How Can Novel Imaging Improve Clinical Outcomes in Systemic Inflammatory Diseases?

The integrated application of novel multimodality imaging techniques may improve diagnostic precision for the screening and monitoring of disease activity for patients with systemic inflammatory diseases (SIDs), according to a JACC Scientific Statement published Nov. 20 in JACC.

Brittany N. Weber, MD, PhD, FACC, et al., note that common immune-mediated SIDs, which include systemic inflammatory arthritis, systemic lupus erythematosus, systemic vasculitis, idiopathic inflammatory myopathies, systemic sclerosis and cardiac sarcoidosis, are commonly associated with adverse cardiovascular manifestations. They write that, “Integrated multimodality imaging can improve screening, detection and serial monitoring of cardiac function in patients with [SIDs],” and this can assist in preclinical studies, enhance patient selection and provide surrogate endpoints for clinical trials, ultimately improving patient outcomes.

The authors provide an overview of these SIDs and their most common cardiovascular manifestations, provide a clinical imaging framework for SIDs, along with a review of novel and emerging imaging techniques that may improve clinical outcomes.

They also discuss 2D echocardiography as an essential clinical imaging framework component for SIDs as well as several emerging imaging techniques, including coronary computed tomography (CT) and fat attenuation index; CT perfusion; myocardial contrast echocardiography; cardiac MRI and 4D flow; and PET and molecular imaging.

The authors note that each imaging technique offers strengths and limitations, and that making the choice is based on the specific question, clinical presentation, and the expertise and resources available.

“Ultimately, the further refinement and advancement of these existing technologies have the potential to understand the biology of inflammation at an individual level and guide precision-based personalized medicine. Ongoing research and collaboration between imaging specialists and clinical cardio-rheumatology experts are crucial to continue advancing these technologies and translating them into clinical benefits for patients with SIDs,” they write.

Clinical Topics: Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Vascular Medicine, Interventions and Imaging, Interventions and Vascular Medicine, Computed Tomography, Echocardiography/Ultrasound, Magnetic Resonance Imaging, Nuclear Imaging

Keywords: Rheumatology, Inflammation, Tomography, X-Ray Computed, Magnetic Resonance Imaging, Echocardiography, Sarcoidosis, Lupus Erythematosus, Systemic, Scleroderma, Systemic, Arthritis, Myositis, Systemic Vasculitis, Positron Emission Tomography Computed Tomography, Biomarkers, Molecular Imaging, Perfusion

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