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Aims: Vitamin D plays a role in controlling the function of vascular smooth muscle and endothelial cells, even in the pulmonary artery. We hypothesized that pulmonary artery elasticity were comprimised in individuals with relatively low vitamin D levels. Methods: Adult individuals with the complaint of shortness of breath were enrolled. They were divided into 2 groups according to vitamin D levels, with a cut-off of 20 ng/mL. Pulmonary artery stiffness (PAS) was calculated using the following formula: PAS (kHz/sec) = maximal frequency shift/pulmonary acceleration time. The six-minute walk distance (6MWD) was used to assess the functional exercise capability of subjects. Results: A total of 71 individuals (male: 31%) were enrolled. Subjects with low vitamin D levels had lower 6MWD than subjects with higher vitamin D levels (443.58±56.20 m vs. 483.20±58.43 m, p=0.007). The PAS was significantly higher in individuals with vitamin D level <20 ng/mL compared with subjects with vitamin D level > 20 ng/mL (11.65±3.76 vs. 9.46±2.53, respectively, p=0.011). Multiple regression showed that vitamin D level was inversely associated with PAS (ß=-0.280, p=0.009). Conclusions: We found that PAS was associated with lower vitamin D levels. Vitamin D deficiency might involved in the dynamics of the pulmonary artery vasculature, even in the absence of significant pulmonary artery pressure elevation. [ABSTRACT FROM AUTHOR]

Caseous calcification of the mitral annulus (CCMA) is a very rare form of mitral annular calcification (MAC). CCMA accounts for 0.63% of all cases and 0.06-0.07% of the total population and usually seen in elderly and female patients. It mostly affects the posterior leaflet of the mitral valve. The pathogenesis of CCMA remains unclear. Hypercholesterolemia and the dissolution of lipid-laden macrophages may be implicated in liquefaction necrosis. CCMA is composed of a mixture of calcium, fatty acid, and cholesterol. The name "caseous" comes from the cheese-like or toothpaste-like consistency of the mass. Cardiac magnetic resonance imaging may help in differentiating MAC from CCMA and should perform. The first treatment option should be conservative treatment because of surgical complications of the procedure. We presented a case report which is about CCMA with preoperative and intraoperative robotic images. [ABSTRACT FROM AUTHOR]

Constrictive pericarditis (CP) consists of pericardial fibrotic thickening and calcification and causes the impaired diastolic filling of the ventricles. Echocardiography and other imaging modalities and left-right cardiac catheterization are used for diagnosis. The standard treatment for chronic CP is pericardiectomy. However, in the transient form of the disease, anti-inflammatory therapy should be the primary treatment option. In two cases of CP, the diagnostic process and the importance of distinguishing the chronic form of the disease from the transient form, and the difference in the two treatment modalities have been highlighted. [ABSTRACT FROM AUTHOR]

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 nonborderline 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. [ABSTRACT FROM AUTHOR]

The article presents case study of 74-year-old female with ischemic heart failure with New York Heart Association class III dyspnea. It mentions association of Dilated cardiomyopathy (DCM) with variable degrees of functional mitral regurgitation (FMR); and also mentions CARILLON Mitral Contour System, an approach using the anatomical proximity of the coronary sinus (CS) to the mitral annulus.