Immune-mediated inflammatory diseases (IMIDs) such as scleroderma, rheumatoid arthritis, systemic lupus erythematosus (SLE), myositis, and dermatomyositis affect thousands of people in the UK. These conditions are increasingly recognised to carry a significantly higher risk of developing cardiac complications, including heart failure, myocarditis, arrhythmias, and coronary microvascular dysfunction. Cardiovascular involvement is a major contributor to disability, reduced quality of life, and premature mortality in this patient population.
Despite this, cardiac disease in IMIDs is frequently under-diagnosed or detected late, partly because symptoms can be subtle and overlap with underlying inflammatory disease activity. Current approaches to cardiac assessment vary widely between centres, and there is no established pathway to identify which IMID patients require advanced cardiac testing. As a result, some patients undergo invasive investigations that may not be necessary, while others with early cardiac involvement remain undetected until their disease has significantly progressed.
Through discussions with our patient and public involvement partners—including representatives from Scleroderma & Raynaud’s UK, Lupus UK, Myositis UK, and the National Rheumatoid Arthritis Society—we consistently hear that IMID patients value early detection but wish to avoid unnecessary invasive procedures whenever possible. Many express anxiety about the risks, discomfort, and disruption associated with invasive cardiac tests.
The IMID-HEART study aims to develop a clearer understanding of how best to identify cardiac complications in IMID patients using accessible, patient-friendly diagnostic approaches. By combining clinical data, advanced non-invasive imaging, and biomarker assessment, we hope to create practical pathways that improve early detection, reduce reliance on invasive testing, and ultimately improve long-term outcomes for people living with immune-mediated inflammatory diseases.
