{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:05:03Z","timestamp":1785297903848,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271718"],"award-info":[{"award-number":["82271718"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This retrospective study evaluated the clinical characteristics, management, and maternal\u2010neonatal outcomes of 24 twin pregnancies complicated by acute left heart failure (ALHF) delivered at Peking University Third Hospital from January 2015 to December 2025. Patients were stratified by timing of onset (antenatal vs. postnatal). The mean maternal age was 33.8 years, and 70.8% had preeclampsia. ALHF occurred antenatally in 9 cases (37.5%) and postnatally in 15 cases (62.5%). Dyspnea was the most common initial symptom (79.2%). The mean left ventricular end\u2011diastolic diameter was 50.6\u00a0\u00b1\u00a03.7\u00a0mm, and the median NT\u2011proBNP level was 1406.0 pg\/ml (IQR: 1146.5\u20132053.5 pg\/ml). All patients received multidisciplinary care and diuretics, with 37.5% requiring intensive care. Full cardiac recovery by 6 weeks postpartum was achieved in 87.5% of patients. The preterm birth rate was 87.5%, and the perinatal mortality rate was 10.4%. Compared with the postnatal\u2011onset group, the antenatal\u2011onset group had significantly higher NT\u2011proBNP levels at disease onset or diagnosis (2388.5\u00a0vs. 1257.0 pg\/ml,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.018), longer hospital stay (11\u00a0vs. 8 days,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.019), earlier gestational age at delivery (30\u00a0vs. 36 weeks,\n                    <jats:italic>p\u00a0<\/jats:italic>\n                    =\u00a00.002), and higher rates of neonatal intensive care unit admission (92.3%\u00a0vs. 40.0%,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.01) and perinatal mortality (27.8%\u00a0vs. 0,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.016). In conclusion, ALHF in twin pregnancies predominantly occurs postnatally and is frequently associated with preeclampsia; maternal outcomes are favorable with multidisciplinary care, whereas neonatal outcomes were poorer in the antenatal\u2010onset group, likely reflecting medically indicated early preterm delivery in the setting of maternal decompensation.\n                  <\/jats:p>","DOI":"10.1111\/jch.70326","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:20:09Z","timestamp":1783491609000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Left Heart Failure in Twin Pregnancies: Clinical Characteristics and Outcomes\u2014A 10\u2011Year Retrospective Analysis of 24 Cases"],"prefix":"10.1111","volume":"28","author":[{"given":"Qianqian","family":"Xiang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking University Third Hospital  Beijing China"},{"name":"National Clinical Research Center of Obstetrics and Gynecology (Peking University Third Hospital)  Beijing China"},{"name":"National Center for Healthcare Quality Management in Obstetrics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking University Third Hospital  Beijing China"},{"name":"National Clinical Research Center of Obstetrics and Gynecology (Peking University Third Hospital)  Beijing China"},{"name":"National Center for Healthcare Quality Management in Obstetrics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking University Third Hospital  Beijing China"},{"name":"National Clinical Research Center of Obstetrics and Gynecology (Peking University Third Hospital)  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