妊娠期高血压性心脏病是在妊娠期高血压疾病基础上发生的心脏泵血功能减退，严重者甚至出现以左心衰竭为主的全心衰竭综合征，其病情凶险，病死率高，发病隐匿，早期症状易被忽略。对于妊娠期高血压疾病患者要采取积极降压等治疗，动态进行心功能评估，积极纠正高危因素，预防心力衰竭（心衰）的发生。已发生急性心衰者，按照一般急性心衰的原则治疗的同时应治疗导致子痫前期的原发病，并及时终止妊娠。

Patients with preeclampsia are at high risk for long-term cardiovascular events, yet the short-term, acute cardiovascular complications that follow preeclampsia are understudied. The objective of this study was to compare the short-term, acute maternal cardiovascular morbidity events after delivery among patients with a diagnosis of preeclampsia versus those without this diagnosis.

Hypoalbuminaemia (serum albumin levels ≤3.5 g/dl) is associated with poor outcomes among patients with heart failure (HF). This narrative review includes original articles and reviews published over the past 20 years and retrieved from PubMed using the following search terms (or their combination): ‘heart failure’, ‘hypoalbuminaemia’, ‘heart failure with reduced ejection fraction’, ‘heart failure with preserved ejection fraction’, ‘all‐cause mortality’, ‘in‐hospital mortality’, ‘hospitalization’, ‘prognosis’. The aims of this review are to provide an overview on the prevalence of hypoalbuminaemia in HF, its impact on clinical outcomes, and potential mechanisms that may suggest future therapeutic strategies. Hypoalbuminaemia is frequent in HF patients, especially among the elderly. However, data about the exact epidemiology of hypoalbuminaemia are scant due to different definitions, and prevalence is estimated between 5% and 70% across the whole spectrum of ejection fraction. Current evidence points to hypoalbuminaemia as a marker of poor outcomes in HF, irrespective of the ejection fraction, and in other cardiovascular diseases. Among patients who suffered from acute coronary syndrome, those with hypoalbuminaemia had an increased risk of new‐onset HF and in‐hospital mortality. Albumin, however, might also play a role in the natural history of such diseases due to its antioxidant, anti‐inflammatory, and antithrombotic properties. Whether albumin supplementation or nutritional support in general would be beneficial in improving clinical outcomes in HF is not completely clear and should be evaluated in adequately designed studies.

子痫前期孕妇存在双胎或低蛋白血症、长期应用保胎药物等因素显著增加心力衰竭风险。结合典型临床表现和辅助检查可以诊断子痫前期合并心功能不全，但心功能不全发病隐匿，早期症状易被忽视，要重视早期心衰表现。积极控制子痫前期，及时终止妊娠是预防发生心脏功能不全的主要措施。子痫前期还是远期心血管并发症的重大危险因素，需要综合多学科诊治，加强远期随访。

Potassium (K) is the most abundant cation in humans and is essential for normal cellular function. Alterations in K regulation can lead to neuromuscular, gastrointestinal, and cardiac abnormalities. Dyskalemia (i.e., hypokalemia and hyperkalemia) in heart failure is common because of heart failure itself, related comorbidities, and medications. Dyskalemia has important prognostic implications. Hypokalemia is associated with excess morbidity and mortality in heart failure. The lower the K levels, the higher the risk, starting at K levels below approximately 4.0 mmol/l, with a steep risk increment with K levels <3.5 mmol/l. Hyperkalemia (>5.5 mmol/l) has also been associated with increased risk of adverse events; however, this association is prone to reverse-causation bias as stopping renin angiotensin aldosterone system inhibitor therapy in the advent of hyperkalemia likely contributes the observed risk. In this state-of-the-art review, practical and easy-to-implement strategies to deal with both hypokalemia and hyperkalemia are provided as well as guidance for the use of potassium-binders.Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

In women with congenital heart disease (CHD), cardiovascular complications during pregnancy are common, but the risk assessment of these patients remains difficult. This study sought to determine the independent role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in addition to other parameters in predicting adverse cardiovascular events during pregnancy in women with CHD.We conducted a national, prospective multicentre cohort study. Follow-up with clinical evaluation and echocardiography and NT-proBNP measurement was performed at 20-week gestation. Adverse cardiovascular events occurred in 10.3% of 213 pregnancies. N-terminal pro-B-type natriuretic peptide levels >128 pg/mL at 20-week gestation, the presence of a mechanical valve, and subpulmonary ventricular dysfunction before conception were independently associated with events [odds ratio (OR) 10.6 (P = 0.039), OR 12.0 (P = 0.016), and OR 4.2 (P = 0.041), respectively]. The negative predictive value of NT-proBNP levels <128 pg/mL was 96.9%. N-terminal pro-B-type natriuretic peptide levels >128 pg/mL at 20 weeks of gestation had an additional value in predicting the occurrence of adverse cardiovascular events on the top of the other identified predictors (area under the curve 0.90 vs. 0.78, P = 0.035).Increased NT-proBNP levels at 20 weeks of gestation are an independent risk predictor of cardiovascular events during pregnancy in women with CHD.