The international database of ambulatory blood pressure in relation to cardiovascular outcome will provide a shared resource to investigate risk stratification by ambulatory blood pressure monitoring to an extent not possible in any earlier individual study.

Abstract-Previous studies have reported results on 24-hour ambulatory blood pressure (ABP) in Europe and Japan, but no data exists from South America. In this study, we conducted a population survey to identify reference values and to compare ambulatory blood pressure with clinic, home, and self-measured values. A random sample of 2650 adults was selected among 190 000 people covered by our prepaid healthcare institution. Clinic (physician and nurse) and home (nurse) blood pressure measurements were performed 3 times each, with semiautomatic electronic equipment. Self-measurements were performed by the subjects manually activating the ambulatory device. We analyzed 1573 individuals who were not receiving antihypertensive therapy from 1921 participants. Self-measurement was available in a subgroup of 577 participants younger than the whole sample. Evidence of the risks of arterial hypertension and the benefits of its treatment are based on casual blood pressure (BP) measurements. 7,8 Nevertheless, BP can be measured in different environments (clinic, home, and workplace), by different personnel (physician, nurse, or patient), and with a conventional sphygmomanometer or ABP devices. This introduces the problem of the correspondence among BP values measured in these different ways and situations, with its practical implications in the usual care of normotensive and hypertensive individuals. Correlation among ABP and the remaining BP measurement methods have been published in the above referred studies, but no one has compared the BP measured by a physician at clinic with BP measured by a nurse at clinic or at home, self-measured BP, and 24-hour ABP in the same sample. The purpose of this study was to estimate normal values of 24-hour ABP in an Uruguayan population and to perform a direct comparison of ABP results with clinic (physician and nurse), home, and self-measured BP values.

Aim of this work was to study in a group of elite cyclists, undergoing laboratory testing, the trend of the left ventricular systolic and diastolic function, echocardiographically and Doppler derived, simultaneously with the evaluation of ergospirometric parameters during maximal exercise. We studied a group of male subjects, consisting of 10 professional elite bicyclists (mean age: 25.1 +/- 3.2 years) during competitive activity (VO2/kg max: 78.5 +/- 7.7 ml.kg.min-1). The maximal exercise test, conducted with Wind Loaded Simulator for optimisation of ergometric capacity, showed, at the end of exercise, at a speed of 49.2 +/- 2.4 km/h, a VO2max of 5365 +/- 543.4 ml/min, with a calculated Cardiac Output (CO) of 19.3 +/- 3.7 l/min. A linear regression relationship was found between VO2max and CO (r = 0.84; p < 0.0001) as well as between VO2max and maximal reached speed (r = 0.97; p < 0.0001). During the aerobic period a slight but significant increase in End Diastolic Volume (EDV) was observed due to the greater venous return from exercising muscles. At stop, in anaerobic period, the EDV remained substantially constant. Ejection Fraction (EF) also increased during exercise through the Frank-Starling mechanism activation. The slight, but not significant, increase in EF at stop level may be explained by an activation of homeometric control of contractility with a sympathetic modulation on myocardial fibres. The early diastolic mitral flow velocity (Peak E) increased significantly during exercise, in comparison with basal upright values. The left ventricular diastolic compliance observed in athletes permits a good left ventricular filling, particularly in early diastolic phase; this allows an excellent left ventricular systolic performance. Based on echocardiography and pulsed Doppler measurements, calculated cardiac output is underestimated by approximately 20%.

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59 Background: Over the last decades the incidence of EOCRC (age 50 or less) has dramatically increased, and so has the scientific interest in this field, given that clinical and molecular characteristics in these patients are not well understood, and may be critical to identify prognostic factors. Methods: We conducted a retrospective analysis of 554 patients with metastatic colorectal cancer (mCRC), analyzing the PFS and OS of 68 (12.25%) patients with EOCRC, as well as their clinical and molecular characteristics. We used a log-rank test to compare PFS and OS, and the estimate of hazard ratio (HR) between the studied groups was calculated by means of Cox proportional hazard model. We also used the exact test of Fisher to identify significant association between categoric variants, while Mann-Whitney test was applied to identify significant differences between numeric values. Results: We performed a survival analysis: those patients with EOCRC had significantly higher median PFS in first line of treatment (16.2 vs. 11.3 months, p = 0.042) and significantly higher median OS (121.5 vs. 58.1 months, p = 0.011). Several characteristics were significantly more frequent in patients with EOCRC (n=68): BMI < 18.5 (n = 16, OR = 1.9, p = 0.046), primary tumor site at transverse colon (n = 9, OR = 2.61, p = 0.03) and ECOG 0 (n = 32, OR = 2.21, p = 0.003). Having peritoneal metastases almost reached statistical signification (n = 17, OR = 1.82, p = 0.055). Some other characteristics were less frequent: BMI 25-30 (n = 13, OR = 0.51, p = 0.046), primary tumor site at sigmoid colon (n = 14, OR = 0.49, p = 0.038) and former-smoker status (n = 7, OR = 0.44, p = 0.048). Moreover, mean values of LDH at diagnosis were significantly higher in EOCRC patients (359 U/L vs. 280 U/L, p = 0.015). EOCRC patients received a significantly higher number of lines of chemotherapy (2.94 vs. 2.38, p = 0.027) and underwent more surgeries (2,42 vs. 1.24, p < 0,001) than patients with > 50 years. Significant differences in tumor mutational status (BRAF, KRAS, NRAS, MSI, PI3K and HER2), sex, primary tumor resection or number of metastatic sites between groups were not found. Conclusions: This retrospective analysis showed that EOCRC patients had significant higher rates of PFS in first-line treatment and OS. Moreover, EOCRC patients had more frequently BMI < 18.5, primary tumor located at transverse colon and ECOG 0.