Heart disease during pregnancy in the KSA: a suggested plan

Objectives: Congenital heart disease in pregnancy is a leading cause of maternal death in developed countries while rheumatic fever is the commonest cause of valvular disease in pregnancy in developing countries. Improvement in neonatal and paediatric cardiac surgery has increased the incidence of congenital heart disease in pregnancy worldwide. Published data regarding heart disease in pregnancy [HDP] in KSA are scant and relatively old. This study examines the current status of HDP in KSA and describes the rationale and design of the suggested plan for HDP in KSA, i.e., the Registry of Saudi Heart Disease and Pregnancy [ROSHDAP]

Methods: A systematic search was conducted through the ProQuest MEDLINE database using the keyword phrase "cardiovascular disease in pregnancy". An extensive literature review about heart disease in pregnancywas performed

Results: There are only 4 available Saudi studies of HDP. The ROSHDAP study is expected to establish a foundation for Saudi research in this field and will create an extensive database that will enrich knowledge about HDP. All Saudi women with HDP who wish to participate are eligible for enrolment in the registry. Five phases are planned for the registry, and data will be collected prospectively, confidentially, and electronically. The data will be transmitted from participating centres to a central coordinating office for data management and analysis

Conclusion: The ROSHDAP study suggested in this article will provide contemporary data on HDP in KSA that will promote research and encourage evidence-based medical care of pregnant women with heart disease

Prevalence of pulmonary hypertension in patients with chronic kidney disease on and without dialysis

Background: Pulmonary arterial hypertension is a newly recognized disease in patients with renal disease. In a recent review, the prevalence of PHT in ESRD patients was reported to be around 40-50%

Aim of the work: To evaluate the prevalence of primary pulmonary hypertension among CKD patients on and without dialysis and to compare clinical, hemodynamic, and metabolic variables among patients with and without PH to search for possible etiologic factors

Patients and methods: Our study included 99 CKD patients; 65 patients on hemodialysis, 12 on peritoneal dialysis and 22 on conservative management. Detailed medical history, examination, and complete laboratory investigations were obtained. Systolic PAP, EF% and cardiac output were evaluated by Doppler echocardiography and AVF flow by Doppler ultrasound

Results: A high prevalence of pulmonary hypertension was demonstrated among 27 patients [41.53%] receiving long-term hemodialysis with a mean systolic PAP of 49.33 +/- 9.18 mmHg; as well as in two patients [16.66%] receiving peritoneal dialysis 43 +/- 1.41 mmHg, and in five patients [[22.72%] receiving conservative management 44.8 +/- 5.89 mmHg

Conclusion: This study demonstrated a high prevalence of pulmonary hypertension among patients with CKD on and without dialysis. The prevalence was highest among patients with ESRD receiving long-term hemodialysis [41.53%] especially in patients with older age, longer duration of dialysis treatment, higher AV fistula flow, cardiac output