Association of C2, a derivative of the radial artery pressure waveform, with new onset of type 2 diabetes mellitus: the MESA study.

BackgroundAlthough microvascular dysfunction is known to result from diabetes, it might also lead to diabetes. Lower values of C2, a derivative of the radial artery pressure waveform, indicate microvascular dysfunction and predict hypertension and cardiovascular disease (CVD). We studied the association of C2 with incident diabetes in subjects free of overt CVD.MethodsAmong multi-ethnic participants (n = 5214), aged 45-84 years with no diabetes, C2 was derived from the radial artery pressure waveform. Incident diabetes (N = 651) was diagnosed as new fasting glucose ≥ 126 mg/dL or antidiabetic medicine over ~ 10 years. The relative incidence density (RID) for incident diabetes per standard deviation (SD) of C2 was studied during ~ 10 years follow-up using four levels of adjustment.ResultsMean C2 at baseline was 4.58 ± 2.85 mL/mmHg × 100. The RID for incident diabetes per SD of C2 was 0.90 (95% CI 0.82-0.99, P = 0.03). After adjustment for demographics plus body size, the corresponding RID was 0.81 (95% CI 0.73-0.89, P < 0.0001); body mass index (BMI) was the dominant covariate here. After adjustment for demographics plus cardiovascular risk factors, the RID was 0.98 (95% CI 0.89, 1.07, P = 0.63). After adjustment for all the parameters in the previous models, the RID was 0.87 (95% CI 0.78, 0.96, P = 0.006).ConclusionsIn a multi-ethnic sample free of overt CVD and diabetes at baseline, C2 predicted incident diabetes after adjustment for demographics, BMI and CVD risk factors. Differences in arterial blood pressure wave morphology may indicate a long-term risk trajectory for diabetes, independently of body size and the classical risk factors

1014-92 Impaired Microcirculation in Chronic Heart Failure

The microcirculation plays a crucial role in the exchange of oxygen, energy rich substrates and metabolites. The effects on the microcirculation of impaired heart function and disturbed peripheral skin circulation in chronic heart failure (CHF) are unknown. Nailfold capillary morphology and dynamics in CHF were studied in relation to parameters of left ventricular (LV) structure and function. Twenty patients (13 male, 7 female, age 64±2 years) with CHF NYHA class II underwent a capillaroscopic examination at the finger nailfold using a computerised videophotometric system (Capiflow) at rest and after 1 min arterial occlusion. Patients were treated with diuretics, ACE inhibitors and digoxin and mean duration of symptoms was 65±9 months. Study parameters were number, length, and diameter of the capillaries as well as capillary blood velocity (CBV). Further experiments included echocardiography and determination of LV ejection fraction by Tc-scintigraphy. Nailfold capillaries in established CHF are enlarged (afferent diameter 6.6±0.4 μm, efferent diameter 8.2±0.4 μm, ref. resp. <6 and <8 μm) and CBV is dramatically decreased (351±64 μ/s, ref. >600 μm/s at 23°C). The reactive hyperemic response to one minute arterial occlusion is attenuated (peak CBV 879±158 μm/s, ref >2000 μm/s). CBV correlates positively with LV ejection fraction (r=0.61, p=001) and inversely with LV end-diastolic (r=-0.56, P=0.04) and end-systolic (r=-0.69, P=0.01) diameters. The time-to-peak flow (35±5 s, ref. 6–10 s) after one min arterial occlusion is positively related (r=0.68, P<0.05) to the duration of CHF. Our data indicate that microcirculation in chronic heart failure deteriorates in function of the severity and duration of heart failure

Associations of body composition measures and C2, a marker for small artery elasticity: The MESA.

ObjectiveLower C2, a continuous blood pressure waveform characteristic asserted to represent small artery elasticity, predicts future cardiovascular disease events. It is hypothesized that the paradoxical positive association between body mass index (BMI) and C2 may reflect muscle instead of excess fat.MethodsIn a multi-ethnic, community-living cohort of 1,960 participants, computed tomography scans of the abdomen were used to measure visceral adipose tissue (VAT) and total abdominal muscle tissue (TAMT), and applanation tonometry of the radial arteries was used to assess C2. The period cross-sectional associations between BMI, TAMT, and VAT with C2 were ascertained.ResultsThe mean age was 62 ± 9 years and 51% were male. After adjustments for age, gender, ethnicity, pack years smoking cigarettes, diabetes, hypertension, and total and HDL cholesterol, higher BMI (standardized beta = 0.09, P-value < 0.01) and more TAMT (standardized beta = 0.12, P-value < 0.01) were significantly associated with higher C2. In contrast, more VAT (standardized beta = -0.09, P-value < 0.01) was associated with lower C2.ConclusionsIn multivariable analysis, VAT, in contrast to TAMT and BMI, was associated with less compliant small arteries. Visceral fat may be a better marker for detrimental excess body fat than BMI

Transformation de polyols en phase aqueuse par catalyse hétérogène bifonctionnelle

Une nouvelle voie de synthèse de carburants à partir de biomasse a été récemment proposée : la transformation directe du sorbitol (sucre hydrogéné d'origine lignocellulosique) en alcanes légers (six atomes de carbone au maximum) en phase aqueuse par catalyse hétérogène bifonctionnelle métal/acide, suivant la réaction : C6O6H14 + 6 H2 -> C6H14 + 6 H2O (déshydratation/hydrogénation du sorbitol en hexane). L'enjeu de la thèse est d'identifier des systèmes catalytiques bifonctionnels stables, actifs et sélectifs pour les hydrocarbures à 5 ou 6 atomes de carbone, valorisables dans le pool essence.Les premiers systèmes étudiés sont des catalyseurs à base de platine et de ruthénium supportés sur silice-alumine. Ces catalyseurs ne sont pas stables en milieu hydrothermal et catalysent des réactions indésirables de rupture C-C : la décarbonylation dans le cas du platine (conduisant au CO2) et l'hydrogénolyse ou la méthanation dans le cas du ruthénium. C'est pourquoi de nouveaux systèmes catalytiques ont été préparés par des mélanges mécaniques de catalyseurs métalliques (Pt, Pd, Ir) déposés sur zircone et d'oxydes tungstés (ZrO2-WOx, Al2O3-WOx, TiO2-WOx). Ces systèmes catalytiques présentent une stabilité en phase aqueuse meilleure que pour les catalyseurs à base de silice-alumine. Les sélectivités varient en fonction de la nature de l'oxyde et de la nature du métal utilisés. En particulier, Un nouveau système catalytique, Pt/ZrO2 + TiO2-WOx, (brevet 12/01.546) s'est révélé actif et très sélectif pour les composés en C6. Enfin, les mécanismes réactionnels mis en jeu pour la réaction de transformation du sorbitol ont été discutés en s'appuyant sur des tests de réactivité modèle.A new way of biofuels synthesis was recently proposed: the direct transformation of sorbitol (ex-lignocellulose hydrogenated sugar) into light hydrocarbons (maximum six carbon atoms) in aqueous phase by metal/acid bifunctional heterogeneous catalysis, following the reaction : C6O6H14 + 6 H2 -> C6H14 + 6 H2O (dehydration/hydrogenation of sorbitol into hexane). The aim of the PhD work is to identify stable and active bifunctional catalytic systems with selectivity to 5-6 carbon atoms hydrocarbons, which can be further upgraded into gasoline. The first studied systems are platinum and ruthenium catalysts supported on silica-alumina. These catalysts are not stable in hydrothermal medium and catalyse undesired C-C cleavage reactions such as decarbonylation for platinum (leading to CO2) and hydrogenolysis or methanation for ruthenium. That is why new catalytic systems have been prepared by mechanical mixing of metallic catalysts (Pt, Pd, Ir) supported on zirconia and tungstated oxides (ZrO2-WOx, Al2O3-WOx, TiO2-WOx). These catalytic systems present an improved hydrothermal stability compared to the silica-alumina based catalysts. Various selectivities are obtained depending on the oxide and metal natures. Particularly, A new catalytic system, Pt/ZrO2 + TiO2-WOx, (patent 12/01.546), was found to be active and very selective to C6 compounds. Finally, the reaction mechanisms involved in the sorbitol transformation reaction have been discussed, referring to model reactivity tests.POITIERS-SCD-Bib. électronique (861949901) / SudocSudocFranceF

Activité et sélectivité de catalyseurs de stockage-réduction des NOx pour la dépollution automobile. Influence de la nature des réducteurs présents

Ce travail porte sur le procédé NSR (NOx Storage-Réduction) de dépollution des gaz d'échappement automobile Diesel. Des catalyseurs contenant 2,12% Pt déposés sur alumine, cérine-zircone ou cérine modifiée, ont été caractérisés et évalués dans des conditions NSR, avec un regard particulier sur la sélectivité de la réduction des NOx. Les tests catalytiques sont effectués dans des conditions complexes : cycles 60s de stockage (mélange pauvre)/ 4s de réduction (mélange riche), avec des traces de réducteurs dans la voie pauvre et d oxydant dans la voie riche. Des sélectivités importantes en N2O (gaz à effet de serre) ont pu être observées. Les émissions de N2O varient en fonction de la nature du support, de la température et des réducteurs mis en œuvre (C3H6, CO, H2 ou mélange C3H6+CO+H2). Dans certaines conditions, la présence de réducteur dans les phases pauvres contribue à la majorité du N2O émis lors des cycles NSR. Ces valeurs sont en bon accord avec les résultats obtenus en parallèle en régime stationnaire (SCR). A 200C, H2 donne la plus grande sélectivité en N2O, essentiellement à cause de la réduction partielle des NOx en milieu pauvre. En revanche, à 300C, C3H6 est le réducteur le plus sélectif en N2O, toujours avec une forte contribution des phases pauvres. Les résultats sont plus homogènes avec les catalyseurs supportés sur oxydes redox car ils favorisent la transformation des réducteurs dans la voie riche (réactions du gaz à l eau et reformage de C3H6), conduisant à mélange réducteur moyenné. Les propriétés redox du support permettent aussi de limiter les émissions de NH3.Lean reduction of NOx was studied on NSR (NOx storage-reduction) catalyst, with a special attention on N-compound selectivities. Platinum (2.12wt%) catalysts supported on various supports (alumina, ceria-zirconia and modified ceria) were characterized and evaluated in cycling conditions. Catalytic tests were performed and realistic and complex conditions: 60s for the storage phases (lean periods)/ 4s for the reduction (rich pulses). Gas mixture was composed of reducers and oxidants in both lean and rich atmosphere. In these conditions, high N2O emissions were measured (powerful greenhouse gas). The N2O selectivity depends on the redox properties of the support, the temperature and the chemical nature of the reducer (C3H6, CO, H2 or C3H6+CO+H2 mixture). In some conditions, more than half of the N2O production can occur during the storage phase, in lean condition. These results are in good agreement with those obtained in specific SCR tests. At 200C, H2 lead to the higher N2O selectivity especially due to the partial NOx reduction in the lean period. At 300C, N2O emission is mainly favoured with C3H6, with still a high contribution of the lean pulses. Results are less distinct with supported catalysts on redox material, due to the support involvement in the reducer transformation reactions (water gas shift and steam reforming), leading to a blend of reducers in the rich pulses. In addition, lower NH3 emissions were observed on platinum supported on redox oxides.POITIERS-SCD-Bib. électronique (861949901) / SudocSudocFranceF

Late systolic central hypertension as a predictor of incident heart failure : the Multi-Ethnic Study of Atherosclerosis

Background: Experimental studies demonstrate that high aortic pressure in late systole relative to early systole causes greater myocardial remodeling and dysfunction, for any given absolute peak systolic pressure. Methods and Results: We tested the hypothesis that late systolic hypertension, defined as the ratio of late (last one third of systole) to early (first two thirds of systole) pressure-time integrals (PTI) of the aortic pressure waveform, independently predicts incident heart failure (HF) in the general population. Aortic pressure waveforms were derived from a generalized transfer function applied to the radial pressure waveform recorded noninvasively from 6124 adults. The late/early systolic PTI ratio (L/ESPTI) was assessed as a predictor of incident HF during median 8.5 years of follow-up. The L/ESPTI was predictive of incident HF (hazard ratio per 1% increase= 1.22; 95% CI= 1.15 to 1.29; P58.38%) was more predictive of HF than the presence of hypertension. After adjustment for each other and various predictors of HF, the HR associated with hypertension was 1.39 (95% CI= 0.86 to 2.23; P=0.18), whereas the HR associated with a high L/E was 2.31 (95% CI=1.52 to 3.49; P<0.0001). Conclusions: Independently of the absolute level of peak pressure, late systolic hypertension is strongly associated with incident HF in the general population

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論

Noninvasive measurements of arterial stiffness: Repeatability and interrelationships with endothelial function and arterial morphology measures

Corey J Huck1, Ulf G Bronas1, Eric B Williamson1, Christopher C Draheim1, Daniel A Duprez2, Donald R Dengel1,31School of Kinesiology, University of Minnesota, Minneapolis, MN, USA; 2Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN; 3Research Service, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USABackground: Many noninvasive arterial assessment techniques have been developed, measuring different parameters of arterial stiffness and endothelial function. However, there is little data available comparing different devices within the same subject. Therefore, the purpose of this study was to examine the repeatability and interrelationships between 3 different techniques to measure arterial stiffness and to compare this with forearm-mediated dilation.Methods: Carotid-radial pulse wave velocity was measured by the Sphygmocor (SPWV) and Complior (CPWV) devices, cardio-ankle vascular index (CAVI) was measured by the VaSera device, vascular structure and function was assessed using ultrasonography and evaluated for reliability and compared in 20 apparently healthy, college-aged men and women.Results: The intraclass correlation coefficient and standard error of the mean for the Sphygmocor&nbsp;(R = 0.56, SEM = 0.69), Complior (R = 0.62, SEM = 0.69), and VaSera (R = 0.60, SEM = 0.56), indicated moderate repeatability. Bland-Altman plots indicated a mean difference of 0.11 &plusmn; 0.84 for SPWV, 0.13 &plusmn; 1.15 for CPWV, and &ndash;0.43 &plusmn; 0.90 for CAVI. No significant interrelationships were found among the ultrasound measures and SPWV, CPWV, and CAVI.Conclusions: The three noninvasive modalities to study arterial stiffness reliably measures arterial stiffness however, they do not correlate with ultrasound measures of vascular function and structure in young and apparently healthy subjects.Keywords: Pulse wave velocity, intima-media thickness, flow-mediated dilatio