13^th European Cardiology Conference December 05-06, 2016 Madrid, Spain

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.

To be updated soon...

Introduction: Pulmonary function testing is an important element in the process of preparing a patient for elective heart surgery. Aim: The aim of the study was to assess respiratory system disorders prior coronary artery bypass grafting (CABG) and to determine their influence on inflammation markers in the early postoperative period. Material & Methods: A total of 397 patients, 306 male and 91 female, aged 65.3±7.8 years were enrolled for the study. The patients were scheduled for elective coronary revascularization in the Department of Cardiac Surgery of the Pomeranian Medical University in Szczecin, Poland. On the basis of spirometry tests performed on the day of admission (AsSPIRO D200 v.101., ASPEL S.A., Poland), the patients were divided into three groups according to international guidelines on the classification of ventilation disorders: Restrictive, obstructive, no disorders. Results: At the admission to hospital, no statistically significant differences were found between the groups regarding sex and age distribution, prevalence of diabetes, BMI, euroSCORE and CRP. The only statistically significant parameter that differed between the two groups was average ejection fraction (p=0.02), which was lower in the group of patients with restrictive disorders in comparison to the group with no disorders. In assays performed on postoperative day 2, patients with restrictive ventilation disorders were found to have a significantly higher CRP concentration in comparison to the group without disorders and the group with obstructive disorders. The increase in CRP concentration was observed in patients both with and without diabetes. Further CRP assays performed on postoperative day 4 indicate higher concentrations in both groups with ventilation disorders. However, these differences did not reach statistical significance. Conclusions: In patients after on-pump CABG, changes in the respiratory system diagnosed as restrictive ventilation disorders temporarily increase inflammatory response in the early postoperative period. Diabetes did not modify the inflammatory response, although average CRP concentrations in all groups and assays were slightly higher in patients with diabetes.

Andre Awaloei graduated from Sam Ratulangi Medical School Manado City-Indonesia in 2009. He finished his Internal medicine from San Pedro Hospital, Inc. Davao City-Philippines in December 2013. He entered the Cardiology Fellowship training in St. Luke’s Medical Center, Quezon City-Philippines in March 2014 up to present.

Left ventricle noncompaction cardiomyopathy (LVNC) is a rare and unique primary genetic cardiomyopathy. It differs from pseudo-noncompaction which is an acquired form of cardiomyopathy that leads to noncompaction-like abnormalities. Absence of co-existing cardiac abnormality is one of the LVNC diagnosis criteria. The aim of this study is to determine diagnostic modality in differentiating primary LVNC from pseudo-noncompaction. We report a case of a 46 years old Filipino female presented with dyspnea and heart failure related symptoms. She had a history of rheumatic carditis when she was 20 years old, which were associated with pericardial effusion, elevated erythrocyte sedimentation rate, high-sensitivity C-reactive protein, and antistreptolysin O titer. Present transthoracic echocardiography showed global left ventricle hypokinesia with depressed ejection fraction of 31%, trabeculation in the mid to apex of the left ventricle, and blood flow into deep intertrabecular recesses by color doppler (figure 1). Cardiovascular magnetic resonance imaging revealed dilated left ventricle; hypertrabeculation with deep intertrabecular recesses at the subendocardial layer of the mid to apical anterior, inferior and lateral left ventricle wall; ratio of non compacted to compacted myocardium during diastole is 3:1 and 2.8:1 during systole; late gadolinium enhancement at the mid-wall interventricular septum suggestive of fibrosis; and normal coronary arteries (figure 2). Noncompacted to compacted layer ratio of >2.3 during diastole is a valuable parameter to distinguish primary LVNC from pseudo-noncompaction cardiomyopathy (sensitive of 86% and specificity of 99%), that can be due to previous carditis. Mid-wall interventricular septum is the most common location of the late gadolinium enhancement that can be found among patients with primary LVNC. These findings support diagnosis of primary LVNC in our patient. Conclusion : Cardiovascular magnetic resonance imaging is a useful diagnostic modality in differentiating primary LVNC from pseudo-noncompaction.