This prospective observational investigation will examine the incidence and progression of cardiologic findings in individuals with OI across different age groups. Cardiopulmonary complications are recognized as major contributors to morbidity and mortality in adults with OI, although life expectancy has significantly improved in recent years due to medical advancements.

By systematically evaluating cardiovascular involvement in this population, the study aims to generate clinically relevant evidence to inform early cardiologic screening strategies and support the development of harmonized and targeted management approaches, ultimately improving clinical practice and the quality of life of individuals living with OI.

Research on extra-skeletal manifestations, particularly those affecting the cardiovascular system, is still rather limited, despite this being one of the main causes of morbidity and mortality among these patients. Cardiovascular abnormalities can also be found in childhood, even in cases of mild Osteogenesis Imperfecta.

This observational prospective cohort study is to evaluate the presence and progression of structural and functional cardiac abnormalities in children and adults with Osteogenesis Imperfecta (OI).

Participants will undergo routine clinical and instrumental evaluations performed during standard follow-up visits at the study center, including:

• Clinical and genetic assessment
• Echocardio, electrocardiogram, and cardiology visit
• Radiographic evaluation
• Quality-of-life questionnaire (EQ-5D)

These assessments will be performed at baseline and periodically over a 60-month follow-up period to characterize cardiovascular involvement in OI and support early cardiologic screening strategies.

The Department of Rare Skeletal Disorders at Istituto Ortopedico Rizzoli, Bologna, Italy, has been a reference centre, and coordinating centre, of ERN BOND, the European Reference Network for rare BONe Diseases (https://ernbond.eu/), since its creation in 2017

Inclusion Criteria:

• Diagnosis of OI according to the modified Sillence classification (Mortier et al., 2019)
• All subjects with OI who attend genetic consultations at the clinic affiliated with the Rare Skeletal Diseases Unit of the IRCCS Rizzoli Orthopaedic Institute (IOR)
• Willingness to undergo clinical and instrumental assessments at the IOR

Exclusion Criteria:

• Acute upper and/or lower respiratory tract infections at the time of assessment
• Cognitive impairment affecting cooperation and the performance of examinations

Patients affected by Osteogenesis Imperfecta