Around 5%-10% of fetal pregnancies impacting maternal and neonatal outcomes have been affected by hypertensive disorders of pregnancy. As a cardiovascular risk factor, pre-eclampsia is now really recognized for women throughout the world. Pre-eclampsia is one hypertensive disorder in pregnancy. It imposes far-reaching influences on women and poses a great threat to life as well, no matter mother or child. Around 2% to 8% of pregnancies worldwide are affected by it. It also gives rise to marked maternal and perinatal morbidity and mortality. The occurrence of cardiovascular diseases is the most severe complication observed in preeclamptic women. As clearly revealed by the newest evidence, remarkable association exists between cardiovascular disease and pre-eclampsia. The aim of our review is to highlight the correlation between pre-eclampsia and the possibility of cardiovascular disease. Moreover, it still cannot establish a clear dependency mechanism between pre-eclampsia and cardiovascular disease for their multifactorial nature.

Background: Optimal valve sizing provides improved results in transcatheter aortic valve replacement. Operators hesitate about the valve size when the annulus measurements fall into borderline area. Our purpose was to compare the results of borderline versus non-borderline annulus and to understand the impact of valve type and under or oversizing.

Methods: Data from 338 consecutive transcatheter aortic valve replacement procedures were analyzed. The study population was divided into 2 groups as “borderline annulus” and “non-borderline annulus.” Balloon expandable valves already have a grey zone definition. Similar to balloon expandable valves, annulus sizes that are within 15% above or below the upper or lower limit of a particular self-expandable valve size are defined as the “borderline annulus” for self-expandable valves. The borderline annulus group was also divided into 2 subgroups according to the smaller or larger valve selection as “undersizing” and “oversizing.” Comparisons were made regarding the paravalvular leakage and residual transvalvular gradient.

Results: Of these 338 patients, 102 (30.1%) had a borderline and 226 (69.9%) had a non-borderline annulus. Both the transvalvular gradient (17.81 ± 7.15 vs. 14.44 ± 6.27) and the frequency of paravalvular leakage (for mild, mild to moderate, and moderate, 40.2%, 11.8%, and 2.9% vs., 18.8%, 6.7%, and 0.4%, respectively) were significantly higher in the borderline annulus than the non-borderline annulus group (P <.001). There were no significant differences between the groups balloon expandable versus self-expandable valves and oversizing versus undersizing regarding the transvalvular gradient and paravalvular leakage in patients with borderline annulus (P >.05).

Conclusion: Regardless of the valve type and oversizing or undersizing, borderline annulus is related to significantly higher transvalvular gradient and paravalvular leakage when compared to the non-borderline annulus in transcatheter aortic valve replacement.

Background: To explore the prognosis and risk factors of postoperative hepatic dysfunction in patients with acute type A aortic dissection.

Methods: A total of 156 patients who underwent surgery for acute type A aortic dissection in our hospital from May 2014 to May 2018 were retrospectively enrolled. The patients were divided into 2 groups based on postoperative liver function. The postop-erative model for end-stage liver disease score was used to define hepatic dysfunction. There were 35 patients with postoperative hepatic dysfunction (group hepatic dysfunction, model for end-stage liver disease score ≥ 15) and 121 patients without postoperative hepatic dysfunction (group non-hepatic dysfunction, model for end-stage liver disease score < 15). Univariate and multiple analyses (logistic regression) were used to identify the predictive risk factors.

Results: In-hospital mortality rate was 8.3%. Multiple logistic analysis showed that preoperative alanine aminotransferase (P <.001), cardiopulmonary bypass time (P <.001), and red blood cell transfusion (P <.001) were independent determinants for postoperative hepatic dysfunction. The patients were followed up for 2 years, with an average follow-up of 22.9 ± 3.2 months, and the lost follow-up rate was 9.1%. The short- and medium-term mortality in hepatic dysfunction group was higher than that in non-hepatic dysfunction group (log-rank P =.009).

Conclusions: The incidence of postoperative hepatic dysfunction is high in patients with acute type A aortic dissection. Preoperative alanine aminotransferase, cardiopulmonary bypass time, and red blood cell transfusion were independent risk factors for those patients. The short- and medium-term mortality in hepatic dysfunction group was higher than that in non-hepatic dysfunction group.

Background: To evaluate the application value of artificial intelligence-based auxiliary diagnosis for congenital heart disease.

Methods: From May 2017 to December 2019, 1892 cases of congenital heart disease heart sounds were collected for learning- and memory-assisted diagnosis. The diagnosis rate and classification recognition were verified in 326 congenital heart disease cases. Auscultation and artificial intelligence-assisted diagnosis were used in 518 258 congenital heart disease screenings, and the detection accuracies of congenital heart disease and pulmonary hypertension were compared.

Results: Female sex and age > 14 years were predominant in atrial septal defect (P <.001) compared with ventricular septal defect/patent ductus arteriosus cases. Family history was more prominent in patent ductus arteriosus patients (P <.001). Compared with no pulmonary arterial hypertension, a male predominance was seen in cases of congenital heart disease–pulmonary arterial hypertension (P <.001), and age was significantly associated with pulmonary arterial hypertension (P =.008). A high prevalence of extracardiac anomalies was found in the pulmonary arterial hypertension group. A total of 326 patients were examined by artificial intelligence. The detection rate of atrial septal
defect was 73.8%, which was different from that of auscultation (P =.008). The detection rate of ventricular septal defect was 78.8, and the detection rate of patent ductus arte-riosus was 88.9%. A total of 518 258 people from 82 towns and 1220 schools were screened including 15 453 suspected and 3930 (7.58%) confirmed cases. The detection accuracy of artificial intelligence in ventricular septal defect (P =.007) and patent ductus arteriosus (P =.021) classification was higher than that of auscultation. For normal cases, the recurrent neural network had a high accuracy of 97.77% in congenital heart disease–pulmonary arterial hypertension diagnosis (P =.032).

Conclusion: Artificial intelligence-based diagnosis is an effective assistance method for congenital heart disease screening.

Background: A higher frequency of premature ventricular complexes is associated with a higher risk of premature ventricular complex-induced cardiomyopathy. Although there are several studies on the systolic functions of the left ventricle in this patient group, it is clearly not known how the diastolic functions of the left ventricle are affected. This study examined the effect of premature ventricular complex on left ventricle diastolic functions using diastolic strain rate.

Methods: The trial included 57 patients with frequent premature ventricular complexes and 54 healthy volunteers. The patient was evaluated using echocardiography in its entirety. The vendor-independent software system determined systolic and diastolic strain parameters via 2-dimensional speckle tracking analysis. Using the auto strain 3P semi-automated endocardial boundary tracking instrument, the global longitudinal strain was measured from the apical 4-chamber, 2-chamber, and long axis. The diastolic strain rate was determined by averaging the strain rates of 17 cardiac segments at 2 distinct periods of diastole.

Results: In the patient group, early diastolic strain rate was significantly lower than that in the control group (1.62 ± 0.58 vs. 1.25 ± 0.38, P <.001). There were found to be significant negative connections between PVC's electrocardiographic QRS wave length and early diastolic strain rate and coupling interval and early diastolic strain rate. Significant positive associations between coupling interval and early diastolic strain rate were discovered (P <.001 and P <.001, respectively).

Conclusions: Patients with premature ventricular complex exhibited a lower early diastolic strain rate than healthy individuals. The early diastolic strain rate can be used to predict left ventricle diastolic dysfunction, and persons with premature ventricular complex may have a higher risk of left ventricle diastolic dysfunction than the general population.

Background: The present study aimed to identify the frequency of Fabry disease in patients with cardiac hypertrophy of unknown etiology and to evaluate demographic and clinical characteristics, enzyme activity levels, and genetic mutations at the time of diagnosis.

Methods: This national, multicenter, cross-sectional, single-arm, observational registry study was conducted in adult patients with a clinical echocardiographic diagnosis of left ventricular hypertrophy and/or the presence of prominent papillary muscle. In both genders, genetic analysis was performed by DNA Sanger sequence analysis.

Results: A total of 406 patients with left ventricular hypertrophy of unknown origin were included. Of the patients, 19.5% had decreased enzyme activity (≤2.5 nmol/mL/h). Although genetic analysis revealed GLA (galactosidase alpha) gene mutation in only 2  patients (0.5%), these patients were considered to have probable but not “definite Fabry disease” due to normal lyso Gb3 levels and gene mutations categorized as variants of unknown significance.

Conclusion: The prevalence of Fabry disease varies according to the characteristics of the population screened and the definition of the disease used in these trials. From cardiology perspective, left ventricular hypertrophy is the major reason to consider screening for Fabry disease. Enzyme testing, genetic analysis, substrate analysis, histopathological examination, and family screening should be performed, when necessary, for a definite diagnosis of Fabry disease. The results of this study underline the importance of the comprehensive use of these diagnostic tools to reach a definite diagnosis. The diagnosis and management of Fabry disease should not be based solely on the results of the screening tests.