Dilated cardiomyopathy (DCM), characterized by ventricular dilation and systolic dysfunction, has a 10-year survival rate of 25%. The number of young and middle-aged patients with DCM is increasing, with progressive physical limitations and psychosocial distress substantially impairing quality of life. However, illness experiences in this population remain underexplored, particularly in non-Western contexts. Social media platforms such as Zhihu and Weibo offer a novel avenue for exploring patient narratives and peer support.

A qualitative descriptive study was conducted to explore the multidimensional experiences of young and middle-aged Chinese patients with DCM through the social narratives shared on social media.

A qualitative reflexive thematic analysis was conducted on 872 questions and responses from Zhihu, a Chinese Q&A platform. Data were extracted using a Python (Python Software Foundation) application programming interface, manually filtered, and analyzed with NVivo 14.0 (Lumivero). Thematic codes were developed iteratively, with researcher reflexivity and team discussions ensuring analytical rigor.

Five themes emerged: (1) bodily control loss (persistent sleep disturbances, severe respiratory compromise, and physical activity limitations), (2) enmeshed in emotional turmoil (anxiety over survival challenges, guilt over burdening family, and heterogeneous responses to death), (3) social and family role disruption (impacts on academic and career paths and family responsibility interruptions), (4) support needs in health care (urgent demand for information on diseases and treatments and desire for continuous care and guidance), and (5) life reconstruction-between disease and life (lifestyle modifications, exploring diversified treatment paths, peer support and experience sharing, and reconstructing the meaning of life).

This study provides an interpretive account of the intertwined physical, psychological, and social experiences of young and middle-aged patients with DCM in China, emphasizing the influence of life-course stage and sociocultural context. Patients' perceptions of family responsibilities, societal role expectations, and death shape their understanding of illness and their processes of meaning reconstruction. These findings underscore the importance of incorporating life-stage and culturally sensitive perspectives in future research and highlight the potential value of tailored psychological support and digital health platforms in improving access to illness-related information and ensuring continuity of care.

Iatrogenic cerebral amyloid angiopathy (iCAA) is a rare form of CAA believed to result from β-amyloid (Aβ) transmission during neurosurgical procedures. We aimed to compare amyloid PET burden, CSF biomarkers, and APOE genotype between iCAA and sporadic CAA (sCAA).

In this single-center, cross-sectional study, adults fulfilling diagnostic criteria for probable sCAA or iCAA who underwent amyloid PET and CSF assessment between 2021 and 2024 were included. Amyloid burden was quantified using Centiloid scaling of ^18Fflutemetamol or ^18Fflorbetaben PET scans. CSF Aβ42, Aβ40, Aβ42/Aβ40 ratio, p-tau181, and total tau (t-tau) were measured with Lumipulse assays. Multivariable regression adjusted for age and sex examined associations with Centiloid values.

Ninety-five patients were included (24 with iCAA, 71 with sCAA; median age 56.5 vs 70 years). Patients with iCAA showed significantly higher amyloid deposition (median Centiloid 57.3 vs 30.5; p = 0.0026). iCAA diagnosis was independently associated with +34.99 Centiloid units (95% CI 15.25-54.74; p = 0.001) after adjusting for age and sex. In patients with sCAA, Centiloid values correlated inversely with CSF Aβ42 and Aβ42/Aβ40 ratio, whereas no significant correlations were observed in patients with iCAA. APOE ε4 was markedly less frequent in iCAA (4.5% vs 34.2%).

Patients with iCAA exhibit higher amyloid burden and a distinct biomarker profile compared with those with sCAA, supporting a divergent-possibly exogenous-mechanism of amyloid propagation.

SENECA, ClinicalTrials.gov Identifier: NCT04204642 (submitted on December 19, 2019).

Elevated low-density lipoprotein cholesterol is one of the major modifiable risk factors for cardiovascular disease. Lipid management is integral to primary and secondary prevention of cardiovascular disease, but undermined by high prevalence of non-adherence to lipid-lowering medications. Innovative, personalized multicomponent interventions may address the gaps in medication non-adherence. We aim to evaluate the effectiveness of a human coach-supported digital personal health assistant (mobile health app) intervention in improving adherence to statins in adults with hyperlipidaemia.

AdLip is a multicentre, open-label, parallel, two-arms, randomized controlled trial aiming to recruit a minimum of 376 adult participants who are non-adherent to statins from primary care ambulatory clinic setting in Singapore. Participants recruited will be randomly assigned (1:1) to human-coach supported mobile health app intervention or control group. The primary outcome will be adherence to statins at 6 months, measured by Medication Adherence Report Scale-5. Secondary outcomes will include change in serum low-density lipoprotein cholesterol levels, health motivation and attitudes, self-efficacy, self-care behaviours, quality of life, app acceptability, user engagement, and cost-effectiveness. Outcomes will be analysed using intention-to-treat approach.

The AdLip trial will provide empirical evidence on a multicomponent approach to the long-standing challenge of suboptimal adherence to statins in a multi-ethnic Asian setting. Findings from this study may inform a more personalized approach to addressing non-adherence in the short term, and how it relates to cardiovascular disease prevention in the longer term. Trial Registration: ClinicalTrials.gov NCT06614049.

Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) remains a significant burden in Ethiopia. People living with HIV/AIDS (PLWHA) are at increased risk of cardiovascular diseases due to both the virus and the side effects of antiretroviral therapy. Despite a growing body of research on cardiovascular diseases in PLWHA in Ethiopia, no review has synthesised the available evidence. This scoping review aims to summarise the existing literature on cardiovascular diseases among PLWHA in Ethiopia.

This scoping review followed the Arksey and O'Malley (2005) framework, with enhancements from Levac et al. (2010). A systematic search was conducted across six electronic databases (PubMed, EMBASE, ProQuest, Global Index Medicus, and Web of Science) in November 2023 and updated in March 2026. Studies on cardiovascular diseases among PLWHA in Ethiopia were included. Two reviewers independently screened titles, abstracts, and full texts. A data extraction template was used, and findings were synthesised narratively. The selection process was documented using a PRISMA flow diagram.

Twenty-six studies were included, with nearly two-thirds (61.5%, n = 16) focused on hypertension. The prevalence of hypertension among PLWHA in Ethiopia ranged from 11.0 to 41.3%. Factors associated with hypertension included male gender, old age, rural residence, alcohol consumption, smoking, family history, low physical activity, obesity, and HAART duration/type. Other cardiovascular conditions studied included ischemic stroke, dilated cardiomyopathy, ECG abnormalities, atherosclerotic cardiovascular disease, and pericardial effusion. Most studies were cross-sectional and institution-based.

This review highlights the limited yet growing evidence on cardiovascular diseases among PLWHA in Ethiopia, with a predominant focus on hypertension. Future research should use more robust study designs, such as longitudinal and interventional studies, encompass a broader range of cardiovascular diseases, and include community-based studies to better understand the prevalence and burden of cardiovascular diseases among PLWHA in Ethiopia.

To evaluate the effects of different types of music (instrumental Turkish music and Western music without lyrics) played during wound care on pain, anxiety, and patient satisfaction among individuals with venous ulcers.

In this randomized controlled trial, 97 patients with venous ulcers were assigned to three groups: Western music ( n  = 32), Turkish music ( n  = 32), and Control ( n  = 33). Patients in the music groups listened to their assigned music during routine wound dressing, while all patients received individualized, evidence-based care. Pain and anxiety were measured using the Visual Analogue Scale (VAS) and the State-Trait Anxiety Inventory before, during, and after dressing, and patient satisfaction was assessed with the VAS post-procedure.

The mean age was 56.5 ± 8.5 years; 61% were female ( n  = 59) and 39% male ( n  = 38). Between-group comparisons revealed a significant effect of music on anxiety ( F (2.94) = 27.771, P < 0.001, η2  = 0.371). These findings indicate that listening to music significantly reduced anxiety levels, with Turkish music producing a stronger effect than Western music. Music had a pain-reducing effect during dressing, with Turkish music significantly lowering pain compared to the control group ( F (4.188) = 9.039, P < 0.001, η2  = 0.161). Although pain levels decreased in the Western music group, this reduction did not reach statistical significance. Patient satisfaction was also higher in the music groups ( P < 0.001).

In this study, Turkish music was particularly effective, demonstrating greater reductions in anxiety and pain, as well as higher patient satisfaction compared to both Western music and the control group. The findings emphasize the importance of cultural characteristics and patient preference in music-based interventions; they demonstrate that music is an effective nursing intervention that can be applied independently by nurses, is low-cost, and is non-invasive.

This study aimed to analyse the analgesic efficacy of Shangdiao music (a specific pentatonic modality) combined with diclofenac sodium suppositories after mixed haemorrhoid surgery.

The clinical data of 130 patients who underwent mixed haemorrhoid surgery at our institution between January 2023 and January 2024 were retrospectively analysed. The participants were stratified into two groups according to postoperative analgesia protocols: a pharmacotherapy group ( n  = 70) receiving diclofenac sodium suppositories alone and a combined therapy group ( n  = 60) receiving diclofenac sodium suppositories combined with Shangdiao music. The treatment course was 7 days. Outcomes were as follows: postoperative pain conditions (Visual Analogue Scale [VAS]), urinary function, defecation function (Chinese version of the Patient Assessment of Constipation Quality of Life questionnaire [PAC-QOL]), negative emotions (Hospital Anxiety and Depression Scale - Anxiety Subscale [HADS-A] and Hospital Anxiety and Depression Scale - Depression Subscale [HADS-D]), quality of life (General Quality of Life Inventory-74 [GQOLI-74]) and incidence of adverse reactions.

No significant differences in baseline characteristics were observed between the two groups ( P > 0.05; Cohen's d range: 0.00-1.00). Both groups demonstrated progressive reductions in VAS scores at 3, 5 and 7 days relative to their 12-hour and 1-day assessments, with the combined therapy group showing significantly greater reductions than the controls at all timepoints ( P < 0.001; Cohen's d : 1.78-3.91). At 7 days, both groups exhibited increased average urine flow rates and GQOLI-74 scores relative to their 1-day measurements, with the combined therapy group demonstrating significantly greater improvements than the controls. Similarly, PAC-QOL, HADS-D and HADS-A scores decreased in both groups at 7 days compared with baseline, with the combined therapy group exhibiting significantly greater reductions ( P < 0.001; Cohen's d : 0.93-1.86).

The integration of Shangdiao music with diclofenac sodium suppositories remarkably enhances analgesia, accelerates the recovery of urinary/defecatory functions, mitigates negative psychological states and improves the quality of life of patients following mixed haemorrhoid surgery.

International guidelines for the management of arterial hypertension fail to consider environmental pollutants as risk factors for the development of the disease and its cardiovascular complications. The reasoning behind this may stem from the failure to acknowledge compelling evidence from research on the cardiovascular effects of environmental pollution. In this narrative review, we summarize the effects of environmental air pollution and noise on individuals with arterial hypertension. We explore how these pollutants interact with other environmental and individual risk factors and discuss why such individuals should be considered a vulnerable group. We also discuss local studies to help national authorities adjust international recommendations to better fit the local context. In summary, national recommendations for managing hypertension should encompass more than just blood pressure goals and prescribed antihypertensive medications. Clinicians should recommend evidence-based behavioral changes related to environmental issues to individuals with arterial hypertension. These changes can help people with arterial hypertension control their blood pressure; delay adverse cardiovascular outcomes; and enhance the effectiveness of antihypertensive medications during episodes of poor air quality, environmental noise exposure, exposure to extremely cold or warm weather, or any combination of these risk factors. Guidelines must be adapted to account for environmental pollution, social factors, cultural norms, patient preferences, equity concerns, patient lifestyle, the healthcare system, and the economic situation in the region.

Earthquakes are associated with an increase in cardiovascular events through various physiological and environmental mechanisms. However, data on their effects on ventricular arrhythmias (VA) are limited.

The aim of our study is to investigate the effect of earthquakes on the incidence of VA and device response by examining implantable cardiac device records.

The device records of patients with an implantable cardioverter defibrillator (ICD) or a cardiac resynchronization therapy with defibrillator (CRT-D) device, implanted for any reason, at least 1 month prior to the February 6, 2023, earthquake were reviewed by cardiologists for VA, antitachycardia pacing (ATP), and shock, and analyzed for VA, ATP, and shock. Statistical analysis was performed using the McNemar test.

There were 163 participants with a mean age of 60.84 ± 12.74 years, and 69.9% were male. Seventy-one patients (43.6%) had a single ICD, 23 patients had a dual ICD (14.1%), and 69 patients (42.3%) had a CRT-D. When compared to the pre-earthquake period, a significant difference was observed in the incidence of VA in the acute period ( P = 0.008) and subacute period ( P < 0.001). The frequency of receiving ATP or shock significantly increased during the acute period ( P = 0.013) and the subacute period ( P < 0.001) compared to the pre-earthquake period.

The findings suggest that major earthquakes may be associated with an increased incidence of VA and device therapy, particularly during the subacute period. These results emphasize the importance of carefully monitoring patients with implantable cardiac devices following major earthquakes.

Clinical guidance for perimenopausal hormone replacement therapy (HRT) varies across regions, creating uncertainty when clinicians need to balance safety with testing burden and cost. We conducted an evidence-based narrative review to summarize the clinical value of key indicators used in perimenopausal HRT decision-making. To gather relevant evidence, we searched PubMed, Web of Science, and Scopus for studies published from January 2014 to December 2025 using keywords related to perimenopause, HRT, biomarkers, clinical decision-making, and risk stratification. We focused on indicators from hormonal, skeletal, and cardiometabolic domains, as well as selected imaging and symptom measures. Traditional hormones such as follicle-stimulating hormone (FSH) and estradiol are useful for staging, but single measurements are limited by cyclic fluctuations. For bone health, combining bone mineral density with bone turnover markers (e.g., β-CTX and PINP) may improve the assessment of fracture risk and treatment response. For cardiometabolic safety, lipid profiles and inflammatory markers (e.g., C-reactive protein) support risk evaluation. Based on the literature, we propose a tiered evaluation framework: utilizing standard, widely available tests for routine assessment, while reserving advanced biomarkers for high-risk or unclear cases. This approach aims to support practical clinical assessment without replacing individualized clinical judgment, offering a highly cost-effective strategy tailored for resource-limited settings.

High dietary salt intake is a well-established modifiable risk factor for hypertension and cardiovascular disease. Salt sensitivity - a blood pressure (BP) phenotype defined by exaggerated BP response to salt loading, remains underrecognised in normotensive populations despite its strong link to adverse cardiovascular outcomes. The burden and determinants of salt sensitivity amongst young Nigerians remain poorly understood.

This study aimed to identify demographic and behavioural risk factors associated with salt sensitivity, explore potential ethnic and sex-related differences and determine the independent predictors of salt-sensitive (SS) BP response amongst normotensive young adult Nigerians.

An interviewer-administered questionnaire was used to collect demographic and behavioural data. Participants underwent a 5-day salt-loading protocol. BP, serum and urinary electrolytes were assessed before and after salt-loading. Data were analysed using appropriate statistical tools and P values set at P < 0.05.

Among the participants, 24% were SS. The prevalence of salt sensitivity was higher in Igbos (47.8%) compared to Yorubas (20.5%). SS individuals had significantly lower baseline systolic, diastolic and MA P values and reduced urinary sodium concentrations pre-salt loading, particularly among females. There were no statistically significant associations between salt sensitivity and body mass index, sleep duration or residential location ( P > 0.05).

Salt sensitivity is common amongst normotensive young adult Nigerians, with clear ethnic and sex-related differences. The observed subclinical BP alterations and reduced sodium excretion suggest early renal or vascular dysregulation in SS individuals. These findings underscore the need for early identification and targeted prevention strategies to reduce future hypertension risk in this population.