Abstract Background The association between exaggerated systolic blood pressure response to exercise (ESBPRE) and myocardial ischemia is controversial and little studied in patients with established or suspected chronic coronary syndrome. Objective To verify the relationship between myocardial ischemia and ESBPRE in patients undergoing exercise stress echocardiography (ESE). Methods This is a cross-sectional study with 14,367 patients undergoing ESE, from January 2000 to January 2022, divided into the following 2 groups: G1, composed of patients whose peak systolic pressure increased ≥ 90 mmHg (value corresponding to the 95th percentile of the study population), and G2, patients who did not demonstrate an exaggerated hypertensive response. The groups were compared using Student’s t and chi-square tests. P values < 0.05 were considered significant. Logistic regression was also performed to identify independent risk factors for myocardial ischemia, ESBPRE, complaints of typical chest pain prior to the exam, and angina during the test. Results Of the 14,367 patients, 1,500 (10.4%) developed ESBPRE, and 7,471 (52.0%) were female. The percentages of previous complaints of typical chest pain, angina during the test, and myocardial ischemia in patients with ESBPRE were 5.8%, 2.4% and 18.1%, compared to 7.4%, 3.9%, and 24.2%, in patients without ESBPRE, respectively (p = 0.021,p = 0.004, p < 0.001). In multivariate analysis, ESBPRE was independently associated with a lower probability of myocardial ischemia (odds ratio: 0.73; 95% confidence interval: 0.58 to 0.93; p = 0.009). Conclusion Exaggerated increase in systolic blood pressure during ESE may be a marker for excluding myocardial ischemia. (ESBPRE syndrome ESE. . (ESE) crosssectional cross sectional 14367 14 367 14,36 200 2022 G1 G 9 value th population, population , population) G2 Students Student s chisquare chi square tests 005 0 05 0.0 significant exam test 1500 1 500 1,50 10.4% 104 10 4 (10.4% 7471 7 471 7,47 52.0% 520 52 (52.0% female 58 5 8 5.8% 24 2.4 181 18 18.1% 74 7.4% 39 3 3.9% 242 24.2% 0021p 021 0004 004 0.004 0.001. 0001 0.001 001 0.001) analysis odds ratio 0.73 073 73 95 interval 058 0.5 0.93 093 93 0.009. 0009 0.009 009 0.009) (ESE 1436 36 14,3 20 202 00 0. 150 50 1,5 10.4 (10.4 747 47 7,4 52.0 (52.0 5.8 2. 18.1 7.4 3.9 24.2 02 000 0.00 0.7 07 0.9 09 143 14, 15 1, 10. (10. 7, 52. (52. 5. 18. 7. 3. 24. (10 (52 (1 (5 (

Resumo Fundamento A associação entre resposta exagerada da pressão arterial sistólica ao exercício (REPASE) e isquemia miocárdica é controversa e pouco estudada em indivíduos com síndrome coronariana crônica estabelecida ou suspeita. Objetivo Verificar a relação entre isquemia miocárdica e REPASE em indivíduos submetidos à ecocardiografia sob estresse físico (EEF). Métodos Trata-se de estudo transversal com 14.367 indivíduos submetidos à EEF, de janeiro de 2000 a janeiro de 2022, divididos em dois grupos: G1 – composto por pacientes cuja pressão sistólica de pico apresentou incremento ≥ 90 mmHg (valor correspondente ao percentil 95 da população estudada) –, e G2 – formado por indivíduos que não apresentaram resposta hipertensiva exagerada. Os grupos foram comparados mediante os testes t de Student e qui-quadrado. Foram considerados significativos os valores de p < 0,05. Realizou-se, também, regressão logística para identificação de fatores de risco independentes para isquemia miocárdica, REPASE, queixa de precordialgia típica prévia ao exame e angina durante o teste. Resultados Dos 14.367 pacientes, 1.500 (10,4%) desenvolveram REPASE e 7.471 (52,0%) eram do sexo feminino. Os percentuais de queixa prévia de precordialgia típica, angina durante o teste e isquemia miocárdica dos pacientes com REPASE foram de 5,8%, 2,4% e 18,1% contra 7,4%, 3,9% e 24,2%, em indivíduos sem REPASE, respectivamente (p = 0,021, p = 0,004, p < 0,001). Na análise multivariada, a REPASE foi associada, independentemente, a uma menor probabilidade de isquemia miocárdica (odds ratio: 0,73; intervalo de confiança de 95%: 0,58 a 0,93; p = 0,009). Conclusão O incremento exagerado da pressão arterial sistólica durante a EEF pode ser um marcador de exclusão de isquemia miocárdica. (REPASE suspeita EEF. . (EEF) Tratase Trata se 14367 14 367 14.36 200 2022 G 9 valor quiquadrado. quiquadrado qui quadrado. quadrado qui-quadrado 005 0 05 0,05 Realizouse, Realizouse Realizou se, Realizou-se também 1500 1 500 1.50 10,4% 104 10 4 (10,4% 7471 7 471 7.47 52,0% 520 52 (52,0% feminino 58 5 8 5,8% 24 2 2,4 181 18 18,1 74 7,4% 39 3 3,9 242 24,2% 0021 021 0,021 0004 004 0,004 0,001. 0001 0,001 001 0,001) multivariada associada independentemente odds ratio 0,73 073 73 95% 058 0,5 0,93 093 93 0,009. 0009 0,009 009 0,009) (EEF 1436 36 14.3 20 202 00 0,0 150 50 1.5 10,4 (10,4 747 47 7.4 52,0 (52,0 5,8 2, 18, 7,4 3, 24,2 002 02 0,02 000 0,00 0,7 07 0, 0,9 09 143 14. 15 1. 10, (10, 7. 52, (52, 5, 7, 24, (10 (52 (1 (5 (

Abstract Background Cardiotoxicity is the main complication related to cancer therapy. Studies indicate that global longitudinal strain is an early detector of subclinical dysfunction of the left ventricle, preceding the decline in ejection fraction (EF). However, the reproducibility of such methodology has not been tested outside specialized centers. Objectives To assess the frequency of subclinical cardiotoxicity and to compare global longitudinal strain and EF measurements during the clinical course of patients undergoing chemotherapy for breast cancer. Methods This was an observational prospective study of 78 adult women who underwent serial echocardiograms (baseline and 1, 3, and 6 months after the beginning of chemotherapy), to evaluate biplane and 3D EF and global longitudinal strain. Cardiotoxicity and subclinical dysfunction were defined according to American Society of Echocardiography/European Association of Cardiovascular Imaging criteria. Statistical significance was set at p < 0.05. Results The mean age of the patients was 50.1 ± 11.48 years. The frequency of subclinical cardiotoxicity (defined by global longitudinal strain) was 14.9% after 30 days of chemotherapy, 16.7% after 3 months, and 19.7% after 6 months, compared to 4.5%, 3%, and 6.6%, respectively, when clinical cardiotoxicity was determined according to EF. The group that developed subclinical cardiotoxicity by 30 days (group A) had a higher frequency of clinical cardiotoxicity at 3 months (p=0.028) and a lower mean biplane EF after 30 days (p= 0.036) than the group that showed no evidence of subclinical cardiotoxicity (group B). Conclusion Subclinical cardiotoxicity was frequent and began early, being associated with a drop in EF during the clinical course.

ABSTRACT Viticulture is an activity of great economic and social importance in the Submedium region of the São Francisco River Valley, with emphasis on table grape and wine production. With the increasing expansion of the viticulture, a growing number of alternatives that do not affect fruit quality have been studied to maximize table grape yield, such as pruning and load adjustment. The aim of the present study was to evaluate the influence of different bud loads on canopy management to enable the marketable and economic production of cv. Sugrathirteen (Midnight Beauty®) in the submedium region ofthe São Francisco River Valley. This study was carried out for two years (2014/2015) in an experimental area for the introduction of new cultivars patented by Prodomo Farm in the municipality of Petrolina, Pernambuco, Brazil. The experiment was conducted in a randomized block factorial 2 × 5 design, with two seasons and 5 treatments, 6, 8, 10, 12 and 14 buds short_textwhich correspond toshort_text 17, 23, 29, 34 and 40 buds·m–2 short_textrespectivelyshort_text, distributed in 4 plots, considering five plants per replicate. Our results show that pruning seasons significantly affected sprouting percentage. However, the difference in bud load influenced this variable, with higher values in the pruning at 14 buds in both seasons. According to the results, the selection of pruning system according to bud load and to genetic features of the cultivar, and their interaction with the environment, produced higher yields in pruning with 10 buds, without negatively affecting grape quality.