Background: Behçet’s disease is a systemic vasculitis that can affect all sizes of arteries and veins. Arterial stiffness is a term used to describe the visco-elastic properties of vessel wall. In this study, we aimed to evaluate the relationship between pulmonary artery stiffness (PAS) and the right ventricular (RV) functions in asymptomatic Behçet’s patients with no cardiovascular risk factors. Methods: We studied 40 patients who were diagnosed by the international diagnostic criteria of Behçet’s disease and 40 healthy individuals who were matching demographic properties with the patients. Two groups were matched by age, gender, clinical history and other clinical features. Substantial medical history concerning the factors that can affect right ventricle diastolic function (such as medications, smoking status, other comorbities, etc.) was taken and general physical examination was carried out. The right and left ventricular functions as well as valvular functions were evaluated by using echocardiography. Also Two-dimensional, M-mode, pulsed wave (PW) Doppler echocardiographic parameters were measured for right ventricular functions. PW Doppler flow trace was obtained from the pulmonary valve with regards to pulmonary artery stiffness. Results: There was no significant difference in terms of clinical and demographic properties. No statistically significant difference was found upon comparison of the left ventricular end of systole and diastole diameters, the diastolic and systolic thicknesses of the interventricular septum (IVS) and left ventricular posterior wall (LVPW), left atrium (LA) diameter and left ventricular ejection fraction (LVEF) values (p>0.05) of the two groups. Right ventricular myocardial performance index (MPI) value was found higher in Behçet’s patients and a statistically significant difference was detected between the groups (p<0.01). Tricuspid annular plane systolic excursion (TAPSE) values were found to be statistically significantly lower in the patient group as compared to the control group (p<0.01). In PW Doppler measurements, early passive filling (E) wave flow velocity and E/A ratio were found to be statistically significantly lower, deceleration time (DT) was higher in the patient group (p<0.01). In Behçet’s patients without clinical pulmonary involvement, the pulmonary artery systolic pressure (PASP) was found to be statistically significantly higher in the patient group (p<0.01). The values of pulmonary artery stiffness (PAS) were found to be significantly higher in the patient group (p<0.01). The relationship between the right ventricular function markers and PAS were evaluated in the patient group. There was no statistically significant relationship between PAS and MPI and TAPSE. But there was a significant correlation between PAS and PASP and duration of illness (p<0.001 and r=0.682 ; p=0.047 and r=0,316). Conclusion: Behçet’s patients without cardiac symptoms and signs, reduction in right ventricular functions and increase in PAS was detected. Although there is no correlation between right ventricular functions and PAS, increased PAS may be an early marker of reduction of the right ventricular functions. Consequently, routine cardiological examination and detailed evaluation of biventricular functions by using echocardiography should be greatly beneficial in Behcet’s patients, even though there are no signs or symptoms.

Aortic pseudocoarctation is a rare congenital aortic anomaly that causes elongation, stenosis and kinking of the aorta at the isthmus level. Although aortic coarctation and pseudocoarctation share a similar clinical spectrum, pseudocoarctation rarely results in a significant gradient in descending aorta and haemodynamic consequence. Therefore, it's critical to differentiate in coarctation. All imaging modalities but especially cardiac CT angiography and catheterization are very important in the differential diagnosis. Our case highlighted to differences between aortic pseudocoarctation and coarctation, with other cardiac anomalies accompanying pseudocoarctation. And also the importance of cardiac imaging in the differential diagnosis of pseudocoarctation was emphasized.

Mitral valve repair is the preferred treatment option in primary mitral valve disease especially degenerative mitral valve disease. Surgical results are quite successful with appropriate surgical techniques in suitable patients. But technically, surgery may result in any degree of narrowing of the orifice of the mitral valve. Also, surgical repair of rheumatic mitral valve disease is technically more demanding however, mitral repair is preferred over mechanical valve implantation if possible. İn this case report we presented the case of functional mitral stenosis after surgical mitral valve repair and annuloplasty ring implantation for rheumatic mitral regurgitation. Written and verbal consents of the patient were obtained prior to this case report.