Ocular involvement is a major cause of morbidity in Behçet's disease (BD), and its diagnosis may be challenging, particularly for patients with isolated ocular manifestations or incomplete fulfillment of diagnostic criteria. Increased common femoral vein (CFV) wall thickness measured by Doppler ultrasonography (US) has previously been shown to be a sensitive and specific marker for systemic BD. This study aimed to evaluate whether CFV wall thickness measurement may serve as a supportive tool in distinguishing Behçet's uveitis (BU) from other forms of inflammatory uveitis.

This retrospective study included 45 patients with BU fulfilling the International Study Group criteria for BD and 72 patients with non-BD uveitis of infectious and noninfectious etiologies. Bilateral CFV wall thickness was measured using color Doppler US by a radiologist blinded to the clinical data. Group comparisons were performed and multivariate linear regression analyses were used to assess whether BU was independently associated with increased CFV wall thickness after adjustment for potential confounders. Exploratory analyses additionally evaluated the effects of disease duration and systemic treatment status.

Mean CFV wall thickness was significantly higher in the BU group than in the non-BU group in both extremities (p < 0.001). BU remained an independent predictor of increased CFV wall thickness after adjustment for sex and venous Doppler findings. Additional exploratory analyses adjusting for disease duration and current systemic treatment status did not change this association.

CFV wall thickness measured by Doppler US was significantly increased in patients with BU compared to other forms of inflammatory uveitis. These findings suggest that CFV wall thickness may serve as a supportive or adjunctive imaging marker in selected cases to assist in the differential diagnosis of ocular BD.

Transcatheter closure of ventricular septal defects (VSDs) has become a widely accepted alternative to surgical repair, owing to its high success rates and lower risk of complications. Advances in three-dimensional (3D) echocardiography, including 3D speckle-tracking and global longitudinal strain analysis, now allow for detailed assessment of ventricular performance and provide valuable insights into left ventricular remodeling following transcatheter VSD closure.

This prospective observational study enrolled 56 children aged 2-16 years with congenital perimembranous or muscular VSD undergoing transcatheter device closure at Ain Shams University Hospitals, and 56 age- and sex-matched healthy controls. 3D speckle-tracking echocardiography (3D-STE) was performed at baseline and at six-month follow-up to quantify global longitudinal (GLS), circumferential (GCS), and radial strain (GRS), alongside LV volumes and ejection fraction.

At six months, LV volumes showed no significant change; however, ventricular function improved significantly. Mean 3D ejection fraction improved from 55% ± 4% preoperatively to 58% ± 3% at six months (p = 0.001), with parallel improvement in GLS, GCS, and GRS (all p = 0.001). LV end-diastolic and end-systolic volumes did not change significantly at six months.

This study demonstrates a significant improvement in 3D echocardiography-derived ejection fraction and global strain indices following transcatheter VSD closure, reflecting early favorable functional recovery and improved myocardial mechanics rather than complete structural reverse remodeling. These findings support transcatheter VSD closure as a safe and effective intervention with acceptable short-term outcomes, though longer follow-up is needed to determine whether volumetric reverse remodeling ensues.

Tricuspid regurgitation (TR) progression is a recognized complication following permanent pacemaker (PPM) implantation with a significant impact on morbidity and mortality. The role of procedural aspects as well as advanced echocardiographic parameters in predicting TR progression remains incompletely defined.

To investigate procedural factors and echocardiographic parameters predicting progression to moderate-to-severe TR following PPM implantation.

Fifty-two consecutive patients undergoing PPM implantation were prospectively included. Conventional echocardiography and speckle-tracking echocardiography (STE) were performed at baseline, 3 months, and 6 months post-implantation. Patients were classified according to the development of moderate-to-severe TR during follow-up.

Moderate-to-severe TR developed in 17 patients (32.7%) during follow-up. Baseline clinical and echocardiographic parameters were largely comparable between groups, although patients with subsequent TR progression had mildly impaired baseline RV free wall longitudinal strain (RV-FWLS) (p = 0.04). At 3 months, patients with TR progression demonstrated worse RV-FWLS (p = 0.01), higher RV dyssynchrony index (p = 0.02), and larger tricuspid annular diameter (p = 0.04). On multivariable analysis, the direct trans-tricuspid crossing technique (OR 5.42, 95% CI 1.01-29.12; p = 0.048), ventricular pacing burden (OR 1.39, 95% CI 1.05-1.86; p = 0.02), 3-month RV-FWLS (OR 1.47, 95% CI 1.01-2.15; p = 0.04) and 3-month RV dyssynchrony index (OR 1.54, 95% CI 1.02-2.31; p = 0.03) could independently predicted TR progression. ROC analysis showed good predictive performance for RV dyssynchrony index (AUC 0.86) and RV-FWLS (AUC 0.83).

Early abnormalities in RV strain and mechanical dyssynchrony were associated with subsequent TR progression following PPM implantation, highlighting the potential value of advanced echocardiographic assessment for early risk stratification.

ST-segment elevation myocardial infarction (STEMI) remains a major cause of cardiovascular mortality and morbidity worldwide. Despite advances in reperfusion therapy, many patients still develop irreversible myocardial injury and adverse ventricular remodeling. Intracoronary mesenchymal stem cell (MSC) administration has been investigated as a potential therapeutic approach, but clinical evidence remains inconsistent. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing intracoronary MSC administration with standard care in STEMI patients. Databases were searched from inception through February 2026. Eight RCTs involving 796 patients were identified, and seven trials with 400 patients were included in the quantitative analysis after excluding one study under Expression of Concern. MSC administration significantly improved ΔLVEF (I² = 44.6%, p = 0.108; WMD = 3.18, 95% CI: 1.52-4.83, p < 0.001). No significant differences were detected in rehospitalization for heart failure (I² = 0.0%, p = 0.592; RR = 1.14, 95% CI: 0.36-3.61, p = 0.831), all-cause mortality (I² = 0.0%, p = 0.525; RR = 1.51, 95% CI: 0.24-9.31, p = 0.659), or MACE (I² = 0.0%, p = 0.887; RR = 2.47, 95% CI: 0.55-11.05, p = 0.236). Intracoronary MSC administration after STEMI is associated with a modest improvement in left ventricular function, while no reduction in clinical events was found. No major safety signal was identified, although available safety data remain limited. Larger and well-designed trials with longer follow-up are still needed. Trial Registration: PROSPERO: CRD420261286620.

The platelet-to-albumin ratio (PAR) has shown to be linked with cardiovascular disorders. However, the specific association between the admission PAR and one-year outcomes in patients with acute coronary syndrome (ACS) remains to be fully characterized. This study investigated the linkage between PAR levels and the occurrence of one-year all-cause mortality and major adverse cardiovascular and cerebrovascular events (MACCEs) in the ACS population.

This retrospective cohort study enrolled patients diagnosed with ACS between January 2022 and December 2023. The primary endpoint was one-year all-cause mortality, and the secondary endpoint was MACCE, defined as a composite of all-cause mortality, non-fatal myocardial infarction, ischemic stroke, heart failure rehospitalization, target vessel revascularization or in-stent thrombosis, and malignant arrhythmia. To evaluate the relationship between PAR and these clinical events, we employed multivariate Cox proportional hazards models, restricted cubic splines (RCSs) and two-piecewise linear regression to identify potential non-linear associations and specific inflection points.

A total of 1326 participants (median age: 67 years) were followed for one year, during which 137 (10.3%) deaths and 280 (21.1%) MACCE events occurred. The one-year all-cause mortality rates across the PAR quartiles (Q1-Q4) were 11.6%, 6.1%, 7.0% and 16.7%, respectively, with a similar trend observed for MACCE (22.1%, 15.2%, 18.7% and 28.5%). RCS analysis revealed significant nonlinear associations between the PAR and both clinical endpoints (all p for nonlinear < 0.05). Two-piecewise linear regression analysis identified specific inflection points at 5.28 (95% confidence interval [CI]: 4.86-9.86) for one-year all-cause mortality and 5.29 (95% CI: 4.37-6.58) for MACCE.

The PAR demonstrates a significant nonlinear relationship with one-year all-cause mortality and MACCE in patients with ACS.

Return to work (RTW) after stroke is a complex process influenced by residual impairments, workplace demands, and rehabilitation support. However, how therapeutic support is structurally incorporated into RTW processes and the specific contributions of occupational therapy (OT) remain unclear.

This scoping review is aimed at examining how therapeutic support is incorporated into RTW processes following stroke and at clarifying the roles of OT within these support structures.

Comprehensive literature searches were conducted in Ichushi-Web, PubMed, and Web of Science, complemented by manual searches. Studies published in Japanese or English up to February 2026 were included if they addressed stroke survivors and work participation-related support. Data were extracted using a structured framework to map therapeutic integration during RTW and OT roles. Facilitators, barriers, and assessment approaches were also summarized.

Fifty-eight studies met the inclusion criteria. Therapeutic support was described at different stages of the RTW process, ranging from interventions completed before work resumption to support provided alongside RTW and support integrated with workplace demands. OT roles were identified across 10 categories, most commonly involving work participation-oriented assessment and job analysis, employer liaison and stakeholder meetings and mediation, and workplace evaluation and accommodations. Functional impairments and fatigue were frequently reported as barriers to sustained work participation; however, fatigue-specific assessments were reported less frequently.

Therapeutic integration within ongoing work participation is a key structural feature of RTW support for stroke survivors and may also be relevant to how work-treatment balance (WTB) is addressed in practice. The findings highlight the diverse roles of OT in linking worker capacity, workplace demands, and service coordination. They also suggest a discrepancy between commonly reported barriers, particularly fatigue, and the assessment approaches used in RTW-focused studies.

To explore experiences of loneliness among community-dwelling stroke survivors through a secondary qualitative analysis.

A secondary analysis of a qualitative dataset was conducted, including 26 transcripts from semi-structured interviews that originally aimed to explore psychosocial experience after stroke. Data relevant to loneliness were finally extracted from 20 transcripts. Thematic analysis was adopted for data analysis.

Three themes and six subthemes were identified: (1) Disconnection from social belonging, including difficulty in engaging in social activities and perceived sense of difference from others. (2) Lack of closeness to familiar people or loved ones, including decline in meaningful interactions or relationships with friends and family members, and lack of understanding and empathy from social networks. (3) Loss of direction, hope, and meaning, including perceived sense of learned helplessness, and diminished expectations and purposes in life.

Loneliness after stroke is a complex experience. There is a clear need for designing tailored interventions to address loneliness following stroke. Addressing loneliness should be considered as a core issue of stroke recovery within both policy frameworks and practical guidelines. In addition, further research is needed to explore the pathways leading to social, emotional, and existential loneliness following stroke.

Frequent premature ventricular complexes (PVC) can lead to a reversible form of left ventricular (LV) dysfunction termed PVC-induced cardiomyopathy (PIC). Catheter ablation is increasingly recognized as the most effective treatment; however, outcomes may differ by the anatomical site-of-PVC origin.

We conducted a systematic review and meta-analysis of studies published from 2000 to 2025 evaluating catheter ablation in patients with PIC. Eligible studies reported outcomes stratified by PVC origin, including right ventricular outflow tract (RVOT), LV outflow tract (LVOT), papillary muscle, and epicardial/para-His regions. Primary outcomes were change in LV ejection fraction (LVEF) and normalization (≥ 50%). Secondary outcomes included PVC recurrence, repeat ablation, and major complications. Pooled estimates were calculated using random-effects models.

Twelve studies (n = 718) met inclusion. Overall, ablation improved LVEF by a mean of 11.0% (95% confidence interval 9.5-12.5; P < .001), with normalization in ~65% of patients. Outcomes varied by PVC origin: RVOT (ΔLVEF ~12.5%, normalization ~70%), LVOT (ΔLVEF ~11.0%, normalization ~65%), papillary muscle (ΔLVEF ~8.0%, normalization ~55%), and epicardial/para-His (ΔLVEF ~6.5-7.0%, normalization ~50%). Recurrence rates were lowest for RVOT/LVOT (~12-20%) and highest for papillary and epicardial sites (~28-30%). Major complications were infrequent (~3-5%), but more common with epicardial or para-His ablations.

Catheter ablation provides substantial and often reversible improvement in LVEF for patients with PIC, with generally low complication rates. However, outcomes are strongly site-dependent, favoring RVOT and LVOT origins.

Individuals with LDL cholesterol (LDL-C) ≥ 190 mg/dL face a markedly increased risk of major adverse cardiovascular events (MACE). Traditional risk calculators such as SCORE2 and the Framingham risk score often underestimate this risk. In this study, we aimed to apply machine learning techniques to identify clinical and laboratory features associated with the presence of MACE among patients with very high LDL-C. In this single-center, cross-sectional study, 246 patients aged 40 to 80 years with at least 1 documented LDL-C ≥ 190 mg/dL between 2014 and 2025 were evaluated. Comprehensive demographic, clinical, anthropometric, lifestyle and laboratory data - including composite scores such as STOP-BANG and fibrosis-4 (FIB-4) - were collected. MACE was defined as acute coronary syndrome, arterial revascularization, peripheral artery disease, ischemic stroke, or transient ischemic attack. Patients were stratified into MACE and non-MACE groups and both conventional statistical analyses and artificial intelligence-based models were employed. Logistic regression, CatBoost, LightGBM, random forest, and XGBoost models were trained (80% training set) and validated (20% test set) to identify variables contributing to the discrimination between patients with and without MACE. CatBoost achieved the highest area under the receiver operating characteristic curve (AUROC) (0.894), followed by logistic regression (0.886), XGBoost (0.860) and LightGBM (0.845). Variables recurrently identified across models in association with MACE status included STOP-BANG score, older age, hypertension, duration of prior statin use, glycated hemoglobin, triglyceride, neutrophil count, aspartate aminotransferase, absence of peripheral pulses, smoking exposure, creatinine, body mass index, apolipoprotein B, alanine aminotransferase and FIB-4 score. Notably, lipid-lowering therapy was suboptimal in this high-risk cohort: although 61% reported prior treatment, only 28% were on active therapy at evaluation, statin discontinuation was frequent and high-intensity regimens were underutilized, including among patients with MACE. Machine learning models identified multiple clinical and laboratory variables associated with prevalent MACE in patients with markedly elevated LDL-C, integrating traditional cardiovascular determinants with potentially underrecognized modifiers. The STOP-BANG score, as a proxy measure for obstructive sleep apnea risk, emerged as one of the most consistently identified variables across models. Prospective, multicenter studies are needed to validate these findings and further explore their potential relevance for cardiovascular risk assessment in this population.

Stroke is a major global health issue, and inflammation plays a key role in its pathogenesis. The neutrophil-to-albumin ratio (NPAR) is a novel inflammatory biomarker reflecting inflammation and oxidative stress. However, its association with stroke remains unclear. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999-2020. The association between NPAR and stroke was assessed by determining NPAR and employing various analytical methods, including weighted univariate logistic regression, restricted cubic spline (RCS) regression, and Least Absolute Shrinkage and Selection Operator (LASSO) regression models. Furthermore, a risk prediction nomogram was developed, and its efficacy was validated through the use of receiver operating characteristic (ROC) curve analysis. A total of 393 clinical cases were selected, comprising 193 stroke patients and 200 non-stroke patients. The disease data were validated using bootstrap methods, while clinical data underwent logistic regression analysis and T test to confirm compliance with the established NPAR prediction model. The median NPAR of stroke patients was significantly higher than that of non-stroke patients (14.53 vs 13.72, P < .01). RCS analysis demonstrated a positive association between NPAR and stroke risk, especially when NPAR > 13.75. Subgroup analyses showed that this association remained stable in subgroups such as gender, ethnicity, hypertension, coronary heart disease, etc. The LASSO regression model further identified 13 factors closely related to stroke, such as age, ethnicity, high-density lipoprotein, and hypertension, and constructed a nomogram model with high predictive performance (area under the curve [AUC] = 84%). The T test analysis of clinical data revealed a statistically significant difference in NPAR between stroke and non-stroke groups, as well as between low-risk and high-risk stroke classifications (P < .0001). Findings from the clinical cohort were consistent with those of the NHANES analysis. This suggests that NPAR can not only predict the risk of stroke but also reflect its severity. A nonlinear positive association has been observed between NPAR and stroke, a connection that persists regardless of multiple confounding variables. NPAR may function as a crucial indicator for stroke risk, particularly among men. Given the cross-sectional design, further longitudinal studies are needed to establish causality and explore the underlying mechanisms linking inflammation to stroke.