Troponin elevation as a marker of short deterioration and one-year death in a high-risk surgical patient cohort in a low and middle income country setting: a postoperative approach to increase surveillance.

PURPOSE: Myocardial injury after noncardiac surgery is common and mostly asymptomatic. The ideal target population that will benefit from routine troponin measurements in low and middle income countries (LMICs) is unclear. This study aims to evaluate the clinical outcomes of a cohort of high-risk surgical patients according to high-sensitivity troponin T (hsTnT) in an LMIC setting. METHODS: We conducted a prospective cohort study of 442 high-risk patients undergoing noncardiac surgery at a Brazilian hospital between February 2019 and March 2020. High-sensitivity troponin T levels were measured preoperatively, 24 hr, and 48 hr after surgery and stratified into three groups: normal (< 20 ng·L-1); minor elevation (20-65 ng·L-1); and major elevation (> 65 ng·L-1). We performed survival analysis to determine the association between myocardial injury and one-year mortality. We described medical interventions and evaluated unplanned intensive care unit (ICU) admission and complications using multivariable models. RESULTS: Postoperative myocardial injury occurred in 45% of patients. Overall, 30-day mortality was 8%. Thirty-day and one-year mortality were higher in patients with hsTnT ≥ 20 ng·L-1. One-year mortality was 18% in the unaltered troponin group vs 31% and 41% for minor and major elevation groups, respectively. Multivariable analysis of one-year survival showed a hazard ratio (HR) of 1.94 (95% confidence interval [CI], 1.22 to 3.09) for the minor elevation group and a HR of 2.73 (95% CI, 1.67 to 4.45) for the troponin > 65 ng·L-1 group. Patients with altered troponin had more unplanned ICU admissions (13% vs 5%) and more complications (78% vs 48%). CONCLUSION: This study supports evidence that hsTnT is an important prognostic marker and a strong predictor of all-cause mortality after surgery. Troponin measurement in high-risk surgical patients could potentially be used as tool to scale-up care in LMIC settings. STUDY REGISTRATION: ClinicalTrials.gov (NCT04187664); first submitted 5 December 2019.

RéSUMé: OBJECTIF: Les lésions myocardiques après une chirurgie non cardiaque sont courantes et la plupart du temps asymptomatiques. Nous ne connaissons pas la population cible idéale qui bénéficierait de mesures régulières de la troponine dans les pays à revenu faible et intermédiaire (PRFI). Cette étude vise à évaluer les issues cliniques d'une cohorte de patient·es de chirurgie à haut risque grâce à la troponine T à haute sensibilité (hsTnT) dans un contexte de PRFI. MéTHODE: Nous avons mené une étude de cohorte prospective auprès de 442 patient·es à haut risque bénéficiant d'une chirurgie non cardiaque dans un hôpital brésilien entre février 2019 et mars 2020. Les taux de troponine T à haute sensibilité ont été mesurés avant l'opération, 24 heures et 48 heures après la chirurgie, et stratifiés en trois groupes : normaux (< 20 ng·L−1), élévation mineure (20­65 ng·L−1) et élévation majeure (> 65 ng·L−1). Nous avons réalisé une analyse de survie pour déterminer l'association entre les lésions myocardiques et la mortalité à un an. Nous avons décrit les interventions médicales et évalué les admissions non planifiées à l'unité de soins intensifs (USI) ainsi que les complications à l'aide de modèles multivariables. RéSULTATS: Une lésion myocardique postopératoire est survenue chez 45 % des patient·es. La mortalité globale à 30 jours était de 8 %. La mortalité à trente jours et à un an était plus élevée chez les patient·es avec une hsTnT ≥ 20 ng·L−1. La mortalité à un an était de 18 % dans le groupe troponine inchangée vs 31 % et 41 % pour les groupes à élévation mineure et majeure de la troponine, respectivement. L'analyse multivariée de la survie à un an a montré un rapport de risque (RR) de 1,94 (intervalle de confiance [IC] à 95 %, 1,22 à 3,09) pour le groupe d'élévation mineure et un RR de 2,73 (IC 95 %, 1,67 à 4,45) pour le groupe avec une troponine > 65 ng·L−1. Les admissions non planifiées à l'USI étaient plus fréquentes chez les patient·es présentant une troponine altérée (13 % vs 5 %), tout comme les complications (78 % vs 48 %). CONCLUSION: Cette étude soutient les données probantes selon lesquelles la hsTnT est un marqueur pronostique important et un prédicteur fort de la mortalité toutes causes confondues après la chirurgie. La mesure de la troponine chez la patientèle chirurgicale à risque élevé pourrait potentiellement être utilisée comme outil pour intensifier les soins dans les PRFI. ENREGISTREMENT DE L'éTUDE: ClinicalTrials.gov (NCT04187664); soumis pour la première fois le 5 décembre 2019.

Developing and validating a machine learning ensemble model to predict postoperative delirium in a cohort of high-risk surgical patients: A secondary cohort analysis.

BACKGROUND: Postoperative delirium (POD) has a negative impact on prognosis, length of stay and the burden of care. Although its prediction and identification may improve postoperative care, this need is largely unmet in the Brazilian public health system. OBJECTIVE: To develop and validate a machine-learning prediction model and estimate the incidence of delirium. We hypothesised that an ensemble machine-learning prediction model that incorporates predisposing and precipitating features could accurately predict POD. DESIGN: A secondary analysis nested in a cohort of high-risk surgical patients. SETTING: An 800-bed, quaternary university-affiliated teaching hospital in Southern Brazil. We included patients operated on from September 2015 to February 2020. PATIENTS: We recruited 1453 inpatients with an all-cause postoperative 30-day mortality risk greater than 5% assessed preoperatively by the ExCare Model. MAIN OUTCOME MEASURE: The incidence of POD classified by the Confusion Assessment Method, up to 7 days postoperatively. Predictive model performance with different feature scenarios were compared with the area under the receiver operating characteristic curve. RESULTS: The cumulative incidence of delirium was 117, giving an absolute risk of 8.05/100 patients. We developed multiple machine-learning nested cross-validated ensemble models. We selected features through partial dependence plot analysis and theoretical framework. We treated the class imbalance with undersampling. Different feature scenarios included: 52 preoperative, 60 postoperative and only three features (age, preoperative length of stay and the number of postoperative complications). The mean areas (95% confidence interval) under the curve ranged from 0.61 (0.59 to 0.63) to 0.74 (0.73 to 0.75). CONCLUSION: A predictive model composed of three indicative readily available features performed better than those with numerous perioperative features, pointing to its feasibility as a prognostic tool for POD. Further research is required to test the generalisability of this model. TRIAL REGISTRATION: Institutional Review Board Registration number 04448018.8.0000.5327 (Brazilian CEP/CONEP System, available in https://plataformabrasil.saude.gov.br/ ).

Derivation and validation of a national multicenter mortality risk stratification model - the ExCare model: a study protocol.

INTRODUCTION: Surgical care is essential for proper management of various diseases. However, it can result in unfavorable outcomes. In order to identify patients at higher risk of complications, several risk stratification models have been developed. Ideally, these tools should be simple, reproducible, accurate, and externally validated. Unfortunately, none of the best-known risk stratification instruments have been validated in Brazil. In this sense, the Ex-Care model was developed by retrospective data analysis of surgical patients in a major Brazilian university hospital. It consists of four independent predictors easily collected in the preoperative evaluation, showing high accuracy in predicting death within 30 days after surgery. OBJECTIVES: To update and validate a Brazilian national-based model of postoperative death probability within 30 days based on the Ex-Care model. Also, to develop an application for smartphones that allows preoperative risk stratification by Ex-Care model. METHODS: Ten participating centers will collect retrospective data from digital databases. Variables age, American Society of Anesthesiologists (ASA) physical status, surgical severity (major or non-major) and nature (elective or urgent) will be evaluated as predictors for in-hospital mortality within 30 postoperative days, considered the primary outcome. EXPECTED RESULTS: We believe that the Ex-Care model will present discriminative capacity similar to other classically used scores validated for surgical mortality prediction. Furthermore, the mobile application to be developed will provide a practical and easy-to-use tool to the professionals enrolled in perioperative care.

Evaluation of a Brazilian's cardiovascular anesthesia fellowship by its former trainees / Avaliação do programa de aprimoramento em anestesia cardiovascular por seus ex-estagiários

Abstract Background: After advancement of cardiovascular surgery, there is also exponential development of anesthetic techniques in this field. Patients with increasing clinical complexity challenge cardiac anesthesiologists to keep constantly updated. An evaluation of Brazilian's cardiovascular anesthesia fellowship at Dante Pazzanese Institute of Cardiology has been made and information has been collected to evaluate the fellowship program in cardiovascular anesthesia. Method: Target participants were made up of former fellowships, contacted via e-mail containing an invitation to voluntarily participate. Explanation of the survey's purpose was provided. This communication was signed by the authors and contained a hyperlink to the survey, which was constructed on and hosted on a web platform. The survey was composed of 10 objectives questions designed to describe training and subsequent career. Results: The adjusted survey response rate was 71%. Two-thirds of respondents agreed that fellowship training provided them an advantage in the job market and 93% of respondents currently work with cardiac anesthesia. At least 87% of participants would recommend the course to other anesthesiologists. Conclusion: Fellowship graduates judge their technical training as excellent and incorporated the knowledge acquired in their daily practice. However, there are improvements to be made. We believe this document may be useful as a reference for other institutions to develop their own cardiovascular anesthesia fellowship programs.

Resumo Justificativa: Com o avanço da cirurgia cardiovascular nos últimos anos, houve também um desenvolvimento exponencial das técnicas anestésicas. Pacientes com complexidade clínica crescente desafiam os anestesiologistas cardíacos a se manterem constantemente atualizados. Uma avaliação do programa de aprimoramento em anestesia cardiovascular brasileira do Instituto Dante Pazzanese de Cardiologia foi feita e informações foram coletadas para avaliar o programa. Método: Os participantes-alvo eram formados por ex-aprimorandos, contatados via e-mail com um convite para participação voluntária. A explicação do objetivo da pesquisa foi fornecida. Essa comunicação foi assinada pelos autores e continha um link para a pesquisa, que foi construída e hospedada em uma plataforma web. A pesquisa foi composta por 10 questões objetivas destinadas a descrever o treinamento e a carreira subsequente. Resultados: A taxa de resposta ajustada para a pesquisa foi de 71%. Dois terços dos entrevistados concordaram que o treinamento do programa lhes proporcionou uma vantagem no mercado de trabalho e 93% dos entrevistados trabalham atualmente com anestesia cardíaca. Pelo menos 87% dos participantes recomendariam o curso a outros anestesiologistas. Conclusão: Os graduados do programa de aprimoramento julgam sua formação técnica como excelente e incorporaram os conhecimentos adquiridos em sua prática diária. No entanto, há melhorias a serem feitas. Acreditamos que este documento possa ser útil como referência para outras instituições desenvolverem seus próprios programas de aprimoramento em anestesia cardiovascular.

Predictors of in-hospital mortality in patients undergoing elective surgery in a university hospital: a prospective cohort / Preditores de mortalidade intra-hospitalar em pacientes submetidos a cirurgias não eletivas em um hospital universitário: uma coorte prospectiva

Abstract Introduction Morbidity and mortality associated with urgent or emergency surgeries are high compared to elective procedures. Perioperative risk scores identify the non-elective character as an independent factor of complications and death. The present study aims to characterize the population undergoing non-elective surgeries at the Hospital de Clínicas de Porto Alegre and identify the clinical and surgical factors associated with death within 30 days postoperatively. Methodology A prospective cohort study of 187 patients undergoing elective surgeries between April and May 2014 at the Hospital de Clínicas, Porto Alegre. Patient-related data, pre-operative risk situations, and surgical information were evaluated. Death in 30 days was the primary outcome measured. Results The mean age of the sample was 48.5 years, and 84.4% of the subjects had comorbidities. The primary endpoint was observed in 14.4% of the cases, with exploratory laparotomy being the procedure with the highest mortality (47.7%). After multivariate logistic regression, age (odds ratio [OR] 1.0360, p < 0.05), anemia (OR 3.961, p < 0.05), acute or chronic renal insufficiency (OR 6.075, p < 0.05), sepsis (OR 7.027, p < 0.05), and patient-related risk factors for mortality, in addition to the large surgery category (OR 7.502, p < 0.05) were identified. Conclusion The high mortality rate found may reflect the high complexity of the institution's patients. Knowing the profile of the patients assisted helps in the definition of management priorities, suggesting the need to create specific care lines for groups identified as high risk in order to reduce perioperative complications and deaths.

Resumo Introdução Quando comparada a procedimentos eletivos, a morbimortalidade associada às cirurgias de urgência ou emergência é alta. Escores de risco perioperatório identificam o caráter não eletivo como fator independente de complicações e morte. O presente estudo objetiva caracterizar a população submetida a cirurgias não eletivas no Hospital de Clínicas de Porto Alegre e identificar fatores clínicos e cirúrgicos associados à morte em 30 dias no pós-operatório. Metodologia Coorte prospectiva de 187 pacientes submetidos a cirurgias não eletivas entre abril e maio de 2014 no Hospital de Clínicas de Porto Alegre. Avaliaram-se dados relacionados ao paciente, situações de risco pré-operatórias e informações do âmbito cirúrgico. Mensurou-se óbito em 30 dias como desfecho primário. Resultados A média de idade da amostra foi 48,5 anos; 84,4% dos indivíduos apresentavam comorbidades. O desfecho primário foi observado em 14,4% dos casos, laparotomia exploradora foi o procedimento com maior mortalidade (47,7%). Após regressão logística multivariada, identificaram-se idade (odds ratio [OR] 1.0360, p < 0,05), anemia (OR 3.961, p < 0,05), insuficiência renal aguda ou crônica agudizada (OR 6.075, p < 0,05) e sepse (OR 7.027, p < 0,05) como os fatores de risco relacionados ao paciente significativos para mortalidade, além da categoria cirurgia de grande porte (OR 7.502, p < 0,05). Conclusão A elevada taxa de mortalidade encontrada pode refletir a alta complexidade dos pacientes da instituição. O conhecimento do perfil dos pacientes atendidos auxilia na definição de prioridades de gerenciamento, sugere a necessidade de criação de linhas de cuidado específicas para grupos identificados como de alto risco, a fim de reduzir complicações e óbitos no perioperatório.

[Evaluation of a Brazilian's cardiovascular anesthesia fellowship by its former trainees]. / Avaliação do programa de aprimoramento em anestesia cardiovascular por seus ex­estagiários.

BACKGROUND: After advancement of cardiovascular surgery, there is also exponential development of anesthetic techniques in this field. Patients with increasing clinical complexity challenge cardiac anesthesiologists to keep constantly updated. An evaluation of Brazilian's cardiovascular anesthesia fellowship at Dante Pazzanese Institute of Cardiology has been made and information has been collected to evaluate the fellowship program in cardiovascular anesthesia. METHOD: Target participants were made up of former fellowships, contacted via e-mail containing an invitation to voluntarily participate. Explanation of the survey's purpose was provided. This communication was signed by the authors and contained a hyperlink to the survey, which was constructed on and hosted on a web platform. The survey was composed of 10 objectives questions designed to describe training and subsequent career. RESULTS: The adjusted survey response rate was 71%. Two-thirds of respondents agreed that fellowship training provided them an advantage in the job market and 93% of respondents currently work with cardiac anesthesia. At least 87% of participants would recommend the course to other anesthesiologists. CONCLUSION: Fellowship graduates judge their technical training as excellent and incorporated the knowledge acquired in their daily practice. However, there are improvements to be made. We believe this document may be useful as a reference for other institutions to develop their own cardiovascular anesthesia fellowship programs.

[Predictors of in-hospital mortality in patients undergoing elective surgery in a university hospital: a prospective cohort]. / Preditores de mortalidade intra­hospitalar em pacientes submetidos a cirurgias não eletivas em um hospital universitário: uma coorte prospectiva.

INTRODUCTION: Morbidity and mortality associated with urgent or emergency surgeries are high compared to elective procedures. Perioperative risk scores identify the non-elective character as an independent factor of complications and death. The present study aims to characterize the population undergoing non-elective surgeries at the Hospital de Clínicas de Porto Alegre and identify the clinical and surgical factors associated with death within 30 days postoperatively. METHODOLOGY: A prospective cohort study of 187 patients undergoing elective surgeries between April and May 2014 at the Hospital de Clínicas, Porto Alegre. Patient-related data, pre-operative risk situations, and surgical information were evaluated. Death in 30 days was the primary outcome measured. RESULTS: The mean age of the sample was 48.5 years, and 84.4% of the subjects had comorbidities. The primary endpoint was observed in 14.4% of the cases, with exploratory laparotomy being the procedure with the highest mortality (47.7%). After multivariate logistic regression, age (odds ratio [OR] 1.0360, p <0.05), anemia (OR 3.961, p <0.05), acute or chronic renal insufficiency (OR 6.075, p <0.05), sepsis (OR 7.027, p <0.05), and patient-related risk factors for mortality, in addition to the large surgery category (OR 7.502, p <0.05) were identified. CONCLUSION: The high mortality rate found may reflect the high complexity of the institution's patients. Knowing the profile of the patients assisted helps in the definition of management priorities, suggesting the need to create specific care lines for groups identified as high risk in order to reduce perioperative complications and deaths.

Vasodilator Agents in Pediatric Cardiac Surgery with Cardiopulmonary Bypass

Surgical management of congenital heart disease has become regularly performed in tertiary hospitals worldwide. Although routinely needed, cardiopulmonary bypass (CPB) deleteriously affects physiological processes being among the main causes of increased morbidity in cardiac surgery, especially in neonates and children.Recent studies have shown that vasodilator agents’ use during CPB improved peripheral tissue perfusion while maintaining high flow during bypass. Hence, an improvement in perfusion and oxygenation of the skin, musculature and intestinal mucosa has been demonstrated, with favorable result throughout the postoperative period.These agents, by reducing systemic vascular resistance (SVR), lead to greater peripheral blood flow, improvement in peripheral perfusion, decreased base deficit and lactic acidosis and therefore improved respiratory and circulatory status.The present article reviews the main aspects of vasodilator agents most commonly used in pediatric cardiac surgery with CPB, including: chlorpromazine, phentolamine, phenoxybenzamine, sodium nitroprusside, volatile anesthetic agents, calcium channel blockers, angiotensin blockers and inodilators.

Efeito do vinho tinto associado ao exercício físico no sistema cardiovascular de ratos espontaneamente hipertensos / Effect of red wine associated with physical exercise in the cardiovascular system of spontaneously hipertensive rats / Efecto del vino tinto asociado al ejercicio físico en el sistema cardiovascular de ratones espontáneamente hipertensos

FUNDAMENTO: Prática de exercício físico (EF) é eficiente no tratamento e na prevenção da hipertensão, associada à melhora do perfil lipídico e da função contrátil cardíaca. Consumo moderado e regular de bebidas alcoólicas, como vinho tinto, desempenha efeito cardiovascular protetor. Polifenóis da bebida apresentam propriedades antioxidantes, beneficiando vasos sanguíneos. Há poucas evidências sobre o consumo de vinho tinto associado ao EF e as influências no sistema cardiovascular. OBJETIVO: Investigar o efeito da interação entre o EF e o consumo moderado de vinho tinto na pressão arterial sistólica (PAS), lipoproteína de alta densidade (HDL), desempenho físico e fração de ejeção do ventrículo esquerdo (FEVE) de ratos espontaneamente hipertensos (SHR). MÉTODOS: Amostra de 32 SHR distribuídos em quatro grupos: grupo vinho e exercício (GVE), grupo vinho (GV), grupo exercício (GE) e grupo controle (GC). Doses de vinho tinto, equivalentes ao consumo moderado em humanos, foram administradas por gavagem, durante dez semanas, simultâneas ao período de EF, realizado em esteira. Os SHR receberam 3,715 ml/kg/dia de vinho. O desempenho físico foi analisado por teste de esforço (TE), e a FEVE foi obtida por medidas ecocardiográficas. A aferição da PAS ocorreu antes e após o protocolo do EF. RESULTADOS: Demonstrou-se redução significativa da PAS nos grupos de intervenção, comparados ao GC. Ao final do protocolo, o GVE apresentou a maior redução. Assim como na PAS, o GVE apresentou melhor resultado nos níveis de HDL. Não houve diferença significativa no desempenho físico e na FEVE entre os grupos. CONCLUSÃO: O EF associado à ingesta moderada de vinho tinto exerce efeito cardioprotetor na PAS e na HDL de SHR. O desempenho físico e a FEVE não são alterados.

BACKGROUND: Physical exercise (PE) is effective in the treatment and prevention of hypertension associated with improved lipid profile and cardiac contractile function. Regular and moderate consumption of alcoholic beverages such as red wine brings a cardiovascular protective effect. Beverage-derived polyphenols have antioxidant properties benefiting blood vessels. There is little evidence on the consumption of red wine associated with PE and the influences on the cardiovascular system. OBJECTIVE: To investigate the effect of physical exercise (PE) and moderate red wine intake interaction on systolic blood pressure (SBP), high density lipoprotein (HDL) levels, physical performance (PP) and left ventricular ejection fraction (LVEF) in spontaneously hypertensive rats (SHR). METHODS: Sample of 32 SHRs divided into four groups: wine and exercise group (WEG), wine group (WG), exercise group (EG) and control group (CG). Red wine doses were given by intra-gastric gavage, during ten weeks, coincident with PE period, performed on treadmills. The SHRs received red wine doses of 3.715 ml/kg/day. Physical performance was analyzed by maximal exercise test (MET) and LVEF by echocardiographic measures. SBP measurement was made before and after the PE protocol. RESULTS: Demonstrated that the three groups which suffered intervention presented significant SBP reduction compared to CG. At the end of the protocol, WEG showed the largest reduction. Like in SBP results, WEG showed the best outcome on HDL levels at the experiment end. There was no significant difference of physical performance and LVEF between groups. CONCLUSION: PE associated with moderate red wine intake has cardioprotective effects on SBP and HDL levels in SHR. Their physical performance and LVEF are not modified.

FUNDAMENTO: Práctica de ejercicio físico (EF) es eficiente en el tratamiento y en la prevención de la hipertensión, asociada a la mejora del perfil lipídico y de la función contráctil cardíaca. Consumo moderado y regular de bebidas alcohólicas, como vino tinto, desempeña efecto cardiovascular protector. Polifenoles de la bebida presentan propiedades antioxidantes, beneficiando vasos sanguíneos. Hay pocas evidencias sobre el consumo de vino tinto asociado al EF y las influencias en el sistema cardiovascular. OBJETIVO: Investigar el efecto de la interacción entre el EF y el consumo moderado de vino tinto en la presión arterial sistólica (PAS), lipoproteína de alta densidad (HDL), desempeño físico y fracción de eyección del ventrículo izquierdo (FEVI) de ratones espontáneamente hipertensos (SHR). MÉTODOS: Muestra de 32 SHR distribuidos en cuatro grupos: grupo vino y ejercicio (GVE), grupo vino (GV), grupo ejercicio (GE) y grupo control (GC). Dosis de vino tinto, equivalentes al consumo moderado en humanos, fueron administradas por gavaje, durante diez semanas, simultáneas al período de EF, realizado en cinta. Los SHR recibieron 3,715 ml/kg/día de vino. El desempeño físico fue analizado por test de esfuerzo (TE), y la FEVI fue obtenida por medidas ecocardiográficas. La medición de la PAS ocurrió antes y después del protocolo del EF. RESULTADOS: Se demostró reducción significativa de la PAS en los grupos de intervención, comparados al GC. Al final del protocolo, el GVE presentó la mayor reducción. Así como en la PAS, el GVE presentó mejor resultado en los niveles de HDL. No hubo diferencia significativa en el desempeño físico y en la FEVI entre los grupos. CONCLUSIÓN: El EF asociado a la ingesta moderada de vino tinto ejerce efecto cardioprotector en la PAS y en la HDL de SHR. El desempeño físico y la FEVI no son alterados.

Effect of red wine associated with physical exercise in the cardiovascular system of spontaneously hipertensive rats.

BACKGROUND: Physical exercise (PE) is effective in the treatment and prevention of hypertension associated with improved lipid profile and cardiac contractile function. Regular and moderate consumption of alcoholic beverages such as red wine brings a cardiovascular protective effect. Beverage-derived polyphenols have antioxidant properties benefiting blood vessels. There is little evidence on the consumption of red wine associated with PE and the influences on the cardiovascular system. OBJECTIVE: To investigate the effect of physical exercise (PE) and moderate red wine intake interaction on systolic blood pressure (SBP), high density lipoprotein (HDL) levels, physical performance (PP) and left ventricular ejection fraction (LVEF) in spontaneously hypertensive rats (SHR). METHODS: Sample of 32 SHRs divided into four groups: wine and exercise group (WEG), wine group (WG), exercise group (EG) and control group (CG). Red wine doses were given by intra-gastric gavage, during ten weeks, coincident with PE period, performed on treadmills. The SHRs received red wine doses of 3.715 ml/kg/day. Physical performance was analyzed by maximal exercise test (MET) and LVEF by echocardiographic measures. SBP measurement was made before and after the PE protocol. RESULTS: Demonstrated that the three groups which suffered intervention presented significant SBP reduction compared to CG. At the end of the protocol, WEG showed the largest reduction. Like in SBP results, WEG showed the best outcome on HDL levels at the experiment end. There was no significant difference of physical performance and LVEF between groups. CONCLUSION: PE associated with moderate red wine intake has cardioprotective effects on SBP and HDL levels in SHR. Their physical performance and LVEF are not modified.