Dr. Nattapong Thaiyanurak graduated his MD from College of Medicine, Rangsit University, Bangkok. He completed his residency in internal medicine and cardiology fellowship training from Siriraj Hospital, Mahidol Universtiy, Bangkok. He is currently the cardiologist at the Lampang Hospital and devotes his time in teaching medical students of Lampang Hospital Medical Education Center, Chiang Mai University.
Introduction: Type 3 aortic arch is a major predictor of neurological adverse events during carotid artery stenting. The aim of study was to determine the prevalence of different aortic arch types and predictors for aortic arch type 3 in Thai patients. Methods: Data were analyzed on 250 retrospectively enrolled patients who underwent thoracic aorta computed tomography angiogram (CTA) between February 2013 and July 2015. Patient data including age, height, body weight, and underlying diseases were reviewed. Two independent investigators comprehensively evaluated CTA studies to identify aortic arch type and variants, including variable carotid artery branch points according to preset definitions. Results: Type 2 arch (n=144,57.6%) was the most common morphologic variant in followed by type 3 (n=77,30.8%) and type 1 arch (n=29,11.6%). An anomalous aortic arch was found in 20 patients (8%). The most frequent anomaly was the bovine arch branching pattern, where there is a common origin of the innominate and left common carotid arteries (n=17,7%). Compared to simple arch (normal type 1 and 2), factors like older age (70.5years±13.6vs.61.8years ±16.6,p<0.001), lower body weight (56.9kg±15.2vs.62.9kg±14.5,p=0.002), lower body-mass index(BMI)(21.7±4.5vs.23.7±4.8,p=0.001), lower body surface area(BSA)(1.59m2±0.23vs.1.67m2±0.22,p=0.005) and lower glomerular filtration rate(ml/min /1.73m2)(67.5±26.5vs.75.2±26.6,p=0.028) were associated with more complex arch (type 3 and variants). Multiple logistic regression analysis demonstrated that age ≥ 65 years (OR=2.98,95%CI 1.65-5.38,p<0.001) and BMI ≤ 21kg/m2 (OR=2.40,95%CI 1.38-4.19,p=0.002) were predictor variables for complex arch. Conclusions: Type 2 arch was the most common variant. We found that age ≥ 65 years and BMI ≤ 21 kg/m2 were strong predictors of complex arch.
Mr. Anton Cherepov graduated from Medical-Biology Faculty (Biochemistry department) of N.I.Pirogov Moscow Medical Institute in 1989. His first research dealt with the role of lipid peroxidation in Parkinson diseases at the Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences. Then he studied immediately-early genes expression in learning and memory on the model of filial imprinting in chicks and other learning models in mice at P.K.Anokhin Institute of Normal Physiology, Russian Academy of Medical Sciences. His current research interest involves methodological approaches for evaluation of specific and non-specific responses of human organism under normal and extreme conditions.
Human adaptation to extreme conditions primarily involves the basic vital systems of the body. The aim of our study was to analyze the mechanisms of adaptation of the cardiovascular system to simulated conditions of space flight and stay on the lunar surface. Hypo- and microgravity was simulated using orthostatic and antiorthostatic hypokinesia, respectively (bedrest at different angles: -6° and +9.6°) and was carried out on volunteers in hospital setting. Analysis of blood pressure variability (BPV) revealed significant increase in the systolic BPV by 8 day in head-down bedrest group (HDBRG) and return of these parameters to baseline values by day 21. Analysis of the frequency components of systolic BPV spectrum in HDBRG showed that the main contribution to the total spectral power on day 8 was made by the very-low-frequency component. At the same term, we observed a pronounced increase in the very-low-frequency component of heart rate variability (HRV) in HDBRG in comparison with that in head-up bedrest group (HUBRG). Coincidence of these changes may indicate that significant contribution into adaptation is made by central neural mechanisms that are activated during the first week of simulated microgravity. The diastolic BPV was markedly changes by day 21 in both experimental groups in comparison with baseline values, primarily at the expense of very-low-frequency component of BPV. In HRV, no similar changes were observed by day 21 of the experiment. These findings probably attest to predominance of local mechanisms of vascular tone regulation not directly related with the autonomic control.