Search Results (6,579)

Objective: This study examined the association between glycemic status, indexed by HbA1c, and cognitive functioning in individuals with bipolar disorder (BD), recurrent major depressive disorder (rMDD), schizophrenia (SZ), and healthy controls (HCs). Methods: In this cross-sectional study, 215 participants (45 HCs, 64 BD, 62 rMDD, 44 SZ) were assessed. Cognitive performance was evaluated using a comprehensive neuropsychological battery measuring attention, processing speed, memory, executive functions, and social cognition. Sociodemographic characteristics, chlorpromazine-equivalent antipsychotic doses (CEDA), and metabolic variables (body mass index, waist circumference, lipid profile, fasting glucose, and HbA1c) were collected. Group differences, correlation analyses, and multiple regression models were performed. Results: All patient groups showed significantly poorer cognitive performance compared with HCs. HbA1c levels were highest in the SZ group; however, associations between HbA1c and cognitive performance were strongest in the BD group and less consistent in rMDD. In regression analyses, HbA1c was associated with cognitive performance in BD and HCs, with weaker effects in rMDD. CEDA was associated with HbA1c levels and partially attenuated the relationship between HbA1c and cognitive outcomes. Conclusions: HbA1c levels were associated with cognitive performance in non-diabetic individuals, particularly in BD and rMDD. These findings suggest that subclinical variation in glycemic regulation may be relevant to cognitive functioning in psychiatric disorders. Further longitudinal studies are needed to clarify the influence of metabolic factors and psychotropic medication on cognitive outcomes. Full article

Background: Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease and end-stage renal disease worldwide. Despite robust evidence-based guidelines, real-world adherence to recommended preventive care remains inadequate. Most prior evaluations have focused on individual care components rather than comprehensive composite care delivery. Methods: A retrospective cross-sectional study of 1010 adult patients with diabetes attending outpatient clinics at King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia. Full guideline-concordant care (GCC) was defined as composite completion of HbA1c monitoring, albuminuria screening using the urine albumin-to-creatinine ratio (ACR), and renin–angiotensin–aldosterone system inhibitor (RAASi) use among patients with detected albuminuria. Multivariable logistic regression (n = 1007) identified independent predictors of full GCC. Results: Only 22.7% (95% CI: 20.1–25.3%) of patients achieved full GCC. Partial care was the most common pattern (46.2%), followed by no care (20.7%) and near-complete care (10.4%). HbA1c testing was performed in 55.0% and albuminuria screening in 49.3% of patients. Among those with detected albuminuria, RAASi therapy was prescribed in 78.9%. Primary care management (OR 4.79, 95% CI 3.45–6.66; p < 0.001) and hypertension (OR 2.00, 95% CI 1.33–3.00; p = 0.001) were independently associated with full GCC. Age, gender, kidney function, and cardiac disease were not significant predictors. Conclusions: Substantial gaps exist in guideline-recommended DKD care, driven primarily by screening deficiencies rather than treatment failures. Care delivery is influenced more by healthcare setting than by patient characteristics, highlighting the need for system-level interventions targeting detection infrastructure across all care settings. Full article

Background/Objectives: Functional secondary hypogonadism is frequent in men with obesity, metabolic syndrome, and type 2 diabetes mellitus (T2DM), but whether testosterone replacement therapy (TRT) produces clinically relevant metabolic benefits remains uncertain. This systematic review evaluated double-blind randomized placebo-controlled trials of TRT in obese men with functional secondary hypogonadism and either T2DM or metabolic syndrome. Methods: PubMed and Scopus were searched up to May 2026. Eligible studies enrolled adult men with biochemical hypogonadism and T2DM or metabolic syndrome, compared TRT with placebo, and reported metabolic outcomes. Open-label, single-blind, and non-randomized studies were excluded. Risk of bias was assessed with the Cochrane RoB 2 framework and certainty of evidence with GRADE. Results: Eight trials were included. The most consistent signal was improvement in body composition, mainly increased lean mass and reduced fat mass. Effects on insulin resistance were favorable in several trials but heterogeneous. GRADE certainty was low for fat mass, lean mass, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and it was very low for clamp-derived insulin sensitivity, HbA1c, fasting glucose, lipid outcomes, inflammatory and vascular surrogate markers, and long-term safety. Conclusions: Low-certainty evidence suggests that TRT may improve body composition and HOMA-IR in carefully selected men with functional secondary hypogonadism and metabolic disease, whereas effects on glycemic and lipid outcomes remain very uncertain. TRT should not be regarded as an antidiabetic or lipid-lowering intervention. Larger phenotype-specific trials with longer follow-up are needed. Full article

Hepatitis B surface antigen (HBsAg) signal-to-cutoff (S/CO) values and isolated anti-HBc positivity represent two significant diagnostic challenges in hepatitis B virus (HBV) serology. This retrospective study, conducted in Karabük between 2021 and 2025, aimed to evaluate the correlation between these profiles and HBV DNA positivity to determine the optimal S/CO thresholds for confirmatory testing and clarify the clinical relevance of isolated anti-HBc reactivity. Among 17,356 patients screened for anti-HBc, isolated anti-HBc positivity was identified in 506 patients (2.9%), of whom 3.2% had detectable HBV DNA. Positivity was significantly higher in patients older than 50 years and in the Gastroenterology department. Separately, 213 specimens with HBsAg S/CO values between 1.0 and 10.0 underwent HBV DNA confirmation testing. ROC analysis yielded an excellent area under the curve of 0.937, with an S/CO threshold of ≥3.04, achieving 100% sensitivity for HBV DNA detection. All specimens with S/CO values between 1.0 and 3.0 were HBV DNA-negative. In this study population, no serum HBV DNA positivity was detected among samples with S/CO values below 3.04, suggesting that HBV DNA testing may help avoid unnecessary confirmatory work-up in this range. Anti-HBc screening should be prioritized in older patients. S/CO-based confirmatory algorithm using HBV DNA testing may improve diagnostic accuracy and reduce unnecessary clinical interventions in routine hepatitis B screening programs. Full article

Background/Objectives: optimization of the therapeutic efficacy of antidiabetic agents is still a great challenge in the management of type 2 diabetes mellitus (T2DM), and attention is becoming more and more focused on the use of adjunctive agents that help target the drug action beyond the classic glycemic target. This study examined the effect of co-administration of an Artemisia herba-alba Asso (Asteraceae) aqueous extract on the glucose-lowering effect of dapagliflozin, a sodium–glucose cotransporter-2 (SGLT2) inhibitor. Methods: qualitative phytochemical screening and total phenolic and total flavonoid content were used to characterize the aqueous preparation. Male Wistar albino rats were divided into eight groups (10 rats each): four healthy and four diabetic rats induced with streptozotocin (STZ). Vehicle control, oral administration of an aqueous A. herba-alba preparation (0.39 g/kg twice daily), dapagliflozin (0.143 mg/kg/day), or a combination of both was given for 30 days. At baseline and days 7, 14, 21, and 30, glycated hemoglobin (HbA1c) was measured by nephelometry. Parallel fasting blood glucose (FBG) was monitored. Results: the diabetic animals treated with the combination regimen showed the greatest and most sustained decrease in HbA1c (from 4.42 ± 0.40% at baseline to 3.44 ± 0.17% at day 30; p < 0.001) and the greatest decrease in FBG (from 186.0 to 122.2 mg/dL). A. herba-alba monotherapy had little effect on HbA1c and had minimal effect on FBG (214.9 to 217.6 mg/dL); dapagliflozin monotherapy had a modest effect on HbA1c. The untreated diabetic controls (n = 10) showed a progressive increase in HbA1c from 4.45 ± 0.60% at 72 h post-induction to 11.90 ± 0.99% by day 30 (p < 0.001), consistent with delayed hemoglobin glycation relative to the rise in blood glucose. The repeated-measures ANOVA showed a highly significant interaction between time and treatment (p < 0.001). Conclusions: this study showed that the phytochemically defined aqueous A. herba-alba preparation is a beneficial adjunct to SGLT2 inhibitor therapy, an effect not observed with either treatment alone. Full article

Over the past decade, the incidence of infectious syphilis has been on the rise in the general Chinese population. Consequently, Treponema Pallidum (TP) testing has been proposed as a surrogate marker for sexually transmitted pathogens and for monitoring risky sexual behaviors among blood donors globally. In addition, sexual contact with individuals chronically infected with hepatitis B virus (HBV) is recognized as one of the primary routes of HBV transmission. Blood donors may acquire HBV infection through sexual contact with chronically infected partners, particularly with occult hepatitis B infections (OBIs), which are characterized by intermittent and extremely low viral loads. Therefore, the prevalence of OBIs among syphilis-positive blood donations and the corresponding risks to blood safety require further investigation. This study aimed to investigate the prevalence of OBIs among syphilis-positive blood donors and assess the surrogate value of TP testing for evaluating OBI-related risks to blood supply. After routine screening using serological assays and nucleic acid testing (NAT), blood donation samples with positive anti-TP enzyme-linked immunosorbent assay (ELISA) results were collected and further confirmed by the Treponema Pallidum Particle Agglutination Assay (TPPA). For blood donations confirmed positive for syphilis, further tests were performed to characterize whether the donations had HBV co-infection, including electrochemiluminescence immunoassay (ECLI) for the detection of hepatitis B surface antigen (HBsAg), anti-hepatitis B surface antibody (anti-HBs), hepatitis B e antigen (HBeAg), anti-hepatitis B e antibody (anti-HBe), and anti-hepatitis B core antibody (anti-HBc). Additionally, quantitative real-time polymerase chain reaction (qPCR) was used for HBV DNA quantification, and nested PCRs for the S and basal core promoter/precore (BCP/PC) region were conducted in combination with high-volume nucleic acid extraction. Subsequently, molecular characterization of HBV DNA in these co-infected samples was carried out by DNA sequencing to analyze the viral genetic features. Of 252 anti-TP ELISA+ donations screened from 64,871 blood samples, 138 (138/250, 55.2%) donations were confirmed syphilis-positive but NAT−, among which 78 (78/138, 56.5%) were anti-HBc-positive, and 88 (88/138, 63.7%) had anti-HBs. Notably, seven donations (7/138, 5.1%) were diagnosed as OBI co-infections, and available sequence analysis revealed that three cases were genotype B and one case was genotype C. In addition, several mutations in the S region of the HBV genome were identified, including Q101R, K122R, Q129H, T131N, M133T, G145R, and Y161F mutations. Furthermore, nucleotide mutations such as T1719G, A1752T, G1896A, and A1762T/G1764A in the BCP/PC regions were also detected in these OBI donations. These mutations may contribute to the extremely low HBV viral loads and/or failure in HBsAg detection, collectively leading to OBIs. These data indicate that syphilis screening of blood donors has potential to serve as an additional safeguard measure for excluding donations co-infected with OBIs. The high prevalence of undetected OBIs in syphilis-positive blood donors further supports that syphilis screening has the potential to serve as a surrogate marker for HBV-related risks in the blood supply. Full article

Background and Objectives: Diabetes mellitus is a major systemic modifier of oral infection, periodontal inflammation, and tissue healing. Persistent hyperglycemia may intensify oxidative stress, immune dysfunction, dysbiotic biofilm activity, and advanced glycation end-product/receptor signaling, thereby reducing the predictability of periapical and periodontal healing. In patients with endo-periodontal lesions, these mechanisms may interact with pulpal infection and periodontal breakdown, complicating diagnosis, prognosis, and therapeutic sequencing. This review summarizes current evidence on diabetes, glycated hemoglobin (HbA1c), and endo-periodontal outcomes and proposes an HbA1c-guided clinical framework for risk stratification and treatment planning. Materials and Methods: A structured narrative review with an expert-informed clinical framework was conducted using the literature published between January 2016 and December 2025. Eligible sources included consensus reports, clinical practice guidelines, systematic reviews, meta-analyses, umbrella reviews, randomized and non-randomized clinical studies, observational studies, and selected mechanistic studies or contemporary narrative reviews with direct relevance to the framework. Case reports, animal studies, and in vitro investigations without direct relevance to the clinical framework were excluded from the main synthesis. Results: Diabetes is associated with increased periodontal severity, impaired periodontal treatment response, a higher prevalence of radiolucent periapical lesions in root-filled teeth, delayed periapical healing, and increased non-retention of endodontically treated teeth. Periodontal therapy is safe in diabetic patients and may be associated with modest reductions in HbA1c, especially when baseline metabolic control is poor. Conclusions: HbA1c should complement, not replace, pulpal testing, periodontal charting, and radiographic assessment. The proposed framework prioritizes endodontic infection control when pulpal necrosis or active intracanal infection is present, adapts periodontal intervention to metabolic risk, and postpones elective surgical or regenerative procedures in poorly controlled diabetes until medical stabilization is achieved. Full article

Sickle Cell Disease (SCD) is a hereditary hemoglobinopathy arising from a single-nucleotide transversion (GAG → GTG) at codon six of the HBB gene on chromosome 11, substituting glutamic acid with valine in the β-globin chain and producing hemoglobin S (HbS). Under hypoxic conditions, HbS polymerizes and distorts erythrocytes into the characteristic sickle shape, initiating a cascade of vaso-occlusion, chronic hemolytic anemia, and progressive multi-organ damage that defines the clinical burden of this disease. Although SCD has ancient origins in sub-Saharan Africa, the Indian subcontinent, the Middle East, and the Mediterranean, regions where it conferred heterozygous resistance to malaria, the ease of human migration has long since made it a global health concern, affecting an estimated 300,000–400,000 newborns annually. Advances in molecular and genomic research have deepened our understanding of SCD pathophysiology, revealing the central contributions of hemoglobin polymerization, oxidative stress, endothelial inflammation, and nitric oxide depletion to disease progression. Current management rests on supportive pharmacological interventions, including hydroxyurea, chronic transfusion therapy, L-glutamine, and multimodal pain management, complemented by lifestyle modifications. Curative approaches have advanced substantially: hematopoietic stem cell transplantation (HSCT) remains the established standard of cure, while the regulatory approvals in late 2023 of the CRISPR/Cas9-based exagamglogene autotemcel (Casgevy) and the lentiviral vector-based lovotibeglogene autotemcel (Lyfgenia) represent the most transformative development in the history of SCD therapeutics. This review traces the disease from its ancient origins and molecular characterization through to its clinical manifestations, inheritance patterns, screening strategies, and the full spectrum of current and emerging therapies. Persistent challenges, prohibitive treatment costs, healthcare inequities, the ethical dimensions of genome editing, and the urgent need for long-term safety data, are examined critically, with a view to informing the research and policy agenda that must accompany these remarkable scientific advances. Full article

Background/Objectives: Exogenous ketone supplementation has been proposed to enhance endurance performance by altering substrate metabolism and sparing muscle glycogen. Prolonged carbohydrate restriction may upregulate ketolytic capacity and could therefore modulate the response to exogenous ketone ingestion. This study investigated the impact of increasing circulating ketone bodies through exogenous ketone supplementation on endurance performance in athletes chronically adapted to a ketogenic diet. Methods: Participants (n = 9 recreationally active males, with ≥1 year of ketogenic adherence) visited the lab four times. The first visit determined their $\stackrel{.}{\mathrm{V}}$O₂max. The second visit accustomed them to test procedures. In a counterbalanced design, visits three and four tested the consumption of a 60 g carbohydrate beverage (CHO), or a beverage comprising 60 g carbohydrate and 0.5 g/kg 1,3-butanediol (CHO + BD). This was followed by a 60 min set-intensity exercise bout, followed by a 16.1 km time trial. Results: βHB significantly increased in the CHO + BD group (rest: 0.72 ± 0.33 mmol/L; post-exercise: 1.69 ± 0.30 mmol/L) compared to CHO (rest: 0.80 ± 0.53; post-exercise: 0.55 ± 0.30) (p < 0.001). There was no significant difference in time trial performance between groups (1606 ± 138 s; 1620 ± 134 s; p > 0.05). During set intensity exercise, there was no significant main effect of supplementation on lactate concentration, substrate oxidation, oxygen consumption at a fixed workload, RPE or heart rate (p > 0.05). However, glucose was significantly lower at minutes 40 and 60 of set intensity exercise in CHO + BD compared to CHO. Conclusions: No significant effect of 1,3-butanediol ingestion on endurance performance was detected in this sample of nine chronically ketogenic male athletes. βHB significantly increased from resting levels; however, time trial performance did not differ between conditions. Given the small sample and limited statistical power, these preliminary findings indicate no detectable ergogenic effect under the present conditions rather than evidence of no effect, and larger studies are warranted. Full article

An approach for the thermo-energy and environmental evaluation of polyhydroxyalkanoate (PHA)-based biopolymer coatings in green building envelopes is presented in this study. A boutique hotel designed for Antalya, Türkiye, was selected as a case study, and 117 multi-layer wall composites assemblies incorporating 13 different PHA-based coatings were evaluated. The thermal conductivity values were predicted by a crystallinity-dependent semi-empirical equation and used in dynamic building simulations with Integrated Environmental Solutions–Virtual Environment (IES-VE) to predict the annual energy use and CO₂ emissions. The performance of material was evaluated based on biodegradability, density, crystallinity, thermal stability, and mechanical properties by using the integrated LOGSTA–LODECI weighting and MUNRA ranking techniques. P3HB4HB showed the best overall material performance, in contrast to P3HB, which had the lowest energy requirement and emissions. The findings emphasize crystallinity as a key determinant for material and building energy performance. Full article

The method of how microcapsules and brass powder are added significantly affects the overall effectiveness of decorative coatings. An innovative self-repairing decorative coating for Basswood surfaces was created using melamine resin-coated water-based primer microcapsules as the repair agent under the coating process of “three coats of primer, two coats of topcoat, and introducing brass powder and microcapsules into the primer”. The optical and mechanical properties of this coating were significantly impacted by the curing temperature and brass powder content, respectively. The optical qualities, mechanical properties, liquid resistance, aging resistance, and self-repairing performance of the coating improved at higher curing temperatures under varying brass powder contents. The water-based acrylic wood coating obtained at 60 °C with 3% brass powder and 3% primer microcapsules, featuring a core-wall ratio of 0.58:1, provided the best overall qualities. It has a gloss of 34.1 GU, color difference of 0.00, visible light reflectance of 0.6038, visible light transmittance of 76.20%, color main wavelength of 589.79 nm, hardness of HB, impact resistance of 2 kg·cm, adhesion of grade 1, roughness of 1.125 µm, excellent aging and liquid resistance, and repair rate of 22.93%. This study provides an effective and new strategy for simultaneously improving the decorative, mechanical, and self-repairing properties of water-based wood coatings. Full article

Background/Objectives: Type 2 diabetes mellitus (T2DM) has been evaluated through a glucocentric model centered on hyperglycemia, glycated haemoglobin (HbA1c) targets, and complications. However, obesity-associated T2DM reflects a broader metabolic ecosystem in which glycemic control interacts with adiposity, inflammation, muscle function, renal stability, and treatment mechanisms. Therapeutic response may be better captured through patient-level responder phenotypes than through mean changes in isolated outcomes. We aimed to determine, in adults with obesity-associated T2DM maintained on stable 12-month metformin-based regimens, the distribution of concordant versus discordant glycemic–adiposity response phenotypes and the frequency of high multidimensional response, and to describe how these phenotypes were distributed across treatment classes. Methods: This secondary patient-level analysis used a real-world cohort from a Bucharest tertiary diabetes center. Of 291 screened adults, 166 completed 12-month follow-up without treatment change. Regimens included metformin alone or combined with sulfonylurea, DPP-4 inhibitor, SGLT2 inhibitor, GLP-1 receptor agonist, or insulin. Responses were defined as HbA1c reduction ≥ 0.5 percentage points, fat mass reduction ≥ 5%, hs-CRP reduction ≥ 20%, and handgrip strength decline ≤ 1 kg. Primary phenotypes and a 0–4 multidimensional score were derived. Results: Mean age was 59.7 ± 13.0 years, BMI 36.3 ± 4.4 kg/m², and baseline HbA1c 8.9 ± 1.0%. Glycemic–adiposity, glycemic-only, adiposity-only, and low/non-response phenotypes occurred in 49 (29.5%), 88 (53.0%), 9 (5.4%), and 20 (12.0%) patients, respectively. A high multidimensional response occurred in 78 (47.0%), and complete response in 25 (15.1%). GLP-1 receptor agonists showed the most consistent concordant glycemic–adiposity response, whereas insulin was predominantly glycemic-only. Conclusions: In obesity-associated T2DM, therapeutic response was heterogeneous and frequently discordant across metabolic domains. Patient-level responder phenotyping may complement conventional HbA1c-centered evaluation by identifying response quality across glycemic, adiposity, inflammatory, and functional dimensions. This approach may support more individualized diagnostic interpretation and treatment optimization in real-world diabetes care. Full article

Background: Hereditary Spherocytosis (HS), the most common congenital hemolytic anemia, is characterized by highly heterogeneous clinical manifestations with variable hemolytic anemia, jaundice, reticulocytosis, splenomegaly, and gallstones. The ektacytometric analysis is considered a gold standard tool for HS diagnosis. Two distinct profiles may be observed: the typical bell-shaped profile (HS1) and a right-shifted curve (HS2); nonetheless, the clinical and biochemical significance of these differences, and their correlation with the clinical phenotype of HS remain poorly understood. Methods: We analyzed a large cohort of non-splenectomised HS patients, focusing on their ektacytometric curves and their hematologic and biochemical features. Results: We found that HS2 patients were significantly younger and showed a more severe anemia compared to HS1; in particular, HS2 patients had lower Hb levels and MCHC values, and higher RDW. Interestingly, only in the HS1 group, we observed a negative correlation between MCHC and all osmoscan parameters related to osmolality (Omin, Ohyper, and Omax). Conclusions: All the results indicate that HS may be characterized by two typical shapes of the ektacytometric curve, where HS2 profiles are associated with more severe and young patients, and that in the more HS severe cases red cells show a lower density. Full article

Objectives: Type 2 diabetes mellitus (T2DM) is an increasing public health concern in Thailand, particularly in rural communities where dietary practices and contextual factors may influence glycemic control. This study aimed to assess nutritional knowledge, attitude, and eating behavior using the Knowledge–Attitude–Practice (KAP) framework and to compare nutritional intake profiles between patients with controlled and uncontrolled glycemic status. Methods: A cross-sectional study was conducted among 70 patients with T2DM attending a health-promoting hospital in northeastern Thailand. Participants were classified into glycemic-controlled (GC; HbA1c < 7%, n = 36) and glycemic-uncontrolled (UC; HbA1c ≥ 7%, n = 34) groups. Data were collected using a semi-structured questionnaire covering demographics, anthropometry, body composition, biochemical parameters, and KAP domains. Dietary intake was assessed using three-day food records (two weekdays and one weekend day) and analyzed with the INMUCAL Nutrients program. Statistical analyses included descriptive statistics, group comparisons, logistic regression, and Spearman’s correlation. Results: Overall, participants demonstrated high levels of nutritional knowledge (71.4%) and fair attitude (52.9%), but moderate levels of appropriate eating behavior (58.6%). Eating behavior differed significantly between GC and UC groups (p = 0.038). The UC group consumed significantly higher amounts of total energy, carbohydrates, simple carbohydrates, and protein than the GC group. HbA1c and fasting blood glucose were positively correlated with total energy, carbohydrate, simple carbohydrate, and zinc intake, while protein and phosphorus intake were positively associated with fasting blood glucose only. Logistic regression analysis showed no significant associations between KAP domains and glycemic control. Conclusions: Glycemic control among rural Thai patients with T2DM was more closely related to dietary intake patterns than to nutritional knowledge or attitude alone, highlighting the need for context-specific, community-based dietary interventions. Full article

Background: Sickle cell disease (SCD) is the most common inherited blood disorder globally, affecting approximately 300,000 newborns annually. Cardiac remodeling, resulting from chronic anemia, vascular obstruction, and endothelial dysfunction, substantially contributes to morbidity and mortality in patients with SCD. Therefore, characterizing these patterns is essential to clinical management and outcome improvement in pediatric patients. However, a comprehensive synthesis of cardiac remodeling patterns in pediatric and adolescent patients with SCD and their associations with genotype and clinical severity is lacking. Methods: We conducted a systematic review in accordance with the PRISMA 2020 guidelines and searched five databases for studies published from January 1978 to December 2024. Of 1131 retrieved studies, 37 met the inclusion criteria; of these, 31 focused exclusively on children (Group A), while six included both children and adults (Group B). We analyzed cardiac remodeling patterns, genotype-specific findings, associations with disease severity, and imaging modalities. The 37 studies included approximately 4253 patients from 12 countries, representing diverse populations and imaging techniques. Results: Left ventricular (LV) dilation was the most frequently reported finding, noted in 33 of 37 studies (89.2%; representing study-level reporting frequency, not patient-level prevalence), followed by diastolic dysfunction (reported in 18 of 37 studies; 48.6%); elevated TRV (≥2.5 m/s) as an echocardiographic screening marker for pulmonary hypertension (PH) risk was found in 14 of 37 studies (37.8%; TRV ≥ 2.5 m/s is a screening criterion, not confirmed hemodynamic PH); myocardial fibrosis was found in three studies (8.1%, exclusively from mixed-age cohorts); and QTc prolongation/arrhythmia was found in one study (2.7%). The HbSS genotype was associated with the most severe cardiac changes. Studies that did not stratify by genotype subtype (HbS/β⁰ vs. HbS/β⁺) may underestimate cardiac severity in mixed-genotype cohorts. Markers of disease severity, such as elevated lactate dehydrogenase (LDH) expression, frequent acute chest syndrome (ACS), and increased hospitalizations, were associated with more pronounced cardiac remodeling in individual studies, but the cross-study consistency of this association varied. Study designs and imaging modalities also varied, underscoring the need for standardized assessment protocols to enhance comparability and clinical translation. This review presents a narrative synthesis; individual study statistics are reported as originally published, without formal pooled estimates. Conclusions: Cardiac abnormalities in SCD were reported from early childhood, with more advanced phenotypes being more frequently described in older adolescents and mixed-age cohorts, suggesting possible age-related progression requiring prospective confirmation. Principal limitations include retrospective PROSPERO registration (CRD420261435382), the predominance of cross-sectional study designs, the inconsistent z-score normalization of cardiac dimensions, the incomplete reporting of treatment exposure, the disproportionate contribution of mixed-age cohorts to advanced imaging findings, and inter-study heterogeneity in echocardiographic protocols. Full article