Key result
Integrating biomarkers with multimodal imaging enables early detection of cardiac involvement in DM/PM.
Why the study?
Cardiac involvement in dermatomyositis/polymyositis is a significant cause of mortality, yet it is frequently subclinical and masked by skeletal muscle and skin manifestations. Because conventional examination methods struggle with early diagnosis and endomyocardial biopsy is invasive, an efficient framework for early warning and precise risk assessment is needed.
Does the integration of serum biomarkers and multimodal imaging with clinical high-risk factors improve early identification and risk assessment of cardiac involvement in patients with dermatomyositis/polymyositis?
Does the integration of serum biomarkers and multimodal imaging with clinical high-risk factors improve early identification and risk assessment of cardiac involvement in patients with dermatomyositis/polymyositis?
This review summarizes current and emerging evidence on integrating serum biomarkers and multimodal imaging with clinical high-risk factors to facilitate early detection and risk assessment of subclinical cardiac involvement in patients with dermatomyositis and polymyositis.
May support early non-invasive detection in DM/PM; leaves open prospective validation of outcome benefit.
Idiopathic inflammatory myopathies (IIM) comprise a broad spectrum of clinical and pathological subtypes, including dermatomyositis (DM), anti-synthetase syndrome, immune-mediated necrotising myopathy (IMNM), overlap myositis, inclusion-body myositis, and polymyositis (PM). Among these, DM remains well-defined, whereas PM has become increasingly rare under current classification criteria. A significant number of early studies categorised patients collectively under the term “DM/PM”. Cardiac involvement is recognised as a significant cause of mortality in these patients. The reported incidence of cardiac involvement in DM/PM varies widely and is frequently subclinical. The symptoms are frequently masked by manifestations in the skeletal muscles and the skin, which makes an early diagnosis difficult using conventional examination methods. Although endomyocardial biopsy is regarded as the gold standard, its invasive nature limits its clinical application. It is therefore imperative to establish an efficient framework for early warning and precise risk assessment of cardiac involvement in DM/PM. In this review, we summarize current and emerging evidence on serum biomarkers and multimodal imaging for the early identification and risk assessment of cardiac involvement in DM/PM. These advances are built on the evolving classification system for IIM.The integration of these tools with clinical high-risk factors is intended to facilitate the construction of a comprehensive risk assessment model. This integrated approach is intended to facilitate the early detection and treatment of cardiac involvement in DM/PM patients, thereby improving their prognosis.
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Liu et al. (2026) conducted a review in Cardiac involvement in dermatomyositis and polymyositis (DM/PM). Serum biomarkers (e.g., cTnI, CK, PIIINP, PICP, autoantibodies) and multimodal imaging (echocardiography, CMR, nuclear imaging) vs. Conventional evaluation or healthy controls was evaluated on Early identification and risk assessment of cardiac involvement in DM/PM. Integrating serum biomarkers (such as cTnI and autoantibodies) with multimodal imaging (STE and CMR) enables early detection and risk stratification of cardiac involvement in DM/PM (incidence 6%-72%).
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