{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T03:16:19Z","timestamp":1780456579584,"version":"3.54.1"},"reference-count":114,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by immune dysregulation and systemic inflammation, with the cardiovascular (CV) system representing a major yet frequently under-recognized target. Cardiac involvement spans from subclinical myocardial inflammation to overt pericardial disease, myocarditis, valvular abnormalities, coronary microvascular dysfunction, and accelerated atherosclerosis. Given that CV disease remains a leading cause of morbidity and mortality in SLE, early detection of silent cardiac injury is crucial. Aim: This review aims to provide a comprehensive and clinically oriented overview of CV involvement in SLE, focusing on the role of multimodal cardiac imaging in the detection, characterization, and risk stratification of cardiac abnormalities, as well as its potential implications for clinical management and preventive strategies. Methods: This narrative review is based on a structured, non-systematic search of PubMed (2013\u20132026), combining the term \u201csystemic lupus erythematosus\u201d with imaging-related keywords including \u201ctransthoracic echocardiography,\u201d \u201ccardiac magnetic resonance,\u201d and \u201ccardiac computed tomography.\u201d English-language studies in adult populations were screened and selected according to clinical relevance, methodological robustness, and contribution to understanding SLE-related cardiac involvement. Discussion: Multimodal cardiac imaging plays a central role in the evaluation of SLE-related cardiac disease. Transthoracic echocardiography (TTE) represents the first-line modality for the assessment of ventricular function, pericardial disease, and valvular abnormalities, while deformation imaging enables the detection of subtle myocardial dysfunction. Cardiac magnetic resonance (CMR) provides comprehensive tissue characterization, allowing differentiation between active inflammation and chronic fibrosis. Cardiac computed tomography (cCT) identifies subclinical coronary atherosclerosis and high-risk plaque features, whereas nuclear imaging techniques offer insight into inflammatory activity and microvascular dysfunction. Conclusions: An integrated, imaging-based approach enables early diagnosis, refined CV risk stratification, longitudinal monitoring, and personalized therapeutic strategies. Multimodal imaging thus represents a key pillar of precision medicine in lupus-associated CV disease.<\/jats:p>","DOI":"10.3390\/diagnostics16070988","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T13:57:34Z","timestamp":1774447054000},"page":"988","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Multimodal Cardiac Imaging in Systemic Lupus Erythematosus: From Clinical Suspicion to Diagnosis in Clinical Practice"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2935-2023","authenticated-orcid":false,"given":"Mariagrazia","family":"Piscione","sequence":"first","affiliation":[{"name":"Fondazione Policlinico Campus Bio-Medico, University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7359-4028","authenticated-orcid":false,"given":"Barbara","family":"Pala","sequence":"additional","affiliation":[{"name":"PhD School of Applied Medical-Surgical Sciences, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy"},{"name":"UOC Cardiologia Ospedale, Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2850-1124","authenticated-orcid":false,"given":"Francesco","family":"Cribari","sequence":"additional","affiliation":[{"name":"UOC Cardiologia Ospedale, Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1906-8032","authenticated-orcid":false,"given":"Serena De","family":"Mitri","sequence":"additional","affiliation":[{"name":"UOC Cardiologia Ospedale, Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4754-1549","authenticated-orcid":false,"given":"Giada","family":"La Placa","sequence":"additional","affiliation":[{"name":"PhD School of Applied Medical-Surgical Sciences, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Gaudio","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Campus Bio-Medico, University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1533-4276","authenticated-orcid":false,"given":"Paola","family":"Gualtieri","sequence":"additional","affiliation":[{"name":"Section of Food Science, Clinical Nutrition and Pharmaceutical Sciences, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8875-6723","authenticated-orcid":false,"given":"Laura","family":"Di Renzo","sequence":"additional","affiliation":[{"name":"Section of Food Science, Clinical Nutrition and Pharmaceutical Sciences, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/0002-9343(92)90578-Y","article-title":"Risk factors for coronary artery disease in patients with systemic lupus erythematosus","volume":"5","author":"Petri","year":"1992","journal-title":"Am. 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