Left atrial peak systolic strain as an indicator pathway of diastolic dysfunction of the left ventricle.

BACKGROUND: Left atrial peak systolic strain (LA-PSS) imaging is an emerging index of LA function, and it was shown to be decreased in heart failure with preserved ejection fraction. We aimed to determine whether LA-PSS could be used as an additional diagnostic parameter to current existing guidelines for the presence of left ventricle diastolic dysfunction (LVDD). MATERIALS AND METHODS: A total of 190 consecutive adult patients with cardiovascular risk factors and normal LV ejection fraction with no prior history of heart failure were included in the study. Speckle tracking software was used to study ventricular parietal deformity, left ventricle global longitudinal systolic strain (LV-GLS), and LA-PSS. RESULTS: The median LV-GLS was -19%, with a significant difference (p<0.001) between patients with normal diastolic function vs those with LVDD. The median LA-PSS was 33% (30 to 38%) (p<0.001). Most patients (61%) had grade 1 atrial dysfunction based on PSS (range 24% to 35%). The analysis of the area under the ROC curve of the LA-PSS as a potential indicator pathway of LVDD was 67% (95% CI 62-72), and 75% (95% CI 70-80), when the indeterminate pattern was included. The decreased LA-PSS made it possible to reclassify patients with an indeterminate pattern of diastolic function in 96% of cases. CONCLUSION: These results support the potential role of LA-PSS as an additional parameter for the diagnosis of LVDD in patients with normal ejection fraction, and may be integrated into the guidelines for routine evaluation of patients.

Doble tormenta tiroidea y arrítmica en una gestante con múltiples taquicardias refractarias mediadas por un haz de kent intermitente ablacionado exitosamente

La tormenta tiroidea es un estado crítico y poco frecuente que condiciona la disfunción de múltiples órganos por el efecto del exceso de las hormonas tiroideas, esta disfunción endócrina tiene una elevada mortalidad y genera manifestaciones típicas como la taquicardia, fiebre, alteraciones gastrointestinales, cardiovasculares y del sistema nervioso central. El embarazo se ha asociado con un incremento en la incidencia de arritmias. Necesitan un tratamiento inmediato con drogas antiarrítmicas, cardioversión eléctrica o cesárea de urgencia. El WPW es una anormalidad cardiaca congénita que consiste en la presencia de un haz anómalo (Haz de Kent) que evita el sistema normal de conducción uniendo directamente aurículas y ventrículos. Veremos el caso de una gestante de 32 semanas que presenta un cuadro de tormenta tiroidea y múltiples episodios de taquicardia paroxística supraventricular (TPS), de tórpida y sombría evolución clínica mediada por un haz anómalo de Kent intermitente. Es evidente que la tormenta tiroidea en el contexto de la gestación produjo cambios en las propiedades electrofisiológicas del haz anómalo de Kent intermitente lo cual propició el desarrollo de múltiples taquicardias paroxísticas supraventriculares refractarias a la cardioversión eléctrica y farmacológica. Tampoco mejoró con la tiroidectomía total, solamente cedió por completo con la ablación por catéter de radiofrecuencia del haz anómalo de Kent.

Thyroid storm is a critical and infrequent state that conditions the dysfunction of multiple organs due to the effect of excess thyroid hormones. This endocrine dysfunction has a high mortality and generates typical manifestations such as tachycardia, fever, gastrointestinal, cardiovascular and heart disorders, and the central nervous system. Pregnancy has been associated with an increased incidence of arrhythmias. They need immediate treatment with antiarrhythmic drugs, electrical cardioversion, or emergency caesarean section. WPW is a congenital cardiac abnormality that consists of the presence of an abnormal bundle (Kent bundle) that prevents the normal conduction system, directly joining the atria and ventricles. We will see the case of a 32-week pregnant woman who presented symptoms of thyroid storm and multiple episodes of paroxysmal supraventricular tachycardia (PST), with a torpid clinical course mediated by an abnormal intermittent Kent bundle. It is evident that the thyroid storm in the context of pregnancy produced changes in the electrophysiological properties of the intermittent Kent bundle, which led to the development of multiple PST refractory to electrical and pharmacological cardioversion. Moreover, it also did not improve with total thyroidectomy, only resolved completely with radiofrequency catheter ablation of the Kent bundle.

Role of the Electrocardiographic MVP Risk Score (Morphology-Voltage-P Wave Duration) in Predicting the Development of Atrial Fibrillation in Patients With Systemic Arterial Hypertension.

BACKGROUND: There is a global tendency to emphasize the prevention and early diagnosis of diseases that have a great impact on public health. Atrial fibrillation (AF) has a prevalence affecting 1.5-2% of the general population. Certain variables of the P wave allow us to identify and stratify patients at risk of developing AF. MATERIALS AND METHODS: This is an observational, descriptive, and longitudinal study to determine the applicability of the electrocardiographic (ECG) morphology, voltage, and P wave duration (MVP) risk score to predict the development of AF in consecutive patients with systemic hypertension (SH) in an initial follow-up of 12 months. RESULTS: Initially, 104 patients were included, of whom 12 died during follow-up and 17 did not attend subsequent checkups during the COVID-19 pandemic; therefore, they were excluded. The study patients were 75, of whom AF was detected in 25 patients (33%). The average duration of the P wave was 120 ± 26 ms, the average voltage was 0.1 ± 0.5 Mv. The high-risk MVP ECG score had an [area under the curve, 0.69; 95% confidence intervals (CI), 0.59-0.79] and demonstrated a specificity and a positive predictive value of 100%, a negative predictive value of 76%, and a sensitivity of 40% for predicting the development of AF. CONCLUSIONS: The present study establishes for the first time that SH patients who possess a high-risk MVP ECG score have a significantly higher incidence of developing AF. The high-risk MVP Score has a specificity and a positive predictive value of 100% and a high negative predictive value with a moderate sensitivity for the prediction of the development of AF in SH patients.

Relationship of the T-wave Tpeak-Tend interval with conduction system disorders in arterial hypertension / Relación del intervalo Tpico-Tfinal de la onda T con trastornos del sistema de conducción en hipertensión arterial

Abstract Purpose: The Tpeak-Tend interval of the T wave has emerged as a new electrocardiographic marker of increased transmural dispersion of ventricular repolarization. We aimed to determine the presence of cardiac conduction system disorders in patients with systemic arterial hypertension (SAH) who have altered Tpeak-Tend interval of the T wave. Methods: The 67 patients with SAH were divided into two groups. Those with prolonged (≥ 77 ms) Tpeak-Tend intervals, 21 (31%) patients were in the study group. Those with normal (< 77 ms) Tpeak-Tend intervals, 46 (69%) patients were in the control group. Alteration of ventricular repolarization manifested as a prolongation of the Tpeak-Tend interval was detected by computerized electrocardiographic analysis tools. Results: The median value of QRS complex duration was significantly wider in the study group as compared to the control group (110 ± 12 ms vs. 94 ± 8 ms p < 0.001). There was a significantly greater incidence of left anterior hemiblock in the study group (14% vs. 0% p < 0.04). The median value of the QTc interval was significantly greater in the study group (440 ± 26 vs. 422 ± 15 p < 0.01). There was a significantly greater incidence of patients with prolonged QTc interval in the study group (33% vs. 11% p < 0.02). The median value of the Tpeak-Tend interval was significantly greater in the study group (84 ± 5 ms vs. 65 ± 4 ms p < 0.001), as well as, the Tpeak-Tend/QTc ratio in the study group (0.19 ± 0.1 vs. 0.16 ± 0.1 p < 0.001). Conclusion: There is a significantly greater ventricular repolarization disorders and abnormalities of the cardiac conduction system in SAH patients who possess altered Tpeak-Tend interval of the T wave.

Resumen Objetivo: El intervalo Tpico-Tfinal de la onda T es un marcador electrocardiográfico de la dispersión transmural aumentada de la repolarización ventricular. Investigamos la presencia de trastornos del sistema de conducción cardíaca en pacientes con hipertensión arterial sistémica (HA) que poseen alterado el intervalo Tpico-Tfinal de la onda T. Métodos: Los 67 pacientes con HA fueron divididos en dos grupos. Aquellos con intervalos de Tpico-Tfinal prolongados (≥ 77 ms), 21 (31%) pacientes (grupo de estudio). Aquellos con intervalos normales (< 77 ms) Tpico-Tfinal, 46 (69%) pacientes (grupo control). Los intervalos Tpico-Tfinal fueron medidos por herramientas de análisis electrocardiográfico computarizado. Resultados: El valor mediano de la duración del complejo QRS fue significativamente más amplio en el grupo de estudio (110 ± 12 ms vs. 94 ± 8 ms p < 0.001). Hubo una incidencia significativamente mayor de hemibloqueo anterior izquierdo en el grupo de estudio (14% vs. 0% p < 0.04). El valor mediano del intervalo QTc fue significativamente mayor en el grupo de estudio (440 ± 26 vs. 422 ± 15 p < 0.01). Hubo una incidencia significativamente mayor de pacientes con intervalo QTc prolongado en el grupo de estudio (33% vs. 11% p < 0.02). El valor mediano del intervalo Tpico-Tfinal fue significativamente mayor en el grupo de estudio (84 ± 5 ms vs. 65 ± 4 ms p < 0.001), así como el cociente Tpico-Tfinal/QTc (0.19 ± 0.1 vs. 0.16 ± 0.1 p < 0.001). Conclusión: Existe una alteración de la repolarización ventricular significativamente mayor y anomalías del sistema de conducción cardíaca en pacientes con HA que poseen alteración del intervalo Tpico-Tfinal de la onda T.

Relationship of the T-wave Tpeak-Tend interval with conduction system disorders in arterial hypertension.

PURPOSE: The Tpeak-Tend interval of the T wave has emerged as a new electrocardiographic marker of increased transmural dispersion of ventricular repolarization. We aimed to determine the presence of cardiac conduction system disorders in patients with systemic arterial hypertension (SAH) who have altered Tpeak-Tend interval of the T wave. METHODS: The 67 patients with SAH were divided into two groups. Those with prolonged (≥ 77 ms) Tpeak-Tend intervals, 21 (31%) patients were in the study group. Those with normal (< 77 ms) Tpeak-Tend intervals, 46 (69%) patients were in the control group. Alteration of ventricular repolarization manifested as a prolongation of the Tpeak-Tend interval was detected by computerized electrocardiographic analysis tools. RESULTS: The median value of QRS complex duration was significantly wider in the study group as compared to the control group (110 ± 12 ms vs. 94 ± 8 ms p < 0.001). There was a significantly greater incidence of left anterior hemiblock in the study group (14% vs. 0% p < 0.04). The median value of the QTc interval was significantly greater in the study group (440 ± 26 vs. 422 ± 15 p < 0.01). There was a significantly greater incidence of patients with prolonged QTc interval in the study group (33% vs. 11% p < 0.02). The median value of the Tpeak-Tend interval was significantly greater in the study group (84 ± 5 ms vs. 65 ± 4 ms p < 0.001), as well as, the Tpeak-Tend/QTc ratio in the study group (0.19 ± 0.1 vs. 0.16 ± 0.1 p < 0.001). CONCLUSION: There is a significantly greater ventricular repolarization disorders and abnormalities of the cardiac conduction system in SAH patients who possess altered Tpeak-Tend interval of the T wave.

OBJETIVO: El intervalo Tpico-Tfinal de la onda T es un marcador electrocardiográfico de la dispersión transmural aumentada de la repolarización ventricular. Investigamos la presencia de trastornos del sistema de conducción cardíaca en pacientes con hipertensión arterial sistémica (HA) que poseen alterado el intervalo Tpico-Tfinal de la onda T. MÉTODOS: Los 67 pacientes con HA fueron divididos en dos grupos. Aquellos con intervalos de Tpico-Tfinal prolongados (≥ 77 ms), 21 (31%) pacientes (grupo de estudio). Aquellos con intervalos normales (< 77 ms) Tpico-Tfinal, 46 (69%) pacientes (grupo control). Los intervalos Tpico-Tfinal fueron medidos por herramientas de análisis electrocardiográfico computarizado. RESULTADOS: El valor mediano de la duración del complejo QRS fue significativamente más amplio en el grupo de estudio (110 ± 12 ms vs. 94 ± 8 ms p < 0.001). Hubo una incidencia significativamente mayor de hemibloqueo anterior izquierdo en el grupo de estudio (14% vs. 0% p < 0.04). El valor mediano del intervalo QTc fue significativamente mayor en el grupo de estudio (440 ± 26 vs. 422 ± 15 p < 0.01). Hubo una incidencia significativamente mayor de pacientes con intervalo QTc prolongado en el grupo de estudio (33% vs. 11% p < 0.02). El valor mediano del intervalo Tpico-Tfinal fue significativamente mayor en el grupo de estudio (84 ± 5 ms vs. 65 ± 4 ms p < 0.001), así como el cociente Tpico-Tfinal/QTc (0.19 ± 0.1 vs. 0.16 ± 0.1 p < 0.001). CONCLUSIÓN: Existe una alteración de la repolarización ventricular significativamente mayor y anomalías del sistema de conducción cardíaca en pacientes con HA que poseen alteración del intervalo Tpico-Tfinal de la onda T.

Multivessel coronary thrombosis and acute myocardial infarction associated to two genetic mutations for thrombophilia / Trombosis coronaria de múltiples vasos e infarto agudo de miocardio asociado a dos mutaciones genéticas para trombofilia

Abstract Several studies suggest that gene mutations from thrombophilia may constitute a significant risk factor for coronary artery disease, especially in young patients with normal coronaries and non-significant lesions. It is presented a case of a 42-year-old male patient who arrived at the emergency room due to an acute myocardial infarction. The electrocardiogram showed an ST elevation with upward convexity of 4 mm from V1 to V4 and of 1 mm at V5 and V6. Cardiac enzymes were positive (troponin I 8.4 ng/dl, normal range < 1 ng/dl). It was found septum and apical hypokinesia, with an ejection fraction of 44%. The culprit lesion of the infarction was treated with primary angioplasty, successfully dilating the left anterior descending coronary artery. However, spontaneous thrombi appeared at the middle third of the circumflex artery, an area without occlusive lesions previously. A full laboratory assessment for prothrombotic state diseases revealed positivity for gene mutations at A1298C from the methylene tetrahydropholate reductase (MTHFR) and plasminogen activator inhibitor-1 (PAI-1). Gene mutations at A1298C from the MTHFR and PAI-1 should be considered in young patients with acute coronary syndrome, mainly when thrombi are found in non-culprit arteries with no or non-significant coronary lesions.

Resumen Las mutaciones genéticas de la trombofilia pueden constituir un factor de riesgo significativo para la enfermedad de la arteria coronaria, especialmente en pacientes jóvenes con arterias coronarias normales y lesiones no significativas. Se presenta el caso de un paciente masculino de 42 años con infarto agudo de miocardio. El electrocardiograma demostró una elevación del ST con convexidad ascendente de 4 mm de V1 a V4 y de 1 mm en V5 y V6. Las enzimas cardíacas fueron positivas (troponina I 8.4 ng/dl, rango normal < 1 ng/dl). Se observó hipocinesia septal y apical con fracción de eyección de 44%. La lesión causante del infarto fue tratada con angioplastia primaria, dilatando con éxito la arteria coronaria descendente anterior. Sin embargo, aparecieron trombos espontáneos en el tercio medio de la arteria circunfleja, que previamente no presentaba lesiones ateroscleróticas oclusivas. Al evaluar enfermedades protrombóticas se reveló positividad para mutaciones del gen A1298C de la metileno tetrahidrofolato reductasa (MTHFR) y del inhibidor del activador del plasminógeno (PAI-1) del genotipo heterocigoto 675G. Las mutaciones en A1298C del gen MTHFR y del PAI-1 deben considerarse en jóvenes con síndrome coronario agudo, principalmente cuando se encuentran trombos en arterias no culpables sin lesiones coronarias significativas.

Rol de la morfología y dispersión de la onda P en la predicción de fibrilación auricular

RESUMEN Las características anisotrópicas ocasionadas por un miocardio auricular patológico pueden jugar un papel importante en la creación de circuitos de reentrada al causar propagación no homogénea y discontinua del impulso en el miocardio auricular. Este miocardio auricular alterado puede generar bloqueo unidireccional, retraso de la conducción y ritmos auriculares reentrantes. En estas condiciones la onda P del electrocardiograma (ECG) puede mostrar alteraciones que pueden asociarse con arritmias auriculares y fibrilación auricular (FA). La dispersión de la onda P (DP) se considera un marcador no invasivo del ECG para el remodelado auricular y es predictor sensible y específico del desarrollo de FA. Se ha demostrado que el aumento de la duración de la onda P y la DP reflejan la prolongación del tiempo de conducción auricular dentro de la aurícula derecha y entre ambas aurículas, y una propagación auricular no homogénea y discontinua de los impulsos sinusales. Un valor de corte de 40 ms de la DP demostró tener una sensibilidad del 83%, una especificidad del 85% y un valor predictivo positivo del 89% para la identificación de pacientes con antecedentes de FA paroxística aislada. Los pacientes con alteración de la morfología de la onda P y dispersión de la onda P en el ECG tienen una gran susceptibilidad a desarrollar FA porque poseen electrogramas endocárdicos auriculares anormalmente prolongados y fraccionados, una duración de onda P significativamente mayor, un tiempo de conducción intraauricular e interauricular significativamente más largo, y una mayor incidencia de inducción de fibrilación auricular sostenida.

ABSTRACT The anisotropic characteristics caused by a pathological atrial myocardium can play an important role in the creation of reentry circuits by causing discontinuous and inhomogeneous impulse propagation in the atrial myocardium. This altered atrial myocardium can lead to unidirectional block, conduction delay, and reentrant atrial rhythms. Under these conditions, the P wave of the electrocardiogram (ECG) can demonstrate alterations that can be associated with atrial arrhythmias and atrial fibrillation (AF). The P-wave dispersion (PD) is considered a non-invasive ECG marker for atrial remodeling and is a sensitive and specific predictor of the development of AF. Increased P wave duration and PD have been shown to reflect prolonged atrial conduction time within the right atrium and between both atria, and discontinuous, inhomogeneous atrial propagation of sinus impulses. A cutoff value of 40 ms for PD was shown to have a sensitivity of 83%, a specificity of 85%, and a positive predictive value of 89% for the identification of patients with a history of isolated paroxysmal AF. Patients with abnormal P wave morphology and P wave dispersion on the ECG are highly susceptible to developing AF because they have abnormally prolonged and fractionated atrial endocardial electrograms, significantly longer P wave duration, and significantly longer intra-atrial and inter-atrial conduction time, and a higher incidence of sustained atrial fibrillation induction.

The relation between QRS complex fragmentation and segmental abnormalities of the myocardial contractility in patients with coronary artery disease.

BACKGROUND: Fragmented QRS (fQRS) is defined as any QRS complex with duration of less than 120 ms (ms) and at least one notch in the R or S wave in two or more leads belonging to the same coronary territory. The fQRS represents a delay in ventricular conduction caused by a myocardial scar associated to arrhythmic events. METHODS: This is a descriptive, retrospective, cross-sectional study of a total of 123 patientsadmitted with ischemic heart disease. The aim was to correlate the presence of fQRS in a conventional 12-leads electrocardiogram (ECG) with myocardial regional motility disorders. RESULTS: A total of 62% of the patients were male, the mean age was 63 ± 12 SD. fQRS was observed in 44% (64% men and 36% women), the most frequent location being the inferior wall (61%), followed by the anteroseptal and lateral walls (14% for both). Of the 36 patients with fQRS, 30 had segmental disorders, while 6 did not. Of the 45 patients without fQRS, 28 had segmental disorders, but 17 did not, which gives us a sensitivity of 52% (moderate SnNout) and specificity of 74% (high SpPin), with a positive predictive value of 83%, a negative predictive value of 38% and a prevalence of 72%. CONCLUSION: The presence of fQRS in the ECG has high specificity and a high positive predictive value of the existence of segmental myocardial motility disorders in patients with documented coronary artery disease.

Potential Mechanisms of Cardiac Injury and Common Pathways of Inflammation in Patients With COVID-19.

Due to the lack of prospective, randomized, controlled clinical studies on inflammation and cardiovascular involvement, the exact mechanism of cardiac injury among patients with Coronavirus Disease 2019 (COVID-19) still remains uncertain. It was demonstrated that there is a high and significantly positive linear correlation between troponin T and plasma high-sensitivity C-reactive protein levels, biomarkers of cardiac injury and systemic inflammation, respectively. Cardiac injury and inflammation is a relatively common association among patients hospitalized with COVID-19, and it is related to higher risk of in-hospital mortality. In our literature search, we identified several potential mechanisms of myocardial tissue damage, namely, coronavirus-associated acute myocarditis, angiotensin-converting enzyme 2 receptor binding affinity to the virus Spike protein, increased cytokine secretion, and hypoxia-induced cardiac myocyte apoptosis. Elucidation of the disease pathogenesis and prospective histopathological studies are crucial for future proper treatment in case of renewed outbreaks. Of interest is that with hundred of thousands of bodies available for autopsy studies, no prospective investigation has been reported so far. Strong efforts and continued research of the cardiovascular complications and identification of risk factors for poor prognosis in COVID-19 are steadily needed. The high morbidity and mortality of COVID-19, its monumental economic burden and social impact, the despair of a new pandemic outbreak, and the thread of potential utilization of novel severe acute respiratory syndrome coronavirus 2 as biologic weapons make it a preponderant necessity to better comprehend the therapeutic management of this lethal disease. Emerging as an acute infectious disease, COVID-19 may become a chronic epidemic because of genetic recombination. Therefore, we should be ready for the reemergence of COVID-19 or other coronaviruses.

The Association Between Atrial Fibrillation and Endurance Physical Activity: How Much is too Much?

Atrial fibrillation (AF) is the most common arrhythmia in middle-aged athletes. Physical exercise performed in a regular basis has been shown to be beneficial for cardiovascular health. Moderate physical exercise, aside from producing a nice, peaceful and well-being sensation, has been associated with a reduced risk of AF. However, more strenuous endurance exercise, like the one experiencing marathon runners, seems to increase the risk of AF in healthy athletes without organic heart disease. On the other hand, low physical activity was found to be a risk factor for the appearance of AF. Nevertheless, the relationship of exercise to AF is complex, influenced by the intensity and the duration of the physical activity, and seems to have a U-shaped relationship with the greatest levels of physical activity possibly increasing AF incidence. There is cumulative data associating moderate physical activity to reduced AF incidence, hence physicians should recommend moderate exercise training to patients with AF. This may not only reduce AF risk, but would also contribute to an overall cardiovascular benefit. However, since there is also important data suggesting significant increased incidence of AF in elite athletes with long-term endurance physical activity, it may be a serious concern to go to the extreme. In most things in life it is much better and wiser to be well balanced, always in equilibrium.

Percepción de imagen corporal como factor condicionante del índice de masa corporal en médicos residentes del Hospital de Clínicas / Perception of body image as conditioning factor of body mass index in medical residents at Clinical Hospital

Uno de los factores condicionantes del peso corporal es la percepción que la persona tiene de su imagen corporal. El objetivo fue conocer la percepción de imagen corporal según el índice de masa corporal (IMC) en 107 Médicos Residentes del Hospital de Clínicas.Se utilizó un diseño observacional descriptivo de corte transverso. Se exploraron las variables edad, sexo, circunferencia abdominal, peso, talla, IMC, percepción del peso corporal. La circunferencia abdominal fue de riesgo elevado en 37% de los varones y en 16% de las mujeres, de riesgo muy elevado en 13% de varones y en 29% de las mujeres (p=0,009). En cuanto al IMC la media fue de 25,7±4,6; estando en peso normal el 45% y en sobrepeso el 43%. Se encontró más mujeres con peso normal (63% vs 28%). Los varones presentan más sobrepeso (61% vs 28%) (p=0,0009). En cuanto a la percepción del peso corporal se perciben con obesidad 23%; con sobrepeso 47% y con peso normal 28%. Cruzando los datos con los IMC verdaderos, tenemos que el 43% no tiene la percepción real de acuerdo a su IMC. La concordancia en cuanto a IMC real y la percepción es del 63%. Casi la mitad de los residentes estudiados no tiene la percepción real de acuerdo a su IMC. La percepción de obesidad es mayor en mujeres que en hombres acorde a su IMC real. Se requiere de más investigaciones en referencia al tema aplicándolo a toda la población del hospital para crear medidas educativas de oportuna intervención en la salud del personal sanitario(AU)

The perception of their own body image that a person has is a conditioning factor of the body weight. We aimed to know the perception of body image assessing the body mass index (BMI) in 107 medical residents of the Clinical Hospital. We utilized a descriptive observational design to evaluate multiple variables like gender, age, abdominal diameter, weight, height, body mass index, and perception of body weight. The abdominal diameter was of high risk in 37% of males and 16% in females, and of very high risk in 13% of males and in 29% of females (p=0,009). The medium BMI was 25,7±4,6. There was a normal BMI in 45% of the subjects and overweight in 43%. There were more female with normal weight than male (63% vs 28%), and there were more overweight male than female (61% vs 28%) (p=0,0009). Considering the perception of body weight, 23% perceive themselves to be obese, 47% with overweight, and 28% with normal body weight. Comparing this perception with real BMI, we observed that 43% of the subjects do not have a real perception according to the BMI. The agreement between real BMI and the image perception is 63%. Almost half of the medical residents studied do not have a real body weight perception according to BMI. The perception of obesity is greater in women than in men according to the real BMI. There is a necessity of larger studies including the total population of the hospital to create educational measures for timely intervention in the health of hospital personal(AU)