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Objective: to describe neonatal complications of cardiac and renal function of newborns of monochorionic biamniotic pregnancies complicated by twin-twin transfusion syndrome (TTTS). The sub-objectives are : to establish the prevalence of these cardiac and renal complications and to link the nature of these complications to the donor or recipient status.Method: a descriptive study with a retrospective quantitative approach on 59 newborns from biamniotic monochorionic twin pregnancies complicated with TTTS between 2015 and 2020.Results: neonatal complications of cardiac function in this series were pulmonary artery stenosis, cardiomegaly, ventricular hypertrophy and hypokinesia, tricuspid valve regurgitation, and pulmonary hypertension. The prevalence of these complications in this series of 59 patients was 18.6%. The renal complications were : oliguria or anuria and transient renal failure. The prevalence of these complications in this series was 15.3%.Conclusion: the concordance with the description of the pathophysiological mechanisms of the syndrome suggests that the cardiac complications described are related to recipient status, justifying enhanced monitoring of cardiac function in the postnatal period. However, the link between the occurrence of renal complications and donor status, as suggested by the pathophysiology, was not demonstrated in this study.; Objectif : décrire les complications néonatales de la fonction cardiaque et de la fonction rénale chez les nouveaux nés issus de grossesses monochoriales biamniotiques compliquées du syndrome transfuseur transfusé (STT). Les sous-objectifs sont : d’établir la prévalence de ces complications cardiaques et rénales et de lier la nature de ces complications à la qualité de donneur ou receveur.Méthode : étude descriptive avec une approche quantitative rétrospective sur 59 nouveaux nés issus de grossesses gémellaires monochoriales biamniotiques compliquées du STT dont le suivi de grossesse et la naissance ont eu lieu à la maternité du Centre Hospitalier Universitaire (CHU) Nord de Marseille entre 2015 et 2020.Résultats : les complications néonatales de la fonction cardiaque au sein de cette série ont été : la sténose de l’artère pulmonaire, la cardiomégalie, l’hypertrophie et l’hypokinésie ventriculaire, la régurgitation de la valve tricuspide et l’hypertension artérielle pulmonaire. La prévalence de ces complications au sein de cette série de 59 patients était de 18,6%. Les complications rénales ont été : l’oligurie ou l’anurie et l’insuffisance rénale transitoire. La prévalence de ces complications au sein de cette série était de 15,3%.Conclusion : la concordance avec la description des mécanismes physiopathologiques du syndrome laisse penser que les complications cardiaques décrites sont liées au statut de receveur, justifiant une surveillance renforcée de la fonction cardiaque durant la période postnatale. Cependant, le lien entre la survenue des complications rénales et le statut de donneur, comme le suggère la physiopathologie, n’a pas été mis en évidence dans cette étude.

Summary Background Hypertensive patients with established cardiovascular or renal disease (ECVRD) have an added 10-year risk of cardiovascular events, classified by the European Society of Hypertension/European Society of Cardiology as ‘very high’. Aims To identify determinants of blood pressure (BP) outcomes in hypertensive patients with and without ECVRD treated in second-line with valsartan. Methods This was a subgroup analysis comparing patients with and without ECVRD who participated in the PREVIEW study, a 90-day observational prospective effectiveness study of valsartan, conducted in Belgium. Two-level (patients ‘nested’ under physicians) hierarchical linear and logistic modelling of BP values and BP control (140/90 mmHg; 130/80 mmHg for diabetics) at 90 days was applied to data from 1107 patients with and 2087 patients without ECVRD treated with valsartan by 504 general practitioners. Results Absolute reductions in BP were similar across subgroups, with minor variations in actual BP levels in general and by subgroup. Fewer patients with versus without ECVRD achieved targets for systolic BP, diastolic BP and combined systolic/diastolic BP control. Variability in BP values and control at 90 days attributable to a physician-level class effect ranged from 24.6% to 28.1% and 15.0% to 22.4%, respectively. Physician- and patient-related determinants of 90-day BP outcomes varied considerably between the two subgroups. Conclusion Several determinants of BP outcomes were identified comparing patients with and without ECVRD, including amenable physician-level and patient-level factors and warning signs for continued risk of uncontrolled BP. ECVRD patients present with differential characteristics, conditions and determinants that mandate individualized attention to complement general evidence-based antihypertensive treatment.