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Johnny Chahine, Sarah Kreykes, Jeremy R Van’t Hof, Daniel Duprez, Prabhjot Nijjar Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USACorrespondence: Prabhjot NijjarUniversity of Minnesota Medical School, 420 Delaware Street SE, MMC 508, Minneapolis, MN, 55455, USATel +1 612 626-1391Fax +1 612 626-4411Email nijja003@umn.eduAbstract: The “Lebanese allele” {LDLR c.2043 C>A (p.cys681X)} is a nonsense mutation in the low-density lipoprotein receptor (LDLR) gene that results in a truncated non-functioning LDLR protein. We report two sisters of Lebanese descent who presented with familial hypercholesterolemia (FH) and were both heterozygous for the Lebanese allele, but had very distinct LDL-C levels and clinical phenotypes. Whereas one of the sisters had LDL-C in the expected range of Heterozygous FH (HeFH) with the Lebanese allele (LDL-C of 292 mg/dl), the other sister had a more severe LDL-C phenotype in the Homozygous FH (HoFH) range (LDL-C of 520 mg/dl) along with manifest atherosclerosis. Surprisingly, she did not demonstrate a compound heterozygote or double heterozygote status. We discuss different mechanisms that are purported to play a role in modifying the phenotype of FH, including different variants and polygenic modifiers. HeFH patients with the Lebanese allele can have a wide spectrum of LDL-C levels that range from the typical heterozygous to homozygous phenotypes.Keywords: familial hypercholesterolemia, familial hyperlipidemia, heterozygous, Lebanese allele

Anne H Blaes,1 Aamer Rehman,2 David M Vock,3,4 Xianghua Luo,3,4 Mark Menge,5 Douglas Yee,3 Emil Missov,6 Daniel Duprez6 1Division of Hematology/Oncology/Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, 2Division of Cardiology, University of Louisville, Louisville, KY, 3Masonic Cancer Center, 4Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, 5Park Nicollet Frauenshuh Cancer Center, St Louis Park, 6Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA Background: Anthracycline chemotherapy remains an integral part of the care for curative intent chemotherapy in breast cancer and non-Hodgkin lymphoma patients. Better tools need to be identified to predict cardiac complications of anthracycline chemotherapy. Materials and methods: We investigated the utility of high-sensitivity cardiac troponin T (hscTnT), N-terminal pro-B-type natriuretic peptide, cardiac troponin T and I, and creatine kinase (CK)-MB in cancer patients receiving anthracycline-based chemotherapy, in order to determine whether baseline levels or changes in these biomarkers may help predict the onset of congestive heart failure. Results: Eighteen consecutive patients with a pathologic diagnosis of breast cancer or non-Hodgkin lymphoma were enrolled. The median dose of doxorubicin exposure was 240 mg/m2 (range 240–400 mg/m2). After treatment with doxorubicin, the hscTnT increased to 19.1 pg/mL (P

Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small (SAE) and large (LAE) artery elasticity in heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort (P

Decreasing oil supplies and increasing energy demand provide incentives to find alternative fuels. First, the valorisation of edible crops for ethanol and biodiesel production led to first generation biofuels. Nowadays, research is focused on lignocellulosic biomass as a source of renewable carbon (second generation biofuels). Whereas the cellulosic ethanol production is in progress, a new way consisting of the transformation of ex-lignocellulose sugars and polyols towards light hydrocarbons by heterogeneous catalysis in aqueous phase has been recently described. This process is performed under mild conditions (T < 300 °C and P < 50 bar). It requires on one hand hydrogen formation by catalytic reforming of carbohydrates in aqueous phase and on the other hand, the dehydration/hydrogenation of polyols leading to alkanes by selective C-O bond cleavages. The challenge here is to conceive multifunctional catalytic systems that are stable, active and selective under the reaction conditions. The aim of this article is to present the involved reactions, the catalytic systems described in literature for that kind of transformation and examples of industrial applications. La raréfaction du pétrole et l’augmentation conjointe de la demande en carburants ont conduit à la recherche de carburants alternatifs. Dans un premier temps, la valorisation de ressources agricoles alimentaires pour la production d’éthanol et de biodiesel a permis de développer les biocarburants de première génération. Aujourd’hui les travaux de recherche s’orientent vers l’utilisation de biomasse lignocellulosique comme source de carbone renouvelable (biocarburants de deuxième génération). Alors que la filière de l’éthanol cellulosique est en plein développement, une nouvelle voie consistant à transformer des sucres et polyols d’origine lignocellulosique en alcanes légers par catalyse hétérogène bifonctionnelle en phase aqueuse a été récemment décrite. Ce procédé s’effectue à basse température et pression modérée (T < 300 °C et P < 50 bar). Il nécessite, d’une part, la formation d’hydrogène par reformage catalytique de carbohydrates en phase aqueuse et, d’autre part, la déshydratation/hydrogénation de polyols conduisant à un alcane par ruptures sélectives des liaisons C-O. Un défi lié à cette thématique réside dans le développement de systèmes catalytiques multifonctionnels stables, actifs et sélectifs dans les conditions de la réaction de transformation. L’objectif de l’article est de présenter les réactions mises en jeu, les systèmes catalytiques décrits dans la littérature pour ce type de transformation ainsi que des exemples d’applications industrielles.

Virginia Hebl, Marina Y Zakharova, Mariana Canoniero, Daniel Duprez, Santiago GarciaDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USABackground: The inferior vena cava (IVC) diameter and degree of inspiratory collapse are used as echocardiographic indices in the estimation of right atrial pressure. Brain-natriuretic peptides (BNPs) are established biomarkers of myocardial wall stress. There is no information available regarding the association between the IVC diameter and BNPs in patients with heart failure and various degrees of systolic performance. The purpose of this investigation is to quantify the degree to which natriuretic peptides (BNP and N-terminal pro-B natriuretic peptide [NT-ProBNP]) and echocardiographic-derived indices of right atrial pressure correlate in this patient population.Methods: We examined 77 patients (mean age 61 ± 17 years, 44% male) with decompensated heart failure who underwent transthoracic echocardiography and, within a timeframe of 24 hours, determination of BNP and NT-ProBNP levels in venous blood. BNP and NT-ProBNP were analyzed after log transformation. The degree of association was measured by the correlation coefficient using the Pearson's method.Results: The mean ejection fraction was 50% ± 20%, and 33% of the study cohort had a remote history of heart failure. The mean IVC diameter was 1.85 cm ± 0.5, the mean BNP was 274 pg/mL, the confidence interval (CI) was 95% (95% CI: 197–382), and the mean NT-ProBNP was 1994 pg/mL (95% CI: 1331–2989). There was a positive, albeit small, association between IVC diameter and BNP (r = 0.24, 95% CI: 0.01–0.44; P = 0.03) and NT-ProBNP (r = 0.27, 95% CI: 0.05–0.47; P = 0.01). Among patients with different degrees of IVC collapse in response to inspiration, values for BNP and NT-ProBNP did not differ substantially (P = 0.36 and 0.46 for BNP and NT-ProBNP, respectively).Conclusion: Natriuretic peptides correlate weakly with IVC size and do not predict changes in response to intrathoracic pressure.Keywords: heart failure, inferior vena cava, natriuretic peptides

Daniel Duprez1, Keith Ferdinand2, Das Purkayastha3, Rita Samuel3, Richard Wright41University of Minnesota, Minneapolis, MN, 2Atlanta Clinical Research Centers, Atlanta, GA, 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, 4Pacific Heart Institute, Santa Monica, CA, USABackground: Stage 2 hypertension often requires combination antihypertensive therapy. Ambulatory blood pressure monitoring (ABPM) is a useful tool for assessing antihypertensive drugs and their combinations.Objective: To compare the effect of a moderate dose of angiotensin receptor blocker/calcium channel blocker (ARB/CCB) combined with a diuretic versus a maximal dose of ARB with a diuretic on 24-hour ambulatory blood pressure monitoring (ABPM) and other derived ambulatory blood pressure (ABP) parameters.Methods: The EXforge As compared to Losartan Treatment ABPM substudy was a randomized, double-blind, parallel-group, active-control, forced-titration study of patients with Stage 2 hypertension that compared the efficacy of initial treatment with valsartan/amlodipine 160/5 mg (n = 48) or losartan 100 mg (n = 36). At week 3, hydrochlorothiazide (HCTZ) 25 mg was added in both treatment groups. ABP was measured at baseline and at week 6. Additionaly, 24-hour ABP, nighttime (10 pm to 6 am) and daytime (6 am to 10 pm) ABP, and ABP load (percentage of readings above 140/90 mmHg) were determined.Results: Eighty-four patients (48 ARB/CCB/HCTZ, 36 ARB/HCTZ) had ABPM at baseline and at week 6. Reductions of systolic/diastolic ABP were greater in the ARB/CCB/HCTZ group than in the ARB/HCTZ group for 24-hour mean ABP (–22.0/–13.3 versus –17.4/–8.1 mmHg), as well as nighttime ABP (–22.2/–13.3 versus –16.2/–7.4 mmHg), daytime ABP (–21.9/–13.0 versus –18.1/–8.6 mmHg), ABP in the last 4 hours of the dosing period (–21.5/–13.5 versus –17.0/–7.7 mmHg), and ABP load (21.7%/12.8% versus 30.8%/20.0%).Conclusion: Initiating antihypertensive treatment with moderate doses of ARB/CCB with a diuretic is more effective in lowering nighttime and daytime ABP and reducing ABP load than a maximal dose of an ARB with a diuretic.Keywords: antihypertensive drugs, ambulatory blood pressure, ambulatory blood pressure monitoring, combination therapy, valsartan, amlodipine, hydrochlorothiazide, losartan