Inflammatory rheumatic diseases (IRDs) compromise vascular integrity through systemic inflammation and (auto) immune reactions, which are associated with an increased risk of vascular complications. Venous stasis, endothelial dysfunction, and coagulation imbalance are the primary pathophysiological factors behind thrombotic events in these individuals. The incidence of venous thromboembolism (VTE) in IRDs is higher than in the general population, although the magnitude of this increase varies across diseases. Inflammatory damage to vessel walls, diminished elasticity, and compromised muscle pump function may contribute to the formation of varicose veins (VVs). A sedentary lifestyle, decreased muscular strength, and weight gain worsen the condition, particularly by adversely affecting venous return in the lower extremities. Consequently, the prevention of vascular issues in IRDs should be facilitated by both pharmaceutical interventions and rehabilitation with lifestyle modifications. A multidisciplinary rehabilitation strategy-encompassing regular physical activity, compression therapy, inflammation management, weight control, and patient education-enhances venous return, mitigates thrombosis risk, and improves quality of life.

Giant cell arteritis (GCA) is a medium and large vessel vasculitis. Vision loss is considered the most serious complications traditionally attributed to untreated disease. Urgent corticosteroids (CS) therapy is the standard of care and is considered adequate to prevent blindness. However, in some rare cases blindness may occur despite implementation of the appropriate treatment. We aimed to find patients who went blind despite high dose CS therapy and identify unique features of them together with conducting narrative review of previous case reports to characterize this group in search of common potential risk factors. Cases of blindness prior to treatment induction were not analyzed here. We identified 2 patients in our records who went blind despite high dose CS therapy. We found some repeated common features in patients that went blind in spite of treatment: advanced age, preexisting pronounced arteriosclerosis, thrombocytosis, contraindication to full dose CS therapy resulting in lower doses of CS within the recommended ranges. Defining the subgroup of GCA patients that went blind in spite of proper CS treatment requires further attention as they might potentially benefit from more aggressive therapy (e.g. early introduction of disease-modifying antirheumatic drugs).

Geriatric "failure to thrive" (French "syndrome de glissement") remains used in practice despite limited nosological validity. Objective. To describe care pathways and the clinical, social and biological profiles of older adults hospitalized for "failure to thrive", and to identify factors associated with short-term mortality. Retrospective, observational, single-center study including 419 patients aged ≥ 75 years admitted between 2019 and 2023 to the Assistance Publique-Hôpitaux de Marseille. Cases were retrieved from the French hospital discharge database using ICD-11 R54. We extracted demographics, comorbidities, geriatric syndromes, medications and admission laboratories; outcomes were in-hospital death and 30-day post-discharge death. Descriptive statistics and multivariable logistic regression were performed. Median age was 86; patients were markedly frail (mean Clinical Frailty Scale 6.0) with high comorbidity burden (mean Charlson 7.3). Malnutrition affected 48.9%; polypharmacy (≥ 5 drugs) 64%; psychotropic use was common (antidepressants 33.4%, benzodiazepines 31.3%). Mean length of stay was 14 days. Frequent associated diagnoses included infections (57.5%), electrolyte disorders (47%) and cardiovascular diseases (33.9%). Mortality was 22% in-hospital and 36% within 30 days post-discharge. In multivariable analysis, 30-day mortality was independently associated with severe frailty (CFS ≥ 7; adjusted OR 1.89; 95%CI 1.20-2.95), malnutrition (1.72; 1.10-2.68) and CRP > 50 mg/L (1.63; 1.04-2.56), whereas admission to a geriatric unit was protective (0.58; 0.35-0.95). Patients coded as "failure to thrive" represent an extremely vulnerable group with high early mortality rate. Findings support replacing this label with standardized multidimensional geriatric assessment, systematic nutritional management, medication review (including psychotropic deprescribing), and safer care transitions through dedicated geriatric pathways and early post-acute follow-up.

We sought to systematically catalogue and compare outcomes definitions across prospective clinical trials and registries evaluating ablation in VT to assess the impact of heterogeneous definitions on reported outcomes.

A systematic review (PROSPERO: CRD 42024595265) was performed in accordance with PRISMA guidelines. We searched for prospective studies from January 2000 to November 2024. Randomized trials, single-arm feasibility studies, and prospective registries involving ≥10 patients undergoing VT ablation were included. Study outcomes and their definitions were extracted and categorized. Pooled analyses were performed for comparable randomized trial subgroups, and meta-regression evaluated the effect of VT outcome definitions on reported success and complications. Fifty-nine studies were included: 15 randomized trials, 6 feasibility studies, and 38 prospective studies/registries. Definitions of acute procedural success varied, with most using acute clinical VT non-inducibility and others using only elimination of the clinical VT. VT recurrence was the most frequently reported long-term outcome; however, definitions differed markedly (VT recurrence or recurrence causing device therapy). Pooled analysis of prophylactic ablation vs. delayed ablation showed reduced VT recurrence (HR 0.63, 95% CI: 46-0.86) but no difference in hospitalization or mortality. Meta-regression demonstrated that an outcome of any VT recurrence yielded a higher failure rate of 51.0% compared to stricter definitions, such as VT-causing therapy at 37.3% or VT-causing shock only at 23.4% (P = 0.002). Safety outcomes were inconsistently reported.

Outcome definition in VT ablation trials showed substantial heterogeneity, limiting cross-trial comparability and meta-analytic synthesis. Development of a minimum set of standardized outcomes for VT ablation may improve consistency and clinical interpretability of VT trials.

The purpose of this study was to investigate the morphological and hemodynamic characteristics of the ophthalmic artery (OA) in ocular ischemic syndrome (OIS) and identify features potentially associated with disease pathogenesis.

This retrospective case-control study included 33 patients with OIS, 22 patients with internal carotid artery stenosis (ICAS), and 29 healthy controls. Clinical data and ophthalmic examinations were collected. The morphology and hemodynamics of the OA were quantified using three-dimensional (3D) reconstruction and computational fluid dynamics (CFD). Particle image velocimetry provided a qualitative consistency check for the CFD results.

The OA diameter in the OIS group was significantly smaller than that in the control and ICAS groups. Compared with the control group, the OIS group showed lower blood flow velocity and wall shear stress (8.25 ± 5.34 Pa vs. 13.50 ± 6.24 Pa; P = 0.004) at the OA origin. A smaller OA diameter and lower wall shear stress at the OA origin were significantly associated with the presence of OIS. A low wall shear stress was observed at the OA origin regardless of the flow direction in the OIS. Patients with high-velocity retrograde OA flow present severe ocular ischemic manifestations.

Low wall shear stress may be a consistent hemodynamic characteristic of eyes with OIS. This hemodynamic feature may induce inward remodeling of the OA, leading to further luminal narrowing and exacerbation of ocular ischemia. The presence of high-velocity retrograde OA flow may indicate a severe degree of ocular ischemia, highlighting the potential of OA hemodynamics for improving risk stratification and guiding management.

The management of infants with Ebstein's anomaly is challenging and requires complex involvement of the multidisciplinary team. Surgical repair technique is dependent on the degree of tricuspid leaflet dysfunction and the decision to undergo univentricular or biventricular repair. Patients with a severely dysplastic tricuspid valve are less suited to a cone repair alone and require leaflet reconstruction. Currently used patch materials include autologous untreated pericardium and treated pericardium, with limitations such as unpredictable shrinkage and no growth potential, respectively. To overcome these challenges, we used living autologous wall of the right atrium to reconstruct the tricuspid valve leaflets in a 1-year-old girl with Ebstein's anomaly and a severely dysplastic tricuspid valve.

Heart diseases (CVDs) are a major cause of morbidity and mortality in all global regions and thus there is the pressing need to develop early detection and effective management approaches. Traditional cardiovascular monitoring systems do not necessarily have real-time analyzing solutions and individual understanding, which leads to delayed interventions. Moreover, one of the greatest issues in digital healthcare applications remains to be data privacy and security.

The proposed research is to present a developed model of CVD detection that will combine Internet of Things (IoT)-based wearable devices, electronic clinical records, and access control using blockchain. The system starts by registering patients and medical personnel and then proceeds with collecting physiological as well as clinical data. Kalman filtering helps in improving data reliability in the pre-processing stage. Shallow and deep feature extraction methods are used to describe complicated patterns of data. A Refracted Sand Cat Swarm Optimization (SCSO) algorithm is used as part of feature maximization. A new TriBoostCardio Ensemble model (CatBoost, AdaBoost, and LogitBoost) is used to conduct the classification task and enhance the predictive accuracy. Smart contracts provide safe and transparent access to health information.

There are experimental results that the proposed framework enhances high predictive accuracy and detecting cardiovascular diseases earlier than traditional ones. The combination between SCSO feature selection and the TriBoostCardio Ensemble model improves the sturdiness of the model and precision of classification.

Besides the fact that the presented framework promotes the accuracy and timeliness of CVD detection, it also way to deal with important problems related to the data privacy and integrity with the help of blockchain-based access control. This solution offers a stable and trustworthy solution to the current healthcare systems with the combination of the smart optimization of features, ensemble learning, and secure data management.

Pediatric heart failure (PHF) is a lethal syndrome with a distinct pathophysiology from adult heart failure, posing a significant public health challenge in China. However, the impact of the nation's profound geospatial healthcare disparities on this vulnerable population remains unquantified. This national multicenter cohort study aimed to systematically examine the association between geographic location and PHF patient profiles, management, and survival outcomes.

We conducted a retrospective analysis of 2,903 pediatric inpatients (≤18 years) with a primary HF diagnosis from 30 centers (2013-2022). Patients with >20% missing data were excluded. Geospatial analysis stratified cohorts into Eastern, Western, and Central China. The primary outcome was in-hospital mortality, analyzed using multivariable logistic regression adjusted for key clinical confounders including age, etiology, and disease severity. Length of stay (LOS) was analyzed using a Gamma generalized linear model. All analyses were performed using Python (version 3.12).

Profound geospatial disparities were identified. Western patients presented significantly younger (median 6.93 months) with a higher prevalence of complex congenital heart disease (39.2%) and more severe clinical status (85.9% ROSS Class III-IV). In contrast, cardiomyopathy was the dominant etiology in the East (42.2%). Utilization of guideline-directed medical therapy (GDMT) was lowest in non-Eastern regions. Critically, geographic region was independently associated with mortality. Compared to the East, the adjusted odds of death were 2.58-fold higher in the West (95% CI: 1.5-4.45) and 3.54-fold higher in the Central region (95% CI: 2.11-5.94).

This study provides robust, national-level evidence that geographic location in China is a potent independent predictor of survival for children with heart failure, revealing a tiered healthcare landscape. These findings underscore an urgent public health imperative for targeted interventions to mitigate these disparities and establish equitable care systems through regional capacity building and standardized referral pathways.

This European Association of Cardiovascular Imaging (EACVI) survey evaluated current practice patterns in the imaging assessment of tricuspid regurgitation (TR), focusing on conventional and advanced modalities, the adoption of recent classifications, and barriers to quantitative right heart assessment.

A 25-item online questionnaire was launched during EuroEcho Imaging 2024 and distributed via EACVI channels. From 10 December 2024 to 3 July 2025, 530 respondents from 69 countries participated. Most worked in tertiary/university hospitals (62%) and were imaging specialists (41%) or clinical cardiologists (40%). Transthoracic echocardiography (TTE) was almost universally applied (96%), while use of transoesophageal (TOE) and 3D echocardiography was variable. Tricuspid annular plane systolic excursion (TAPSE) and fractional area change (RVFAC) were frequently used, but RV strain and ejection fraction were underutilized due to time constraints and software unavailability. TR quantification relied mainly on colour Doppler-based parameters, with advanced approaches-3D colour Doppler, cardiac magnetic resonance (CMR)-reserved for selected patients. Half of the respondents routinely applied the 5-grade TR severity scheme, and leaflet-based anatomical classification was inconsistently adopted. Cardiac computed tomography, CMR, and invasive haemodynamics were more often used in patients referred for transcatheter interventions.

This EACVI survey highlights considerable heterogeneity in TR imaging practice, with increasing yet slow adoption of robust quantitative and advanced modalities for assessing TR severity and right heart morphology/function. These findings underscore the need for improved access to advanced imaging technologies and broader dissemination of contemporary standards to enhance the quality and consistency of TR imaging in clinical and research settings.

The "weekend effect" refers to potential disparities in clinical outcomes based on the timing of hospital admission, with prior studies offering conflicting results, particularly in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS). This study evaluates the impact of admission timing on outcomes in patients with ST-elevation myocardial infarction and CS (STEMI-CS) and patients with non-STEMI and CS (NSTEMI-CS).

We conducted a retrospective analysis using the Nationwide Inpatient Sample from 2016 to 2021. Patients with STEMI-CS and NSTEMI-CS were identified using ICD-10 (International Classification of Diseases, Tenth Revision) codes and stratified by weekday versus weekend admissions. Propensity score matching and multivariable logistic regression were employed to adjust for confounders. The primary outcome was in-hospital mortality; secondary outcomes included acute stroke, pacemaker implantation, and resource utilization.

Among 14,060 propensity-matched STEMI-CS patients (7,030 weekday and 7,030 weekend admissions), in-hospital mortality was higher in weekday compared to weekend admissions (2,373 (33.8%) vs. 2,261 (32.2%), p=0.044). Pacemaker implantation was less frequent in weekday admissions (28 (0.4%) vs. 55 (0.8%), p=0.003). Other outcomes, including percutaneous coronary intervention, acute stroke, sudden cardiac arrest, sepsis, pulmonary embolism, arrhythmias, and device implantation, were comparable between groups. Among 9,490 propensity-matched NSTEMI-CS patients (4,745 weekday and 4,745 weekend admissions), weekend admissions were associated with higher in-hospital mortality compared to weekdays (1,485 (31.3%) vs. 1,372 (28.9%), p=0.011), while other outcomes remained similar between groups.

Admission timing influences in-hospital mortality in patients with CS secondary to AMI, with contrasting trends observed between STEMI-CS and NSTEMI-CS cohorts. These findings suggest that variations in hospital protocols, staffing, or resource availability may contribute to these differences. Further research is warranted to elucidate the underlying mechanisms and develop strategies to optimize care delivery across all admission times.