Interstitial lung diseases (ILDs) are common chronic disease characterized by high mortality and morbidity, also linked to cardiovascular implication. Cardiovascular complications, occur early in idiopathic pulmonary fibrosis (IPF) and other ILDs without anysymptoms. Symptoms are often misinterpreted and diagnosis delayed to irreversible stages of cardiac dysfunction. Mechanism of cardiac damage, the main cause of mortality, are heterogeneous raging from ischemic heart disease, acceleration of atherosclerosis, to right ventricle dysfunction secondary, to pulmonary hypertension. So an early recognition and accurate staging are fundamental to avoid disease progression and improve outcomes. The identification of a single non-invasive imaging modality able to simultaneously characterize in an accurate and quantitative way the entity of lung and cardiac damage in patients affected by ILD would be useful to improve risk stratification and to guide treatment.

Inclusion Criteria:

• Adult subjects (>18 y.o.) with previously known ILD or high likelihood for having ILD including CTD diagnosis since at least 5 years before the project starts in order to increase the prevalence of ILD [2] who signed an Informed Consent authorizing data collection.

Exclusion Criteria:

• Subjects with active infectious disease;
• known CAD;
• history of previous percutaneous or surgical revascularization;
• known cardiomyopathy;
• previous heart failure;
• presence of cardiac devices (prosthetic valve, ICD, PM, ICD-CRT, LVAD)
• previous or active neoplasia;
• pregnancy and breastfeeding;
• allergy to iodine contrast agent;
• claustrophobia;
• glomerular filtration rate < 30mL/min
• impossibility to lay down or breath old
• absence of informed consent signed

123 patients will be submitted to standard of care imaging and the informed consent is required for the authorization to use the imaging data for scientific purpose and to collected clinical and laboratory data using electronic medical records, and clinical interview.

All patients will undergo echocardiography, as clinically indicated, that will be performed in accordance with the most recent guidelines for a comprehensive morphofuctional assessment of cardiac chambers, valves, evaluation of pulmonary hypertension and associated remodeling, including the identification of subtle myocardial deformation alteration using strain analysis. Hence, CT will be compared to echocardiography, currently indicated for the monitoring of CTD, in order to establish agreement and potential additional information. Hence, only a subgroup of 74 patients who have an altered troponin T value (> 14 ng/L) will undergo cardiac magnetic resonance imaging (CMR) according to clinical practice.