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Morphological and functional changes in athlete's heart during the competitive season
Evolução das características morfofuncionais do coração do atleta durante uma época desportiva
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If sports activity is sufficiently intense and sustained, morphological and functional changes will occur in the heart,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> known as “athlete's heart”.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The classic distinguishing feature of athlete's heart is left ventricular (LV) remodeling, with increased wall thickness and chamber size but preserved, and even improved, systolic and diastolic function.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">However, morphological and functional changes in other cardiac and vascular structures have been observed in athletes in an increasing number of studies.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The E/A ratio is slightly higher in athletes,<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> and values >2 are generally found in competitive athletes, particularly those engaged in predominantly dynamic sports.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Since an athlete's heart rate is lower, leading to longer diastole and LV filling time, the relative contribution of atrial contraction to filling is smaller,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> which reduces peak A-wave velocity, thus increasing the E/A ratio.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In healthy non-athletes a left atrial diameter of 40 mm, as assessed by echocardiography in parasternal long-axis view, is considered normal,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> but observational studies in highly trained elite athletes suggest higher values,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> 46 mm for women and 50 mm for men. The main factor determining the magnitude of the increase in atrial size is LV end-diastolic diameter (LVEDD), with an estimated increase of 0.4 mm in atrial size for each millimeter of increased LVEDD.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">It has also been suggested that participation in competitive sports induces aortic root dilatation due to the forces generated by chronic elevation of LV ejection volume and the slight increase in blood pressure that occurs during exercise.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Inferior vena cava dilatation is practically universal in response to chronic elevation of circulating intravascular volume,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> irrespective of the type of sport. Pulmonary artery systolic pressure (PASP) increases during exercise,<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11,12</span></a> but there is little information on the chronic effects of sustained exercise on PASP.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The first studies analyzing the types and upper limits of physiological adaptation to exercise were performed almost exclusively in white male athletes aged 18–35 years,<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> these limits being universally accepted as reference criteria for differentiating such adaptations from pathological changes.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The limits have not been validated in populations of African or Afro-Caribbean descent, which may lead to incorrect diagnosis, with potentially serious clinical and personal consequences.</p><p id="par0045" class="elsevierStylePara elsevierViewall">A study comparing adaptive limits between highly-trained athletes of African or Afro-Caribbean descent and whites<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> showed that the mean increase in LV septal thickness was 12% greater in the former group, and that the prevalence of septal thickness >12 mm was 18% vs. 4%, with a maximum value of 16 mm in those of African descent and 14 mm in whites.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Although most of the changes in the heart induced by intense and prolonged sporting activity have now been thoroughly described, especially with regard to the left ventricle, variation over time of such changes requires clarification, particularly in terms of the response of the myocardium to seasonal variation in training intensity.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Objectives</span><p id="par0055" class="elsevierStylePara elsevierViewall">The study had the following objectives: to assess variations in cardiac adaptation to exercise over a competitive season in individuals with previously induced adaptive changes, in order to determine whether additional changes occur in the echocardiographic parameters analyzed between the beginning of the training phase and the peak of the season; to determine whether there is a relationship between the magnitude of changes induced in particular cardiac structures and those in other structures; and to assess whether the adaptive pattern has similar characteristics in all athletes irrespective of ethnicity, age and percentage of participation in competitive games (an indicator of level of performance).</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Methods</span><p id="par0060" class="elsevierStylePara elsevierViewall">Two assessments were performed by two-dimensional, M-mode and Doppler echocardiography in players in the senior squad of one of the top professional Portuguese football clubs at two different stages of the season:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">•</span><p id="par0065" class="elsevierStylePara elsevierViewall">at the beginning of the training phase, following a period of partial deconditioning due to lack of supervised training and competitive games during the holiday period (a mean of 41.24 days);</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">•</span><p id="par0070" class="elsevierStylePara elsevierViewall">at the peak of the competitive season (February/March, the 7th and 8th months of the season), when the playing schedule is heaviest following the reconditioning characteristic of the early weeks of the season.</p></li></ul></p><p id="par0075" class="elsevierStylePara elsevierViewall">The choice of a professional team was dictated by the need to ensure intense daily training, supervised by staff who are experienced in training athletes for competition. It also ensures a high level of previous physical conditioning, particularly cardiovascular, induced by long periods of training and high-level competition.</p><p id="par0080" class="elsevierStylePara elsevierViewall">All the athletes had previously undergone comprehensive evaluation by the club's medical department, and all were considered healthy.</p><p id="par0085" class="elsevierStylePara elsevierViewall">Athletes who left the squad between the first and second assessments were excluded due to the lack of comparative data, as were those who joined between assessments.</p><p id="par0090" class="elsevierStylePara elsevierViewall">All exams were performed by the authors, using the same equipment in all cases (Vivid <span class="elsevierStyleItalic">i</span> Cardiovascular Ultrasound System, General Electric<span class="elsevierStyleSup">®</span> Healthcare, United Kingdom).</p><p id="par0095" class="elsevierStylePara elsevierViewall">The exams were subsequently reviewed by a second observer, and in cases of disagreement, the parameters were jointly reviewed and discussed until a consensus was reached in order to eliminate the interobserver variability inherent to this imaging technique.</p><p id="par0100" class="elsevierStylePara elsevierViewall">The players’ age, height, weight and body surface area (BSA) (using the Mosteller equation), ethnicity and number of years of professional playing were recorded at the beginning of the season. At the end of the season, the total time of participation in competitive games was calculated for each player, as well as that before and after the second echocardiographic assessment. Percentage of participation in competitive games is one aspect of an athlete's performance that can be quantified precisely.</p><p id="par0105" class="elsevierStylePara elsevierViewall">The echocardiographic parameters assessed were LV wall thickness, LV mass (calculated using the Devereux formula), LVEDD, left atrial (LA) diameter, aortic root diameter, LA and right atrial (RA) areas, maximum right ventricular (RV) diameter, LV mass/BSA, E/A ratio, E/E′ gradient, tricuspid annular peak systolic velocity (TAPSV), ejection fraction (calculated by the modified Simpson method), RV-RA gradient, inferior vena cava diameter and respiratory variation, and estimated PASP.</p><p id="par0110" class="elsevierStylePara elsevierViewall">The variables obtained in the first assessment were compared with those of the second for each player. The relationship between changes in echocardiographic parameters and demographic characteristics was then analyzed, as well as between the former and the percentage of participation in competitive games, with a view to determining any differences in the pattern of exercise-induced adaptations in the different subgroups.</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Statistical analysis</span><p id="par0115" class="elsevierStylePara elsevierViewall">The statistical analysis was performed using SPSS version 13.0 (SPSS Inc. Chicago, Ill).</p><p id="par0120" class="elsevierStylePara elsevierViewall">Variables are expressed as means<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation. The Student's t test, Wilcoxon test, Kruskal–Wallis test, and Spearman and Pearson correlation coefficients were used to compare variables and to infer statistical associations. A value of p<0.05 was considered statistically significant, with 95% confidence intervals.</p><p id="par0125" class="elsevierStylePara elsevierViewall">A linear regression model, considering the percentage of participation in competitive games between the second echocardiogram and the end of the season as a dependent variable, and changes in septal thickness, LA diameter, RV-RA gradient and TAPSV as independent variables, was used to assess whether each independent variable was predictive of more competitive playing time during that period.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0130" class="elsevierStylePara elsevierViewall">The study population included 27 athletes. Demographic and anthropometric data and the results of the exams performed are shown in <a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1–8</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><elsevierMultimedia ident="tbl0035"></elsevierMultimedia><elsevierMultimedia ident="tbl0040"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Based on a regression model, considering the percentage of participation in competitive games between the second exam and the end of the season as a dependent variable, and changes in septal thickness, LA diameter, RV-RA gradient and TAPSV (selected using a stepwise method) as independent variables, the following results were obtained (<a class="elsevierStyleCrossRef" href="#tbl0040">Table 8</a>):</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">Significant LV wall thickening was observed over the course of the playing season. At the peak of the season, 66.6% of athletes had a septal thickness of >12 mm, and 33.3% of >13 mm, with a maximum of 15.18 mm in a player of African descent. Differences in this parameter compared to other studies<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> may be related to the particular sport studied and/or the fact that the second echocardiogram was performed at the peak of the season.</p><p id="par0145" class="elsevierStylePara elsevierViewall">The fact that there was no statistically significant difference in LVEDD during the season suggests that a longer latency period is required for changes to be observed in this parameter on resting echocardiography.</p><p id="par0150" class="elsevierStylePara elsevierViewall">Thus, in this type of population, subjected to chronic intense training that has resulted in profound adaptive changes, short-term seasonal variations in training intensity induce LV alterations, particularly in wall thickness and less so in chamber volume.</p><p id="par0155" class="elsevierStylePara elsevierViewall">LV mass, which is derived from wall thickness and LVEDD, also increased between the first and second assessments. As expected, the same was observed with LV mass adjusted for BSA; at the first assessment, 63.0% of athletes had LV mass/BSA above the upper normal limit (102 g/m<span class="elsevierStyleSup">2</span>),<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and 11.1% had criteria for severe LV hypertrophy. At the second assessment, only one player had LV mass/BSA below the upper normal limit and 55.5% had criteria for severe LV hypertrophy. Maximum LV mass was 279 g at the beginning of the season, and 458 g at the peak of the season.</p><p id="par0160" class="elsevierStylePara elsevierViewall">Ejection fraction did not change significantly, since both assessments were performed under the same conditions of circulatory demand, and thus did not entail different conditions of preload and contractility.</p><p id="par0165" class="elsevierStylePara elsevierViewall">Athlete's heart is characterized by normal diastolic function despite the presence of LV hypertrophy, which this study confirmed, since the hypertrophy observed between the two assessments did not impair diastolic function.</p><p id="par0170" class="elsevierStylePara elsevierViewall">The LA, which acts as a conduit between the pulmonary veins and LV in diastole and as a reservoir in systole, has thinner walls than the LV and is thus more compliant and susceptible to chronic small changes in filling volume. There was a significant increase in LA diameters in the study population between the two assessments; however, the LA is not symmetrical<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> and there is thus a difference in the magnitude of the increase in size depending on whether diameter or area is measured.</p><p id="par0175" class="elsevierStylePara elsevierViewall">At the same time, there was a close correlation between increases in E/A ratio and LA diameter (Spearman coefficient 0.44, p=0.02), which suggests that the larger the LA, the greater the quantity of blood stored during ventricular systole, lengthening the E wave in the early diastolic phase of rapid LV filling. Since most ventricular filling occurs during this phase, the effect of greater atrial volume on the A wave is not as marked as on the E wave, resulting in a higher E/A ratio. In addition, as stated above, atrial contraction in trained athletes contributes less to ventricular filling than in sedentary controls, due to the former's lower heart rate and hence longer diastole.</p><p id="par0180" class="elsevierStylePara elsevierViewall">On comparison of the two PASP measurements at rest in athletes with previous adaptive changes (under similar preload conditions), there was no statistically significant increase between the first and second assessments, despite a tendency for greater tricuspid regurgitation.</p><p id="par0185" class="elsevierStylePara elsevierViewall">With regard to ethnic differences, players of African descent had greater LV wall thickness at the beginning and throughout the season, but this was not statistically significant due to the small sample.</p><p id="par0190" class="elsevierStylePara elsevierViewall">Age did not affect the patterns of additional adaptation, but once again this observation is of limited value due to the small number of athletes studied.</p><p id="par0195" class="elsevierStylePara elsevierViewall">Thus, LV wall hypertrophy is the most important feature of additional adaptive changes between the beginning of the training phase and the peak of the season. It also appears to be related to performance, since in the linear regression model, increased septal thickness was an independent predictor of a higher percentage of participation in competitive games after the second assessment (p=0.008, by the F test).</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusion</span><p id="par0200" class="elsevierStylePara elsevierViewall">The differences between the first and second assessments were slight, due to the fact that most of the morphological alterations found in athlete's heart had already occurred, the individuals studied having a long history of competition. The only differences found were in characteristics that tend to appear and disappear rapidly.</p><p id="par0205" class="elsevierStylePara elsevierViewall">One important conclusion that can be drawn from the study is that additional adaptive changes take place over the course of the season depending on different levels of physical activity, mainly in LV wall hypertrophy, and consequent increased LV mass adjusted for BSA, and LA size. By contrast, variables such as LVEDD, ejection fraction and Doppler parameters of diastolic function do not change significantly.</p><p id="par0210" class="elsevierStylePara elsevierViewall">The degree of septal thickening was shown to be an independent predictor of a higher percentage of participation in competitive games. This suggests that greater adaptive changes in the cardiovascular system are linked to better overall physical conditioning, reflected in the level of performance.</p><p id="par0215" class="elsevierStylePara elsevierViewall">No particular characteristic, including hypertrophy and chamber dilatation, changed more in one group than in another.</p><p id="par0220" class="elsevierStylePara elsevierViewall">To summarize, the characteristics of athlete's heart are not irreversible or static, but change according to the demands of the competitive season, and the magnitude of adaptive changes is not the same for all the parameters studied.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of interest</span><p id="par0225" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:2 [ "identificador" => "xres251695" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec239293" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres251696" "titulo" => "Resumo" ] 3 => array:2 [ "identificador" => "xpalclavsec239292" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Objectives" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Statistical analysis" ] ] ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Results" ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0035" "titulo" => "Conclusion" ] 10 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of interest" ] 11 => array:2 [ "identificador" => "xack54266" "titulo" => "Acknowledgements" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-02-18" "fechaAceptado" => "2012-06-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec239293" "palabras" => array:3 [ 0 => "Athlete's heart" 1 => "Cardiac adaptations to effort" 2 => "Echocardiography in athletes" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec239292" "palabras" => array:3 [ 0 => "Coração de atleta" 1 => "Adaptações cardíacas ao esforço" 2 => "Ecocardiografia em atletas" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This research aims to determine the cardiac morphological and functional changes that occur during the competitive season in elite athletes with previously-induced adaptive changes.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Two echocardiographic examinations were performed in each player of a senior professional football team, the first at the beginning of the training phase and the other at the peak of the competitive season.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">It was demonstrated that after the brief period of deconditioning during the holiday period, further changes took place, even in these athletes with several years of prior professional activity.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">There was a significant increase between the two assessments in left ventricular wall thickness and mass, and in left atrial diameter, but left ventricular diastolic diameter and the diastolic function parameters considered remained the same. Greater left ventricular wall hypertrophy was related to more competitive playing time in these players.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The main limitation of the study is the small number of athletes studied.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A presente investigação tem por objetivo estabelecer quais as alterações cardiológicas morfo-funcionais, que ocorrem ao longo de uma época desportiva, em atletas de alta competição com modificações adaptativas previamente induzidas.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Para tal, realizaram-se dois exames ecocardiográficos a cada um dos atletas do plantel sénior de uma equipa de futebol profissional, um no início da fase de treinos e outro no período de maior intensidade competitiva, considerado como o pico de esforço.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Demonstrou-se que, após o breve período de descondicionamento que correspondeu às férias desportivas, existe lugar a adaptações adicionais, mesmo em atletas com vários anos de prática profissional prévia.</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Entre as duas avaliações, verificou-se o aumento significativo da espessura das paredes do ventrículo esquerdo e respetiva massa, e do diâmetro da aurícula esquerda, com manutenção do diâmetro telediastólico do ventrículo esquerdo, e dos parâmetros de função diastólica considerados. Uma maior extensão da hipertrofia da musculatura ventricular relacionou-se com maior utilização em competição por parte dos atletas em que ela ocorreu.</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">A principal limitação do estudo prende-se com o pequeno número de atletas estudados.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Cabanelas N, et al. Evolução das características morfofuncionais do coração do atleta durante uma época desportiva. Rev Port Cardiol. 2013. <span class="elsevierStyleInterRef" href="http://dx.doi.org/10.1016/j.repc.2012.06.015">http://dx.doi.org/10.1016/j.repc.2012.06.015</span>.</p>" ] ] "multimedia" => array:8 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">SD: standard deviation.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Minimum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Maximum \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Weight (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Body surface area (m<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.917 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.088 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.745 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.061 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Years of professional playing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355021.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Demographic and anthropometric data.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">White \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mixed race \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">African descent \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355027.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Ethnicity.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">BSA: body surface area; LV: left ventricular; LVEDD: left ventricular end-diastolic diameter; PASP: pulmonary artery systolic pressure; TAPSV: tricuspid annular peak systolic velocity.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">1st exam (mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">2nd exam (mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Septal thickness (mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.08<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.97 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.51<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Posterior wall thickness (mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.82<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.50<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.61 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LV mass/BSA (g/m<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">111.52<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>16.64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">142.68<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>31.26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LVEDD (mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50.43<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50.90<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.47 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ejection fraction (%) (at rest) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60.25<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.99 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61.26<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Left atrial diameter (mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36.12<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.93<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Left atrial area (cm<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.26<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.56<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.50 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Aortic root diameter (mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.02<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.13<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.92 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.06 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">E/E′ ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.82<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.68<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">E/A ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.57<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.55<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TAPSV (cm/s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.95<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.21<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PASP (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.95<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.68<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.22 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355022.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Changes in echocardiographic parameters.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">LA: left atrial; LVEDD: left ventricular end-diastolic diameter; PASP: pulmonary artery systolic pressure; RA: right atrial; TAPSV: tricuspid annular peak systolic velocity.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Septal thickness vs. LA area \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.95 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Septal thickness vs. LA diameter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.52 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Septal thickness vs. E/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.79 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Septal thickness vs. LA E/E′ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LVEDD vs. LA area \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.17 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LVEDD vs. LA diameter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.17 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">E/A vs. LA diameter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.02 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">E/A vs. LVEDD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.74 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PASP vs. RA area \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PASP vs. TAPSV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.86 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PASP vs. LA area \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PASP vs. LA diameter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.09 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355025.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Statistical significance of correlations between changes in the parameters assessed.</p>" ] ] 4 => array:7 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">LA: left atrial; LV: left ventricular; LVEDD: left ventricular end-diastolic diameter.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ethnicity vs. change in septal thickness \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.56 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ethnicity vs. change in posterior wall thickness \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.80 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ethnicity vs. change in LV mass \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.38 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ethnicity vs. change in LVEDD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.82 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ethnicity vs. change in LA diameter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355024.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Differences in changes in parameters between athletes of different ethnicities.</p>" ] ] 5 => array:7 [ "identificador" => "tbl0030" "etiqueta" => "Table 6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">LV: left ventricular; LVEDD: left ventricular end-diastolic diameter.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age vs. change in septal thickness \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.63 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age vs. change in LVEDD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.68 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age vs. change in LV mass \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.64 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355028.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Influence of age on changes in parameters.</p>" ] ] 6 => array:7 [ "identificador" => "tbl0035" "etiqueta" => "Table 7" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Change in septal thickness vs. total % participation in competitive games \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Change in septal thickness vs. % participation in competitive games before 2nd exam \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.28 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Change in septal thickness vs. participation in competitive games between 2nd exam and end of season \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355023.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Correlation between changes in septal thickness and percentage of participation in competitive games.</p>" ] ] 7 => array:7 [ "identificador" => "tbl0040" "etiqueta" => "Table 8" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">LA: left atrial; RV-RA: right ventricular-right atrial; TAPSV: tricuspid annular peak systolic velocity.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Correlation with % participation in competitive games (dependent variable) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Septal thickness vs. dependent variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.006 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LA diameter vs. dependent variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.796 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RV-RA gradient vs. dependent variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.144 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TAPSV vs. dependent variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.012 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355026.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Analysis of possible predictors of percentage of participation in competitive games.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The athletic heart syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T.P. Huston" 1 => "J.C. Puffer" 2 => "W.M. Rodney" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM198507043130106" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1985" "volumen" => "313" "paginaInicial" => "24" "paginaFinal" => "32" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3158817" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The athlete's heart: historical perspective" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R. Rost" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Cardiology Clinics, the Athlete's Heart" "paginaInicial" => "197" "paginaFinal" => "207" "serieFecha" => "1992" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparative left ventricular dimensions in trained athletes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Morganroth" 1 => "B.J. Maron" 2 => "W.L. Henry" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1975" "volumen" => "82" "paginaInicial" => "521" "paginaFinal" => "524" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1119766" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulsed Doppler tissue imaging in endurance athletes: relation between left ventricular preload and myocardial regional diastolic function" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "P. Caso" 1 => "A. D’Andreas" 2 => "M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 4 | 12 |
| 2024 October | 54 | 42 | 96 |
| 2024 September | 56 | 26 | 82 |
| 2024 August | 41 | 57 | 98 |
| 2024 July | 35 | 31 | 66 |
| 2024 June | 26 | 14 | 40 |
| 2024 May | 30 | 24 | 54 |
| 2024 April | 28 | 31 | 59 |
| 2024 March | 27 | 18 | 45 |
| 2024 February | 22 | 24 | 46 |
| 2024 January | 24 | 20 | 44 |
| 2023 December | 17 | 27 | 44 |
| 2023 November | 17 | 20 | 37 |
| 2023 October | 13 | 14 | 27 |
| 2023 September | 15 | 19 | 34 |
| 2023 August | 20 | 15 | 35 |
| 2023 July | 19 | 9 | 28 |
| 2023 June | 14 | 6 | 20 |
| 2023 May | 26 | 29 | 55 |
| 2023 April | 10 | 3 | 13 |
| 2023 March | 18 | 20 | 38 |
| 2023 February | 21 | 26 | 47 |
| 2023 January | 17 | 10 | 27 |
| 2022 December | 22 | 20 | 42 |
| 2022 November | 26 | 27 | 53 |
| 2022 October | 19 | 14 | 33 |
| 2022 September | 20 | 31 | 51 |
| 2022 August | 16 | 31 | 47 |
| 2022 July | 26 | 33 | 59 |
| 2022 June | 16 | 19 | 35 |
| 2022 May | 17 | 30 | 47 |
| 2022 April | 26 | 24 | 50 |
| 2022 March | 24 | 25 | 49 |
| 2022 February | 26 | 27 | 53 |
| 2022 January | 27 | 26 | 53 |
| 2021 December | 17 | 26 | 43 |
| 2021 November | 28 | 35 | 63 |
| 2021 October | 24 | 36 | 60 |
| 2021 September | 19 | 25 | 44 |
| 2021 August | 28 | 23 | 51 |
| 2021 July | 14 | 24 | 38 |
| 2021 June | 11 | 15 | 26 |
| 2021 May | 20 | 36 | 56 |
| 2021 April | 17 | 67 | 84 |
| 2021 March | 44 | 13 | 57 |
| 2021 February | 53 | 10 | 63 |
| 2021 January | 29 | 9 | 38 |
| 2020 December | 21 | 3 | 24 |
| 2020 November | 21 | 18 | 39 |
| 2020 October | 10 | 14 | 24 |
| 2020 September | 55 | 8 | 63 |
| 2020 August | 17 | 12 | 29 |
| 2020 July | 43 | 8 | 51 |
| 2020 June | 31 | 6 | 37 |
| 2020 May | 28 | 3 | 31 |
| 2020 April | 30 | 7 | 37 |
| 2020 March | 46 | 6 | 52 |
| 2020 February | 31 | 32 | 63 |
| 2020 January | 28 | 5 | 33 |
| 2019 December | 20 | 4 | 24 |
| 2019 November | 21 | 5 | 26 |
| 2019 October | 38 | 3 | 41 |
| 2019 September | 11 | 9 | 20 |
| 2019 August | 32 | 3 | 35 |
| 2019 July | 39 | 9 | 48 |
| 2019 June | 6 | 10 | 16 |
| 2019 May | 27 | 4 | 31 |
| 2019 April | 17 | 14 | 31 |
| 2019 March | 21 | 9 | 30 |
| 2019 February | 30 | 10 | 40 |
| 2019 January | 10 | 4 | 14 |
| 2018 December | 28 | 12 | 40 |
| 2018 November | 38 | 2 | 40 |
| 2018 October | 87 | 16 | 103 |
| 2018 September | 33 | 15 | 48 |
| 2018 August | 28 | 6 | 34 |
| 2018 July | 18 | 2 | 20 |
| 2018 June | 24 | 10 | 34 |
| 2018 May | 36 | 8 | 44 |
| 2018 April | 32 | 9 | 41 |
| 2018 March | 41 | 13 | 54 |
| 2018 February | 31 | 11 | 42 |
| 2018 January | 27 | 2 | 29 |
| 2017 December | 55 | 5 | 60 |
| 2017 November | 40 | 6 | 46 |
| 2017 October | 45 | 11 | 56 |
| 2017 September | 40 | 13 | 53 |
| 2017 August | 45 | 12 | 57 |
| 2017 July | 31 | 8 | 39 |
| 2017 June | 46 | 9 | 55 |
| 2017 May | 47 | 8 | 55 |
| 2017 April | 23 | 5 | 28 |
| 2017 March | 33 | 49 | 82 |
| 2017 February | 34 | 4 | 38 |
| 2017 January | 29 | 2 | 31 |
| 2016 December | 38 | 14 | 52 |
| 2016 November | 27 | 12 | 39 |
| 2016 October | 33 | 7 | 40 |
| 2016 September | 19 | 11 | 30 |
| 2016 August | 2 | 1 | 3 |
| 2016 July | 17 | 6 | 23 |
| 2016 June | 5 | 9 | 14 |
| 2016 May | 9 | 5 | 14 |
| 2016 April | 47 | 1 | 48 |
| 2016 March | 62 | 23 | 85 |
| 2016 February | 85 | 29 | 114 |
| 2016 January | 53 | 23 | 76 |
| 2015 December | 62 | 15 | 77 |
| 2015 November | 70 | 15 | 85 |
| 2015 October | 61 | 26 | 87 |
| 2015 September | 70 | 18 | 88 |
| 2015 August | 69 | 19 | 88 |
| 2015 July | 43 | 5 | 48 |
| 2015 June | 32 | 6 | 38 |
| 2015 May | 48 | 9 | 57 |
| 2015 April | 49 | 21 | 70 |
| 2015 March | 44 | 13 | 57 |
| 2015 February | 55 | 14 | 69 |
| 2015 January | 68 | 8 | 76 |
| 2014 December | 86 | 15 | 101 |
| 2014 November | 67 | 8 | 75 |
| 2014 October | 70 | 13 | 83 |
| 2014 September | 74 | 10 | 84 |
| 2014 August | 59 | 11 | 70 |
| 2014 July | 77 | 8 | 85 |
| 2014 June | 60 | 7 | 67 |
| 2014 May | 61 | 12 | 73 |
| 2014 April | 68 | 9 | 77 |
| 2014 March | 75 | 16 | 91 |
| 2014 February | 69 | 13 | 82 |
| 2014 January | 83 | 24 | 107 |
| 2013 December | 70 | 12 | 82 |
| 2013 November | 83 | 21 | 104 |
| 2013 October | 55 | 16 | 71 |
| 2013 September | 45 | 17 | 62 |
| 2013 August | 69 | 25 | 94 |
| 2013 July | 51 | 20 | 71 |
| 2013 June | 24 | 8 | 32 |
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