Introduction to the Eighth International Workshop on Structure and Function of the Vascular System.

The Eighth International Workshop on Structure and Function of the Vascular System was held in Paris, France, from February 16 through February 18, 2012. In the first editions of this workshop during the 1990s, the focus was on methodologies to assess vascular structure and function in humans, as well as how these changes contribute to cardiovascular risk. We now have well-standardized approaches to assess both large artery and microvascular structure and function. Thus, the focus of the workshop has shifted toward mechanistic studies on how mechanical factors affect arterial remodeling and target-organ damage. In addition, the question of whether pulse wave velocity is an adequate marker for (cardio)vascular disease can now be raised with more experimental evidence to find an answer. During the 3-day symposium, 5 sessions were held. The first dealt with arterial mechanical properties and target-organ damage. In recent years, most therapeutic trials have been focused on their own specific topic, diabetes mellitus or hypertension or hypercholesterolemia. Studies associating several cardiovascular risk factors have been performed only to a limited degree. The most frequent association refers to hypertension and diabetes mellitus type 2. Each of these 2 cardiovascular risk factors increases independently arterial stiffness, but the association has never been specifically investigated in humans. Factors associated with arterial stiffness differ markedly in hypertension (age, blood pressure [BP], and heart rate) and diabetes mellitus (advanced glycation end products and insulin resistance). Michel Safar showed that, for the same mean arterial BP, arterial stiffness is much higher in diabetes mellitus than in hypertension. On the other hand, the risk of stroke is much higher in hypertension and that of coronary heart disease much higher in diabetes mellitus. Nico Westerhof and Michael O’Rourke provided evidence in this workshop that the association of hypertension and diabetes mellitus requires the reduction of arterial stiffness but also of wave reflections. Westerhof proposed a model associating compliance, resistance, and inertance and O’Rourke a model related to pulse pressure amplification. Athanase Protogerou discussed how the noninvasive assessment of 24-hour aortic ambulatory BP provided the opportunity to investigate the interaction between the timedependence and arterial site-dependence of BP variability. In addition, in the study of Weber et al, a novel method for the assessment of wave reflections based on an adopted Windkessel model, a flow curve estimation from the radial pressure waveforms, and wave separation analysis was applied in patients undergoing coronary angiography. The amplitude of reflected wave was significantly associated with the combined effects of cardiovascular end points. Clearly, such methods improve substantially the accuracy of cardiovascular assessments. In the last presentation of this session, Véronique Regnault suggested that hypertension and diabetes mellitus may confer, per se, a hypercoagulable state only because the main observed complications are stroke and myocardial infarction. She showed that, in spontaneous hypertension, there is an increase of vascular synthesis of tissue factor and tissue factor pathway inhibitor. Furthermore, vascular smooth muscle cells of spontaneously hypertensive rats confer a prothrombotic phenotype. The next 2 sessions dealt with arterial remodeling, inflammation, and microcirculation, with a particular focus on eclampsia. Ernesto Schiffrin presented a review on work performed in his own group, as well as by others, on the role of inflammation and immunity in hypertension. Ziad Mallat followed similar lines in his presentation on signal transducers and activators of transcription 3 signaling in atherosclerosis and aneurysm. Together, these 2 lectures represented an important paradigm shift in vascular research. Molecular mechanisms lead to vascular phenotypes, which constitute the basis for different risk factors for cardiovascular disease. Patrick Segers took the systems biology approach one step further in a mathematical model based study in apolipoprotein E1 mice in which he assessed the role of fluid mechanical factors in the development of abdominal aortic aneurysm. Two clinical-based presentations focused on metabolic mechanisms of altered arterial structure and function. Empar Lurbe discussed how BP and obesity exert independent influences on pulse wave velocity in youth. Isabel Ferreira showed that metabolic syndrome is associated with maladaptive carotid remodeling and stiffening. In the session on microcirculation, Harry StruijkerBoudier presented a review on retinal microvascular phenotypes and genotypes. Adam Greenstein reviewed the role of the microcirculation in the cardiovascular risk associated with obesity. He focused on the role of adipose tissue and the vasoactive substances derived from that tissue. The next 2 presentations dealt with pre-eclampsia. Asif Ahmed provided evidence for a potential role of the anti-inflammatory enzyme From the Department of Pharmacology (H.A.S.-B.), Maastricht University, Maastricht, the Netherlands; Paris Descartes University (J.B., M.E.S.), Diagnosis and Therapeutic Center, Hôtel-Dieu, Paris, France; U970 Institut National de la Santé et de la Recherche Médicale (B.I.L.), Hôpital Lariboisière, Paris, France. Correspondence to Harry A.J. Struijker-Boudier, Department of Pharmacology, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands. E-mail [email protected] (Hypertension. 2012;60:504-506.) © 2012 American Heart Association, Inc.