Join the nationwide study into myocardial damage after COVID-19

What is the frequency and what are the consequences of myocardial damage in COVID-19 and what can we do to prevent short and long-term damage? That is the central question for the DEFENCE project that is funded by ZonMw. The researchers are calling on their colleagues at clinical centers to participate in the study.

Defence combines several ongoing studies on children, athletes and adults. Preventing myocard damage is one of the knowledge gaps about COVID-19 that the Federation of Medical Specialists (FMS) has included in its knowledge agenda. The project will run for two years.

Ongoing studies
DEFENCE brings together a number of large ongoing studies, both within and outside the DCVA. The aim is to gain insight into the prevention and consequences of myocardial damage across the entire spectrum of COVID-19 patients. This concerns, for example, healthy professional athletes who have experienced a SARS-CoV-2 infection, patients in the general population who have recovered from the infection at home and adults and children who have been hospitalized because of COVID-19 or Multisystem Inflammatory Syndrome (MIS- C).

Standardized heart examinations and questionnaires
The participating patients undergo standardized examinations: blood tests, echocardiography and an MRI scans of the heart. The researchers will harmonize the imaging protocols among themselves; the images will be assessed centrally. To gain insight into the occurrence of Major Adverse Cardiovascular Adverse Events (MACE) and to relate this to the incidence of MACE in other infectious diseases such as influenza, data will be linked to external data sources. In addition, patients from the various cohorts will receive questionnaires about symptoms and well-being, which will be linked to the clinical findings.

Expansion of CAPACITY projects
The funding from DEFENCE will further expand the CAPACITY projects. DEFENCE enriches the CAPACITY 2 study with an MRI substudy. In addition, patients in the CAPACITY-COVID registry will again be approached for cardiac follow-up and research via questionnaires in collaboration with the EuroQol Research Foundation. This is performed according to the guidelines in the NVVC's recommendation Early detection of cardiac damage in COVID-19. In addition, the FAIR data conditions apply, which means that other scientists can also use the collected data.

Interested in participating?
There is still room for entry into CAPACITY-2, with or without the MRI substudy. Perhaps your center has already participated in the CAPACITY-COVID registration and you wish to participate in the follow-up of these patients. In all cases, you can contact Folkert Asselbergs ( and Marijke Linschoten (

Project team
The DEFENCE project team consists of the following members:
• Prof. dr. Dr Folkert W. Asselbergs, professor of cardiology at UMC Utrecht and pillar chair of Data Infrastructure DCVA
• Drs. Marijke Linschoten, physician-researcher at the UMC Utrecht Cardiology Department
• dr. Harald Jorstad, sports cardiologist Amsterdam UMC
• dr. Chahinda Ghossein, AIOS cardiology Maastricht UMC
• Em. Prof. Dr. Gouke Bonsel, epidemiologist Erasmus MC
• Drs. Astrid Schut, Managing Director Working Group Cardiological Centers Netherlands (WCN)
• dr. Maarten van Smeden, statistician Julius Centrum
• dr. Robert Tieleman, cardiologist Martini Hospital and pillar chair of DCVA implementation
• Prof. dr. Dr. Frans Rutten, professor of general practice at the Julius Center
• Prof. dr. Wiek van Gilst, director DCVA
• dr. Inge Schalkers, Harteraad

In addition to ZonMw, this research was made possible by the efforts of WCN, NLHI, NHR, Hartstichting, NVVC, NVIC, Harteraad and EuroQol Research Foundation, brought together by the Dutch CardioVascular Alliance (DCVA), a combination of forces of a total of nineteen research and care organizations. They work closely together and raise money to accelerate solutions for cardiovascular diseases.

To the article of ZonMw

To the article of FMS