A methodology to analyze, design and implement very fast and robust controls of Buck-type converters

La electrónica digital moderna presenta un desafío a los diseñadores de sistemas de potencia. El creciente alto rendimiento de microprocesadores, FPGAs y ASICs necesitan sistemas de alimentación que cumplan con requirimientos dinámicos y estáticos muy estrictos. Específicamente, estas alimentaciones son convertidores DC-DC de baja tensión y alta corriente que necesitan ser diseñados para tener un pequeño rizado de tensión y una pequeña desviación de tensión de salida bajo transitorios de carga de una alta pendiente. Además, dependiendo de la aplicación, se necesita cumplir con otros requerimientos tal y como proveer a la carga con ”Escalado dinámico de tensión”, donde el convertidor necesitar cambiar su tensión de salida tan rápidamente posible sin sobreoscilaciones, o ”Posicionado Adaptativo de la Tensión” donde la tensión de salida se reduce ligeramente cuanto más grande sea la potencia de salida. Por supuesto, desde el punto de vista de la industria, las figuras de mérito de estos convertidores son el coste, la eficiencia y el tamaño/peso. Idealmente, la industria necesita un convertidor que es más barato, más eficiente, más pequeño y que aún así cumpla con los requerimienos dinámicos de la aplicación. En este contexto, varios enfoques para mejorar la figuras de mérito de estos convertidores se han seguido por la industria y la academia tales como mejorar la topología del convertidor, mejorar la tecnología de semiconducores y mejorar el control. En efecto, el control es una parte fundamental en estas aplicaciones ya que un control muy rápido hace que sea más fácil que una determinada topología cumpla con los estrictos requerimientos dinámicos y, consecuentemente, le da al diseñador un margen de libertar más amplio para mejorar el coste, la eficiencia y/o el tamaño del sistema de potencia. En esta tesis, se investiga cómo diseñar e implementar controles muy rápidos para el convertidor tipo Buck. En esta tesis se demuestra que medir la tensión de salida es todo lo que se necesita para lograr una respuesta casi óptima y se propone una guía de diseño unificada para controles que sólo miden la tensión de salida Luego, para asegurar robustez en controles muy rápidos, se proponen un modelado y un análisis de estabilidad muy precisos de convertidores DC-DC que tienen en cuenta circuitería para sensado y elementos parásitos críticos. También, usando este modelado, se propone una algoritmo de optimización que tiene en cuenta las tolerancias de los componentes y sensados distorsionados. Us ando este algoritmo, se comparan controles muy rápidos del estado del arte y su capacidad para lograr una rápida respuesta dinámica se posiciona según el condensador de salida utilizado. Además, se propone una técnica para mejorar la respuesta dinámica de los controladores. Todas las propuestas se han corroborado por extensas simulaciones y prototipos experimentales. Con todo, esta tesis sirve como una metodología para ingenieros para diseñar e implementar controles rápidos y robustos de convertidores tipo Buck. ABSTRACT Modern digital electronics present a challenge to designers of power systems. The increasingly high-performance of microprocessors, FPGAs (Field Programmable Gate Array) and ASICs (Application-Specific Integrated Circuit) require power supplies to comply with very demanding static and dynamic requirements. Specifically, these power supplies are low-voltage/high-current DC-DC converters that need to be designed to exhibit low voltage ripple and low voltage deviation under high slew-rate load transients. Additionally, depending on the application, other requirements need to be met such as to provide to the load ”Dynamic Voltage Scaling” (DVS), where the converter needs to change the output voltage as fast as possible without underdamping, or ”Adaptive Voltage Positioning” (AVP) where the output voltage is slightly reduced the greater the output power. Of course, from the point of view of the industry, the figures of merit of these converters are the cost, efficiency and size/weight. Ideally, the industry needs a converter that is cheaper, more efficient, smaller and that can still meet the dynamic requirements of the application. In this context, several approaches to improve the figures of merit of these power supplies are followed in the industry and academia such as improving the topology of the converter, improving the semiconductor technology and improving the control. Indeed, the control is a fundamental part in these applications as a very fast control makes it easier for the topology to comply with the strict dynamic requirements and, consequently, gives the designer a larger margin of freedom to improve the cost, efficiency and/or size of the power supply. In this thesis, how to design and implement very fast controls for the Buck converter is investigated. This thesis proves that sensing the output voltage is all that is needed to achieve an almost time-optimal response and a unified design guideline for controls that only sense the output voltage is proposed. Then, in order to assure robustness in very fast controls, a very accurate modeling and stability analysis of DC-DC converters is proposed that takes into account sensing networks and critical parasitic elements. Also, using this modeling approach, an optimization algorithm that takes into account tolerances of components and distorted measurements is proposed. With the use of the algorithm, very fast analog controls of the state-of-the-art are compared and their capabilities to achieve a fast dynamic response are positioned de pending on the output capacitor. Additionally, a technique to improve the dynamic response of controllers is also proposed. All the proposals are corroborated by extensive simulations and experimental prototypes. Overall, this thesis serves as a methodology for engineers to design and implement fast and robust controls for Buck-type converters.

Multiscale analysis of the mechanical behavior of needle-punched nonwoven fabrics

Los fieltros son una familia de materiales textiles constituidos por una red desordenada de fibras conectadas por medio de enlaces térmicos, químicos o mecánicos. Presentan menor rigidez y resistencia (al igual que un menor coste de procesado) que sus homólogos tejidos, pero mayor deformabilidad y capacidad de absorción de energía. Los fieltros se emplean en diversas aplicaciones en ingeniería tales como aislamiento térmico, geotextiles, láminas ignífugas, filtración y absorción de agua, impacto balístico, etc. En particular, los fieltros punzonados fabricados con fibras de alta resistencia presentan una excelente resistencia frente a impacto balístico, ofreciendo las mismas prestaciones que los materiales tejidos con un tercio de la densidad areal. Sin embargo, se sabe muy poco acerca de los mecanismos de deformación y fallo a nivel microscópico, ni sobre como influyen en las propiedades mecánicas del material. Esta carencia de conocimiento dificulta la optimización del comportamiento mecánico de estos materiales y también limita el desarrollo de modelos constitutivos basados en mecanismos físicos, que puedan ser útiles en el diseño de componentes estructurales. En esta tesis doctoral se ha llevado a cabo un estudio minucioso con el fin de determinar los mecanismos de deformación y las propiedades mecánicas de fieltros punzonados fabricados con fibras de polietileno de ultra alto peso molecular. Los procesos de deformación y disipación de energía se han caracterizado en detalle por medio de una combinación de técnicas experimentales (ensayos mecánicos macroscópicos a velocidades de deformación cuasi-estáticas y dinámicas, impacto balístico, ensayos de extracción de una o múltiples fibras, microscopía óptica, tomografía computarizada de rayos X y difracción de rayos X de gran ángulo) que proporcionan información de los mecanismos dominantes a distintas escalas. Los ensayos mecánicos macroscópicos muestran que el fieltro presenta una resistencia y ductilidad excepcionales. El estado inicial de las fibras es curvado, y la carga se transmite por el fieltro a través de una red aleatoria e isótropa de nudos creada por el proceso de punzonamiento, resultando en la formación de una red activa de fibra. La rotación y el estirado de las fibras activas es seguido por el deslizamiento y extracción de la fibra de los puntos de anclaje mecánico. La mayor parte de la resistencia y la energía disipada es proporcionada por la extracción de las fibras activas de los nudos, y la fractura final tiene lugar como consecuencia del desenredo total de la red en una sección dada donde la deformación macroscópica se localiza. No obstante, aunque la distribución inicial de la orientación de las fibras es isótropa, las propiedades mecánicas resultantes (en términos de rigidez, resistencia y energía absorbida) son muy anisótropas. Los ensayos de extracción de múltiples fibras en diferentes orientaciones muestran que la estructura de los nudos conecta más fibras en la dirección transversal en comparación con la dirección de la máquina. La mejor interconectividad de las fibras a lo largo de la dirección transversal da lugar a una esqueleto activo de fibras más denso, mejorando las propiedades mecánicas. En términos de afinidad, los fieltros deformados a lo largo de la dirección transversal exhiben deformación afín (la deformación macroscópica transfiere directamente a las fibras por el material circundante), mientras que el fieltro deformado a lo largo de la dirección de la máquina presenta deformación no afín, y la mayor parte de la deformación macroscópica no es transmitida a las fibras. A partir de estas observaciones experimentales, se ha desarrollado un modelo constitutivo para fieltros punzonados confinados por enlaces mecánicos. El modelo considera los efectos de la deformación no afín, la conectividad anisótropa inducida durante el punzonamiento, la curvatura y re-orientación de la fibra, así como el desenredo y extracción de la fibra de los nudos. El modelo proporciona la respuesta de un mesodominio del material correspondiente al volumen asociado a un elemento finito, y se divide en dos bloques. El primer bloque representa el comportamiento de la red y establece la relación entre el gradiente de deformación macroscópico y la respuesta microscópica, obtenido a partir de la integración de la respuesta de las fibras en el mesodominio. El segundo bloque describe el comportamiento de la fibra, teniendo en cuenta las características de la deformación de cada familia de fibras en el mesodominio, incluyendo deformación no afín, estiramiento, deslizamiento y extracción. En la medida de lo posible, se ha asignado un significado físico claro a los parámetros del modelo, por lo que se pueden identificar por medio de ensayos independientes. Las simulaciones numéricas basadas en el modelo se adecúan a los resultados experimentales de ensayos cuasi-estáticos y balísticos desde el punto de vista de la respuesta mecánica macroscópica y de los micromecanismos de deformación. Además, suministran información adicional sobre la influencia de las características microstructurales (orientación de la fibra, conectividad de la fibra anisótropa, afinidad, etc) en el comportamiento mecánico de los fieltros punzonados. Nonwoven fabrics are a class of textile material made up of a disordered fiber network linked by either thermal, chemical or mechanical bonds. They present lower stiffness and strength (as well as processing cost) than the woven counterparts but much higher deformability and energy absorption capability and are used in many different engineering applications (including thermal insulation, geotextiles, fireproof layers, filtration and water absorption, ballistic impact, etc). In particular, needle-punched nonwoven fabrics manufactured with high strength fibers present an excellent performance for ballistic protection, providing the same ballistic protection with one third of the areal weight as compared to dry woven fabrics. Nevertheless, very little is known about their deformation and fracture micromechanisms at the microscopic level and how they contribute to the macroscopic mechanical properties. This lack of knowledge hinders the optimization of their mechanical performance and also limits the development of physically-based models of the mechanical behavior that can be used in the design of structural components with these materials. In this thesis, a thorough study was carried out to ascertain the micromechanisms of deformation and the mechanical properties of a needle-punched nonwoven fabric made up by ultra high molecular weight polyethylene fibers. The deformation and energy dissipation processes were characterized in detail by a combination of experimental techniques (macroscopic mechanical tests at quasi-static and high strain rates, ballistic impact, single fiber and multi fiber pull-out tests, optical microscopy, X-ray computed tomography and wide angle X-ray diffraction) that provided information of the dominant mechanisms at different length scales. The macroscopic mechanical tests showed that the nonwoven fabric presented an outstanding strength and energy absorption capacity. It was found that fibers were initially curved and the load was transferred within the fabric through the random and isotropic network of knots created by needlepunching, leading to the formation of an active fiber network. Uncurling and stretching of the active fibers was followed by fiber sliding and pull-out from the entanglement points. Most of the strength and energy dissipation was provided by the extraction of the active fibers from the knots and final fracture occurred by the total disentanglement of the fiber network in a given section at which the macroscopic deformation was localized. However, although the initial fiber orientation distribution was isotropic, the mechanical properties (in terms of stiffness, strength and energy absorption) were highly anisotropic. Pull-out tests of multiple fibers at different orientations showed that structure of the knots connected more fibers in the transverse direction as compared with the machine direction. The better fiber interconnection along the transverse direction led to a denser active fiber skeleton, enhancing the mechanical response. In terms of affinity, fabrics deformed along the transverse direction essentially displayed affine deformation {i.e. the macroscopic strain was directly transferred to the fibers by the surrounding fabric, while fabrics deformed along the machine direction underwent non-affine deformation, and most of the macroscopic strain was not transferred to the fibers. Based on these experimental observations, a constitutive model for the mechanical behavior of the mechanically-entangled nonwoven fiber network was developed. The model accounted for the effects of non-affine deformation, anisotropic connectivity induced by the entanglement points, fiber uncurling and re-orientation as well as fiber disentanglement and pull-out from the knots. The model provided the constitutive response for a mesodomain of the fabric corresponding to the volume associated to a finite element and is divided in two blocks. The first one was the network model which established the relationship between the macroscopic deformation gradient and the microscopic response obtained by integrating the response of the fibers in the mesodomain. The second one was the fiber model, which took into account the deformation features of each set of fibers in the mesodomain, including non-affinity, uncurling, pull-out and disentanglement. As far as possible, a clear physical meaning is given to the model parameters, so they can be identified by means of independent tests. The numerical simulations based on the model were in very good agreement with the experimental results of in-plane and ballistic mechanical response of the fabrics in terms of the macroscopic mechanical response and of the micromechanisms of deformation. In addition, it provided additional information about the influence of the microstructural features (fiber orientation, anisotropic fiber connectivity, affinity) on the mechanical performance of mechanically-entangled nonwoven fabrics.

Sequence dependent hypermutation of the immunoglobulin heavy chain in cultured B cells

The variable (V) regions of immunoglobulin heavy and light chains undergo high rates of somatic mutation during the immune response. Although point mutations accumulate throughout the V regions and their immediate flanking sequences, analysis of large numbers of mutations that have arisen in vivo reveal that the triplet AGC appears to be most susceptible to mutation. We have stably transfected B cell lines with γ2a heavy chain constructs containing TAG nonsense codons in their V regions that are part of either a putative (T)AGC hot spot or a (T)AGA non-hot spot motif. Using an ELISA spot assay to detect revertants and fluctuation analysis to determine rates of mutation, the rate of reversion of the TAG nonsense codon has been determined for different motifs in different parts of the V region. In the NSO plasma cell line, the (T)AGC hot spot motif mutates at rates of ≈6 × 10−4/bp per generation and ≈3 × 10−5/bp per generation at residues 38 and 94 in the V region. At each of these locations, the (T)AGC hot spot motif is 20–30 times more likely to undergo mutation than the (T)AGA non-hot spot motif. Moreover, the AGA non-hot spot motif mutates at as high a rate as the hot spot motif when it is located adjacent to hot spot motifs, suggesting that more extended sequences influence susceptibility to mutation.

Medial prefrontal cortex and self-referential mental activity: Relation to a default mode of brain function

Medial prefrontal cortex (MPFC) is among those brain regions having the highest baseline metabolic activity at rest and one that exhibits decreases from this baseline across a wide variety of goal-directed behaviors in functional imaging studies. This high metabolic rate and this behavior suggest the existence of an organized mode of default brain function, elements of which may be either attenuated or enhanced. Extant data suggest that these MPFC regions may contribute to the neural instantiation of aspects of the multifaceted “self.” We explore this important concept by targeting and manipulating elements of MPFC default state activity. In this functional magnetic resonance imaging (fMRI) study, subjects made two judgments, one self-referential, the other not, in response to affectively normed pictures: pleasant vs. unpleasant (an internally cued condition, ICC) and indoors vs. outdoors (an externally cued condition, ECC). The ICC was preferentially associated with activity increases along the dorsal MPFC. These increases were accompanied by decreases in both active task conditions in ventral MPFC. These results support the view that dorsal and ventral MPFC are differentially influenced by attentiondemanding tasks and explicitly self-referential tasks. The presence of self-referential mental activity appears to be associated with increases from the baseline in dorsal MPFC. Reductions in ventral MPFC occurred consistent with the fact that attention-demanding tasks attenuate emotional processing. We posit that both self-referential mental activity and emotional processing represent elements of the default state as represented by activity in MPFC. We suggest that a useful way to explore the neurobiology of the self is to explore the nature of default state activity.

Arabidopsis nph1 and npl1: Blue light receptors that mediate both phototropism and chloroplast relocation

UV-A/blue light acts to regulate a number of physiological processes in higher plants. These include light-driven chloroplast movement and phototropism. The NPH1 gene of Arabidopsis encodes an autophosphorylating protein kinase that functions as a photoreceptor for phototropism in response to low-intensity blue light. However, nph1 mutants have been reported to exhibit normal phototropic curvature under high-intensity blue light, indicating the presence of an additional phototropic receptor. A likely candidate is the nph1 homologue, npl1, which has recently been shown to mediate the avoidance response of chloroplasts to high-intensity blue light in Arabidopsis. Here we demonstrate that npl1, like nph1, noncovalently binds the chromophore flavin mononucleotide (FMN) within two specialized PAS domains, termed LOV domains. Furthermore, when expressed in insect cells, npl1, like nph1, undergoes light-dependent autophosphorylation, indicating that npl1 also functions as a light receptor kinase. Consistent with this conclusion, we show that a nph1npl1 double mutant exhibits an impaired phototropic response under both low- and high-intensity blue light. Hence, npl1 functions as a second phototropic receptor under high fluence rate conditions and is, in part, functionally redundant to nph1. We also demonstrate that both chloroplast accumulation in response to low-intensity light and chloroplast avoidance movement in response to high-intensity light are lacking in the nph1npl1 double mutant. Our findings therefore indicate that nph1 and npl1 show partially overlapping functions in two different responses, phototropism and chloroplast relocation, in a fluence rate-dependent manner.

An immunoglobulin mutator that targets G.C base pairs.

Hypermutation can be defined as an enhancement of the spontaneous mutation rate which the organism uses in certain types of differentiated cells where a high mutation rate is advantageous. At the immunoglobulin loci this process increases the mutation rate > 10(5)-fold over the normal, spontaneous rate. Its proximate cause is called the immunoglobulin mutator system. The most important function of this system is to improve antibody affinity in an ongoing response; it is turned on and off during the differentiation of B lymphocytes. We have established an in vitro system to study hypermutation by transfecting a rearranged mu gene into a cell line in which an immunoglobulin mutator has been demonstrated. A construct containing the mu gene and the 3' kappa enhancer has all the cis-acting elements necessary for hypermutation of the endogenous gene segments encoding the variable region. The activity of the mutator does not seem to depend strongly on the position of the transfected gene in the genome. The mutator is not active in transformed cells of a later differentiation stage. It is also not active on a transfected lacZ gene. These results are consistent with the specificity of the mutator system being maintained and make it possible to delineate cis and trans mutator elements in vitro. Surprisingly, the mutator preferentially targets G-C base pairs. Two hypotheses are discussed: (i) the immunoglobulin mutator system in mammals consists of several mutators, of which the mutator described here is only one; or (ii) the primary specificity of the system is biased toward mutation of G-C base pairs, but this specificity is obscured by antigenic selection.

Structural variation of the pseudoautosomal region between and within inbred mouse strains.

The pseudoautosomal region (PAR) is a segment of shared homology between the sex chromosomes. Here we report additional probes for this region of the mouse genome. Genetic and fluorescence in situ hybridization analyses indicate that one probe, PAR-4, hybridizes to the pseudoautosomal telomere and a minor locus at the telomere of chromosome 9 and that a PCR assay based on the PAR-4 sequence amplifies only the pseudoautosomal locus (DXYHgu1). The region detected by PAR-4 is structurally unstable; it shows polymorphism both between mouse strains and between animals of the same inbred strain, which implies an unusually high mutation rate. Variation occurs in the region adjacent to a (TTAGGG)n array. Two pseudoautosomal probes can also hybridize to the distal telomeres of chromosomes 9 and 13, and all three telomeres contain DXYMov15. The similarity between these telomeres may reflect ancestral telomere-telomere exchange.

The challenge of paleoecological stasis: reassessing sources of evolutionary stability.

The paleontological record of the lower and middle Paleozoic Appalachian foreland basin demonstrates an unprecedented level of ecological and morphological stability on geological time scales. Some 70-80% of fossil morphospecies within assemblages persist in similar relative abundances in coordinated packages lasting as long as 7 million years despite evidence for environmental change and biotic disturbances. These intervals of stability are separated by much shorter periods of ecological and evolutionary change. This pattern appears widespread in the fossil record. Existing concepts of the evolutionary process are unable to explain this uniquely paleontological observation of faunawide coordinated stasis. A principle of evolutionary stability that arises from the ecosystem is explored here. We propose that hierarchical ecosystem theory, when extended to geological time scales, can explain long-term paleoecological stability as the result of ecosystem organization in response to high-frequency disturbance. The accompanying stability of fossil morphologies results from "ecological locking," in which selection is seen as a high-rate response of populations that is hierarchically constrained by lower-rate ecological processes. When disturbance exceeds the capacity of the system, ecological crashes remove these higher-level constraints, and evolution is free to proceed at high rates of directional selection during the organization of a new stable ecological hierarchy.

Linfohistiocitose hemofagocítica secundária a infecção por epstein-barr a propósito de um caso clínico

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Transmissão sexual e tratamento na hepatite C aguda : dois casos clinicos

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

On the initiation of boudinage and folding instabilities in layered elasto-visco-plastic solids - Insights from natural microstructures and numerical simulations

The present understanding of the initiation of boudinage and folding structures is based on viscosity contrasts and stress exponents, considering an intrinsically unstable state of the layer. The criterion of localization is believed to be prescribed by geometry-material interactions, which are often encountered in natural structures. An alternative localization phenomenon has been established for ductile materials, in which instability emerges for critical material parameters and loading rates from homogeneous conditions. In this thesis, conditions are sought under which this type of instability prevails and whether localization in geological materials necessarily requires a trigger by geometric imperfections. The relevance of critical deformation conditions, material parameters and the spatial configuration of instabilities are discussed in a geological context. In order to analyze boudinage geometries, a numerical eigenmode analysis is introduced. This method allows determining natural frequencies and wavelengths of a structure and inducing perturbations on these frequencies. In the subsequent coupled thermo-mechanical simulations, using a grain size evolution and end-member flow laws, localization emerges when material softening through grain size sensitive viscous creep sets in. Pinch-and-swell structures evolve along slip lines through a positive feedback between the matrix response and material bifurcations inside the layer, independent from the mesh-discretization length scale. Since boudinage and folding are considered to express the same general instability, both structures should arise independently of the sign of the loading conditions and for identical material parameters. To this end, the link between material to energy instabilities is approached by means of bifurcation analyses of the field equations and finite element simulations of the coupled system of equations. Boudinage and folding structures develop at the same critical energy threshold, where dissipative work by temperature-sensitive creep overcomes the diffusive capacity of the layer. This finding provides basis for a unified theory for strain localization in layered ductile materials. The numerical simulations are compared to natural pinch-and-swell microstructures, tracing the adaption of grain sizes, textures and creep mechanisms in calcite veins. The switch from dislocation to diffusion creep relates to strain-rate weakening, which is induced by dissipated heat from grain size reduction, and marks the onset of continuous necking. The time-dependent sequence uncovers multiple steady states at different time intervals. Microstructurally and mechanically stable conditions are finally expressed in the pinch-and-swell end members. The major outcome of this study is that boudinage and folding can be described as the same coupled energy-mechanical bifurcation, or as one critical energy attractor. This finding allows the derivation of critical deformation conditions and fundamental material parameters directly from localized structures in the field.

Effect of aldosterone antagonism on myocardial dysfunction in hypertensive patients with diastolic heart failure

Background - Specific treatments targeting the pathophysiology of hypertensive heart disease are lacking. As aldosterone has been implicated in the genesis of myocardial fibrosis, hypertrophy, and dysfunction, we sought to determine the effects of aldosterone antagonism on myocardial function in hypertensive patients with suspected diastolic heart failure by using sensitive quantitative echocardiographic techniques in a randomized, double-blinded, placebo-controlled study. Methods and Results - Thirty medically treated ambulatory hypertensive patients (19 women, age 62 +/- 6 years) with exertional dyspnea, ejection fraction >50%, and diastolic dysfunction (E/A 250m/sec) and without ischemia were randomized to spironolactone 25 mg/d or placebo for 6 months. Patients were overweight (31 +/- 5 kg/m(2)) with reduced treadmill exercise capacity (6.7 +/- 2.1 METS). Long-axis strain rate (SR), peak systolic strain, and cyclic variation of integrated backscatter (CVIB) were averaged from 6 walls in 3 standard apical views. Mean 24-hour ambulatory blood pressure at baseline (133 +/- 17/80 +/- 7mm Hg) did not change in either group. Values for SR, peak systolic strain, and CVIB were similar between groups at baseline and remained unchanged with placebo. Spironolactone therapy was associated with increases in SR (baseline: -1.57 +/- 0.46 s(-1) versus 6-months: -1.91 +/- 0.36 s(-1), P < 0.01), peak systolic strain (-20.3 &PLUSMN; 5.0% versus -26.9 &PLUSMN; 4.3%, P < 0.001), and CVIB (7.4 +/- 1.7dB versus 8.6 +/- 1.7 dB, P = 0.08). Each parameter was significantly greater in the spironolactone group compared with placebo at 6 months (P = 0.05, P = 0.02, and P = 0.02, respectively), and the increases remained significant after adjusting for baseline differences. The increase in strain was independent of changes in blood pressure with intervention. The spironolactone group also exhibited reduction in posterior wall thickness (P = 0.04) and a trend to reduced left atrial area (P = 0.09). Conclusions - Aldosterone antagonism improves myocardial function in hypertensive heart disease.

Myocardial and vascular dysfunction and exercise capacity in the metabolic syndrome

The metabolic syndrome (MS) is associated with cardiovascular risk exceeding that expected from atherosclerotic risk factors, but the mechanism of this association is unclear. We sought to determine the effects of the MS on myocardial and vascular function and cardiorespiratory fitness in 393 subjects with significant risk factors but no cardiovascular disease and negative stress echocardiographic findings. Myocardial function was assessed by global strain rate, strain, and regional systolic velocity (s(m)) and diastolic velocity (e(m)) using tissue Doppler imaging. Arterial compliance was assessed using the pulse pressure method, involving simultaneous radial applanation tonometry and echocardiographic measurement of stroke volume. Exercise capacity was measured by expired gas analysis. Significant and incremental variations in left ventricular systolic (s(m), global strain, and strain rate) and diastolic (e(m)) function were found according to the number of components of MS (p <0.001). MS contributed to reduced systolic and diastolic function even in those without left ventricular hypertrophy (p <0.01). A similar dose-response association was present between the number of components of the MS and exercise capacity (p <0.001) and arterial compliance. The global strain rate and em were independent predictors of exercise capacity. In conclusion, subclinical left ventricular dysfunction corresponded to the degree of metabolic burden, and these myocardial changes were associated with reduced cardiorespiratory fitness.' Subjects with MS who also have subclinical myocardial abnormalities and reduced cardiorespiratory fitness may have a higher risk of cardiovascular disease events and heart failure. (C) 2005 Elsevier Inc. All rights reserved.

Normal ranges for automated analysis of global LV function using 2D Strain

Background: Automated measurement of LV function could extend the clinical utility of echo by less expert readers. We sought to define normal ranges of global 2D strain (2DS) and strain-rate (SR) in an international, multicenter study of healthy subjects, and to assess the determinants of variation. Methods: SR and 2DS were measured in 18 myocardial segts in both apical and short axis views of 227 normal subjects (38% men, 48±14y) with no cardiac history, risk factors or drug therapy. The association of age and resting hemodynamics with global strain indices was sought using multiple regression. Differences in variance were expressed as F values. Results: Baseline SBP was 127±18 mmHg, pulse was 76±13/min and ejection fraction 50±20%. Although global longitudinal strain was influenced by endsystolic volume (F=4.2, p