchers. Anonymised MRI data will be shared with Leeds university for a central MRI database of all COVID-19 patients. |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
COVID-19 Respiratory Tract Infections Infections Pneumonia, Viral Pneumonia Virus Diseases |
Coronavirus Infections Coronaviridae Infections Nidovirales Infections RNA Virus Infections Lung Diseases Respiratory Tract Diseases |