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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Introduction</span><p id="par0100" class="elsevierStylePara elsevierViewall">Intense and prolonged physical exercise leads to changes in cardiovascular physiology known as &#8216;athlete&#39;s heart&#8217;&#46; Chief among these alterations are increased cardiac size&#44; volumes and mass and improved functional parameters&#44; particularly diastolic function&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">1</span></a> Classically&#44; two forms of cardiac remodeling have been described&#58; concentric remodeling associated with static exercise&#44; and eccentric remodeling associated with dynamic exercise&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">2</span></a> For example&#44; marathon runners present eccentric remodeling due to volume overload resulting from increased cardiac output&#44; while weightlifters show concentric remodeling due to pressure overload&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">3</span></a> It should be noted that this distinction is not absolute&#44; since most sports involve both static and dynamic exercise&#44; and hence lead to mixed remodeling&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">4</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">However&#44; athletes are not the only individuals who undergo high-intensity training&#46; Soldiers&#44; especially in the special forces&#44; also undergo physically demanding training that involves various forms of both static and dynamic exercise&#46; Overall&#44; the volume of exercise required of these soldiers can be compared to that of competitive athletes&#44; and may often be even higher&#46; However&#44; military training is unique with regard to the methodologies used and the influence of other variables arising from military life&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">5</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">The manifestations of exercise-induced cardiac remodeling can overlap with those of pathological conditions&#44; especially cardiomyopathy&#44; and differential diagnosis is often challenging&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">6</span></a> In this context&#44; pre-participation screening of athletes and interpretation of diagnostic exams in this population are of great importance&#46; In the last decade&#44; new imaging techniques have been developed that enable detailed myocardial assessment&#44; such as analysis of myocardial mechanics by transthoracic echocardiography &#40;TTE&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">7</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The main aim of this study was to characterize and compare cardiac remodeling in professional basketball players over the course of a season and in soldiers on a special forces course&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Methods</span><p id="par0120" class="elsevierStylePara elsevierViewall">This observational&#44; longitudinal&#44; case-control study assessed special forces soldiers and competitive athletes at the beginning and end of a military training course and a sports season&#44; respectively&#46; Male and female individuals between the ages of 18 and 35 years were included&#46; The soldiers were selected from those who enrolled in a Portuguese Army commando course and were assessed between January and June 2016&#46; The athletes belonged to two professional basketball teams&#44; one men&#39;s and the other women&#39;s&#44; competing in the national men&#39;s Division 1 and the national women&#39;s league&#44; respectively&#44; and were assessed in October 2015 and March&#47;April 2016&#46; Thus&#44; both groups were assessed over a period of about six months&#46; The group of soldiers consisted of the 17 out of 76 trainees &#40;54 dropouts&#44; approximately 70&#37; of trainees&#41; who successfully completed the course and met the inclusion criteria&#46; All of these soldiers had previously participated in competitive sports&#46; The athlete population was composed of 17 basketball players&#44; eight male and nine female&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">All of the study subjects were volunteers and gave their informed consent to participate in the study&#46; The protocol was approved by the Ethics Committee of the Medical School of the University of Coimbra &#40;reference protocol 087&#47;2015&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Characteristics of physical exercise in the study population</span><p id="par0130" class="elsevierStylePara elsevierViewall">The commando course involves high-intensity physical exercise intended to develop aerobic and anaerobic capacity&#46; To this end&#44; the soldiers undergo dynamic and static physical training&#44; including various sports including running&#44; swimming&#44; gymnastics and weightlifting&#46; In addition&#44; they undergo military physical training&#44; which aims to instill and develop psychomotor techniques and abilities that enable soldiers to perform their duties under adverse conditions&#46; This physical training involves obstacle courses&#44; intense running interspersed with marching&#44; carrying loads&#44; and similar activities&#46; The training program is divided into two stages&#58; the first stage consists of 10 weeks of vigorous-intensity physical exercise &#40;77-95&#37; of maximum heart rate &#91;HR&#93;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">8</span></a> five times per week with a mean duration of four hours per day&#44; while the second phase consists of 15 weeks of vigorous-intensity physical exercise &#40;77-95&#37; of maximum HR&#41; interspersed with periods of near maximal- or maximal-intensity exercise &#40;&#8805;96&#37; of maximum HR&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">8</span></a> five times per week for a mean of four hours per day&#46; In addition to this scheduled training&#44; the soldiers are under constant physical&#44; psychological and emotional strain&#44; which is difficult to quantify&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Basketball involves numerous movements that require speed&#44; skill and strength and involve dynamic and static exercise&#44; with a general component and a specific component&#46; The general component is provided by continuous running at speed and with changes in direction&#44; and gymnastic and flexibility exercises&#46; The specific component consists mainly of training in coordination by learning and practicing technical maneuvers&#46; The players train four times a week and play one game a week&#46; The mean duration of each training session is three hours&#44; divided into three separate periods&#58; warmup&#44; basketball training with general and specific exercises&#44; and cooldown&#46; The players are subject to periods of vigorous- to near maximal-intensity exercise&#44; with other periods of low- to moderate-intensity exercise&#46; Overall&#44; the training sessions for these athletes can be classified as vigorous-intensity &#40;77-95&#37; maximum HR&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">8</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Clinical assessment</span><p id="par0140" class="elsevierStylePara elsevierViewall">All participants underwent a full physical examination and thorough collection of medical history&#44; performed by a sports medicine physician or a cardiologist&#46; Emphasis was placed on cardiovascular risk factors&#44; dietary habits&#44; medications&#44; and sports history&#44; including the number of hours of training and of sleep during the course or season&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Anthropometric assessment</span><p id="par0145" class="elsevierStylePara elsevierViewall">The anthropometric assessment was performed by a nurse and a health technician&#46; Height was measured using a tape measure&#44; and weight&#44; percentage fat mass &#40;FM&#41; and muscle mass &#40;MM&#41; were measured using a digital full-body composition monitor &#40;Omron<span class="elsevierStyleSup">&#174;</span> HBF-510W&#41; using bioelectrical impedance&#46; Systolic blood pressure &#40;SBP&#41;&#44; diastolic blood pressure &#40;DBP&#41; and HR were assessed using an upper arm blood pressure &#40;BP&#41; monitor &#40;Omron<span class="elsevierStyleSup">&#174;</span> HEM-7113&#41;&#44; in accordance with current guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">9</span></a> Changes &#40;&#916;&#41; in variables &#40;weight&#44; MM&#44; FM&#44; SBP&#44; and DBP&#41; were calculated according to the following formula&#58; &#40;final value - initial value&#41;&#47;initial value&#215;100&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Electrocardiographic assessment</span><p id="par0150" class="elsevierStylePara elsevierViewall">All individuals underwent a 12-lead electrocardiogram &#40;ECG&#41; &#40;Norav<span class="elsevierStyleSup">&#174;</span> 1200HR&#41;&#44; analyzed by two cardiologists and interpreted according to the &#8216;refined&#8217; criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Echocardiographic assessment</span><p id="par0155" class="elsevierStylePara elsevierViewall">All transthoracic echocardiograms were performed by a cardiologist with a Vivid 7 ultrasound system &#40;GE Healthcare<span class="elsevierStyleSup">&#174;</span>&#41;&#44; and included the various echocardiographic views and techniques recommended by the European Society of Cardiology &#40;two-dimensional&#59; M-mode&#59; color&#44; pulsed wave&#44; continuous wave and tissue Doppler&#59; and myocardial strain assessed by speckle tracking&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">Wall thickness and left ventricular &#40;LV&#41; dimensions were measured via parasternal long-axis view&#46; Relative wall thickness &#40;RWT&#41; was calculated using the formula &#40;2&#215;LV posterior wall thickness&#47;LV end-diastolic diameter &#91;LVEDD&#93;&#41; and LV mass was calculated using the Devereux formula&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">12</span></a> LV volume and left atrial &#40;LA&#41; volume were determined using the modified Simpson&#39;s rule&#44; with images obtained in apical 4- and 2-chamber views&#46; The LA volume index was obtained by indexing to body surface area&#46; LV ejection fraction &#40;LVEF&#41; was determined using Simpson&#39;s method&#46; Pulsed wave Doppler was acquired in apical 4-chamber view&#44; and peak E and A wave velocities and E&#47;A ratio were measured&#46; Tissue Doppler images of the mitral and tricuspid annuli were obtained to measure the E and E&#8242; waves&#44; and to measure S&#8242; wave velocities&#44; respectively&#46; Tricuspid annular plane systolic excursion &#40;TAPSE&#41; was determined by M-mode&#46; Speckle tracking was used to calculate LV global longitudinal strain &#40;GLS&#41; using images from apical 4-&#44; 2- and 3-chamber views and an 18-segment model&#46; Cardiac cycles were acquired during the same respiratory phase &#40;exhalation&#41;&#46; Three consecutive cycles were recorded and mean sinus rhythm was calculated with a frame rate &#62;60 frames per second&#46; The quality of the exam was considered good when no more than two segments were excluded&#44; and excellent when all segments were analyzed&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a> shows examples of TTE of a soldier and of an athlete after the course or season&#44; respectively&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Statistical analysis</span><p id="par0170" class="elsevierStylePara elsevierViewall">Categorical variables were presented as frequency and percentage&#44; and compared with the chi-square and Fisher&#39;s tests as appropriate&#46; The Kolmogorov-Smirnov test was used to test continuous variables for normality of distribution&#46; Variables with a normal distribution were expressed as mean and standard deviation&#44; and the Student&#39;s t test was used for group comparisons&#46; Levene&#39;s test was used to assess the homogeneity of variance of individual variables&#46; Variables with a non-normal distribution were expressed as median and interquartile range&#44; and the groups were compared using the Mann-Whitney and Kruskal-Wallis tests&#46; Pearson&#39;s correlation was used to analyze associations between MM and FM and echocardiographic parameters&#46; For all comparisons&#44; a p-value &#60;0&#46;05 was considered statistically significant with a 95&#37; confidence interval&#46; All data were calculated and analyzed using SPSS version 20 &#40;IBM SPSS<span class="elsevierStyleSup">&#174;</span> Inc&#46;&#44; Chicago&#44; IL&#44; USA&#41;&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Results</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Population characteristics</span><p id="par0175" class="elsevierStylePara elsevierViewall">The characteristics of the study population are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Briefly&#44; the mean age of the two groups was similar&#44; but there were significant differences in terms of gender and race&#46; The soldiers played competitive sports for less time and had a higher body mass index&#46; During the study period&#44; the soldiers completed more hours of scheduled exercise per day and had fewer hours of sleep and fewer meals&#46; Nearly a quarter of the population &#40;20&#46;6&#37;&#41; had at least one cardiovascular risk factor&#44; of which smoking was the most common and was exclusive to the soldiers &#40;17&#46;6&#37;&#41;&#44; followed by dyslipidemia&#44; which was also more common in the soldiers &#40;5&#46;9&#37; vs&#46; 2&#46;9&#37;&#44; p&#61;0&#46;32&#41;&#46; The study population had no family history of cardiovascular disease&#44; hypertension or diabetes&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Changes in anthropometric data</span><p id="par0180" class="elsevierStylePara elsevierViewall">The soldiers experienced significant weight gain&#44; with increased MM&#44; and more marked decreases in FM&#44; SBP&#44; DBP and HR than the basketball players &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The increase in MM and decrease in FM were seen in all male subjects&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0185" class="elsevierStylePara elsevierViewall">The percentage difference between the two groups in the changes in anthropometric data was statistically significant for weight&#44; SBP&#44; DBP&#44; MM and FM &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>&#41;&#46; Unlike the basketball players&#44; the soldiers gained weight &#40;3&#46;1&#177;3&#46;3 vs&#46; -0&#46;2&#177;3&#46;2&#37;&#59; p&#60;0&#46;01&#41;&#44; with an increase in MM &#40;7&#46;5&#177;4&#46;1 vs&#46; 1&#46;7 &#177;2&#46;4&#37;&#59; p&#60;0&#46;01&#41; and greater decrease in FM &#40;-31&#46;4&#177;15&#46;7 vs&#46; -0&#46;8&#177;14&#46;9&#37;&#59; p&#60;0&#46;01&#41;&#46; The soldiers experienced reductions in SBP &#40;-4&#46;8&#177;3&#46;0 vs&#46; 1&#46;4&#177;7&#46;4&#37;&#59; p&#60;0&#46;01&#41; and DBP &#40;-8&#46;6&#177;7&#46;4 vs&#46; 1&#46;5&#177;10&#46;5&#37;&#59; p&#60;0&#46;01&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Electrocardiographic assessment</span><p id="par0190" class="elsevierStylePara elsevierViewall">All ECGs showed sinus rhythm and were considered normal or with only physiological alterations&#46; The most common physiological alteration was sinus bradycardia &#40;41&#46;2&#37;&#41;&#44; followed by early repolarization &#40;29&#46;4&#37;&#41;&#44; LV hypertrophy &#40;20&#46;6&#37;&#41;&#44; incomplete right bundle branch block &#40;11&#46;8&#37;&#41;&#44; and first-degree atrioventricular block &#40;2&#46;9&#37;&#41;&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Echocardiographic assessment</span><p id="par0195" class="elsevierStylePara elsevierViewall">TTE revealed different structural patterns of cardiac remodeling &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; In the soldiers&#44; there was an increase in left chamber size&#44; of both the left ventricle &#40;49&#46;7&#177;3&#46;2 vs&#46; 52&#46;8&#177;3&#46;4 mm&#59; p&#60;0&#46;01&#41; and the left atrium &#40;63&#46;4&#177;10&#46;5 vs&#46; 71&#46;2&#177;12&#46;1 ml&#59; p&#61;0&#46;02&#41;&#44; and a decrease in RWT &#40;0&#46;40&#177;0&#46;1 vs&#46; 0&#46;36&#177;0&#46;1&#59; p&#61;0&#46;05&#41;&#46; In the athletes&#44; LV size decreased &#40;52&#46;0&#177;4&#46;7 vs&#46; 50&#46;4&#177;4&#46;7 mm&#59; p&#61;0&#46;05&#41;&#44; and interventricular septum &#40;IVS&#41; thickness &#40;8&#46;3&#177;1&#46;5 vs&#46; 9&#46;1&#177;1&#46;5 mm&#59; p&#61;0&#46;03&#41; and RWT &#40;0&#46;33&#177;0&#46;1 vs&#46; 0&#46;36&#177;0&#46;1&#59; p&#61;0&#46;05&#41; both increased&#46; With regard to functional parameters&#44; there was a reduction in resting LVEF in the soldiers &#40;60&#177;6 vs&#46; 55&#177;6&#37;&#59; p&#60;0&#46;01&#41;&#44; and an increase in the S&#8242; wave in both the soldiers &#40;15&#177;2 vs&#46; 17&#177;2 cm&#47;s&#59; p&#60;0&#46;01&#41; and the basketball players &#40;13&#177;2 vs&#46; 14&#177;2 cm&#47;s&#59; p&#60;0&#46;01&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0200" class="elsevierStylePara elsevierViewall">When male participants were assessed separately&#44; the different types of remodeling described above applied&#44; with significant differences in LA volume &#40;51&#46;8&#177;8&#46;1 vs&#46; 58&#46;4&#177;10&#46;9 ml&#59; p&#61;0&#46;05&#41; and GLS &#40;-19&#46;4&#177;1&#46;3 vs&#46; -17&#46;6&#177;1&#46;7&#37;&#59; p&#61;0&#46;03&#41; in the basketball players&#46; Although there were no significant differences in GLS in the two groups at the beginning and end of the course or season&#44; there was a significant difference when the two groups were compared &#40;-20&#46;2&#177;1&#46;6&#37; vs&#46; -19&#46;4&#177;2&#46;1&#37;&#59; p&#61;0&#46;03&#41;&#46; The echocardiographic findings in the two groups demonstrated differences in LVEDD&#44; RWT&#44; LVEF and S&#8242; wave &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41;&#46; Alterations in RWT and LVEDD were opposite&#58; for the soldiers&#44; RWT decreased &#40;-10&#46;0&#177;14&#46;3&#37; vs&#46; 12&#46;1&#177;22&#46;5&#37;&#59; p&#60;0&#46;01&#41; and LVEDD increased &#40;6&#46;2&#177;11&#46;3&#37; vs&#46; -3&#46;1&#177;6&#46;1&#37;&#59; p&#60;0&#46;01&#41;&#44; while for basketball players both RWT and LVEDD increased during the season&#46; These findings are similar when only male soldiers and basketball players are compared&#44; with significant differences in RWT &#40;-10&#46;0&#177;14&#46;3&#37; vs&#46; 21&#177;25&#46;3&#37;&#59; p&#61;0&#46;02&#41;&#44; LVEDD &#40;6&#46;2&#177;11&#46;3&#37; vs&#46; -3&#46;1 &#177;4&#46;2&#37;&#59; p&#60;0&#46;01&#41; and LVEF &#40;-5&#46;5&#177;12&#46;8&#37; vs&#46; 4&#46;9&#177;10&#46;5&#59; p&#60;0&#46;01&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Discussion</span><p id="par0205" class="elsevierStylePara elsevierViewall">This study demonstrated the occurrence of anthropometric and cardiovascular remodeling in both soldiers and basketball players&#46; These adaptations had different characteristics in the two groups&#46; In anthropometric terms&#44; the soldiers had a greater increase in body weight&#44; with gains in MM and reductions in FM&#46; Echocardiographic assessment revealed different patterns of remodeling&#44; with the soldiers developing predominantly eccentric and the basketball players developing mainly concentric adaptations&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">The alterations in anthropometric data and vital signs following the military course or sports season were more significant in the soldiers&#8217; group&#44; even when a sub-analysis was performed &#40;data not shown&#41; comparing the soldiers with the Caucasian male athletes&#46; There was a marked transformation in the body composition of the former group&#44; with mean MM gains of 7&#46;5&#37; and mean FM reductions of around 30&#37;&#46; The differences in adaptation in the two groups may be related to the different characteristics of exercise in military training and in basketball&#44; particularly the longer duration and greater intensity of exercise in military training&#44; as well as specific features of the methodologies used&#46; These differences likely explain the more marked adaptations in the soldiers&#46; It has been shown that high-intensity interval training&#44; in this case applied to the soldiers&#44; achieves better results and greater adaptation&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">13</span></a> The mechanisms underlying this adaptation are still unclear&#44; but this type of training is thought to enhance capacity for aerobic and anaerobic metabolism and to increase oxidative enzyme activity&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">14</span></a> Although there were no individuals with hypertension in either group&#44; intense physical exercise led to reductions in the soldiers of around 4&#37; and 9&#37; in SBP and DBP&#44; respectively&#46; These results are in agreement with the literature&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">15</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">Cardiac remodeling occurred in both groups&#44; but had different characteristics&#46; In the soldiers&#44; eccentric remodeling occurred with an increase in left chamber size and a decrease in RWT&#46; At the end of the course&#44; the proportion of soldiers with eccentric ventricular hypertrophy had doubled&#44; from 5&#46;9&#37; to 11&#46;8&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">16</span></a> In the basketball players predominantly concentric remodeling was observed&#44; with increases in LV wall thickness&#44; particularly of the IVS&#44; and RWT&#44; and a slight decrease in LVEDD&#46; One possible explanation for these different types of cardiac remodeling is the intensity of the exercise performed&#46; Moderate- to high-intensity exercise is initially associated with concentric hypertrophy due to the stimulus of pressure overload&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">17</span></a> Vigorous- to near maximal- or maximal-intensity exercise leads to eccentric remodeling&#44; due to volume overload from increased cardiac output&#44; resulting from higher HR and increased ejection volumes&#44; with only a moderate increase in BP&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">17&#44;18</span></a> This moderate increase in BP seems to be associated with acetylcholine-induced endothelium-dependent vasorelaxation&#44; which plateaus with moderate to vigorous levels of exercise&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">19</span></a> Thus&#44; when the level of exercise increases from vigorous-intensity to near maximal- or maximal-intensity&#44; there is a greater increase in cardiac output that is not accompanied by a proportional increase in BP&#44; and this may lead to dilatation of the heart chambers that is disproportionate to the observed wall hypertrophy&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Despite the extent of the adaptations observed over the course or season&#44; the changes were still within the upper limit of normal &#40;no athlete with IVS &#62;13 mm and only one with LVEDD &#62;60 mm &#91;61&#46;4 mm&#93;&#41;&#46; There were also no statistically significant changes in parameters of diastolic function during the study&#46; However&#44; it should be noted that both soldiers and athletes already had above-normal values&#44; as described in similar populations&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">20&#44;21</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">Exercise-induced changes in functional parameters were also different in the two groups&#46; In the soldiers&#44; there was a decrease in resting LVEF&#44; while in the basketball players this parameter remained similar to baseline values&#46; The literature reports that elite athletes who are subject to intense and prolonged exertion may have slightly lower resting LVEF&#44; with mean values of 50-55&#37;&#44; which increases as required when prompted by effort&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">22&#44;23</span></a> In the soldiers&#44; no individual had an LVEF &#60;50&#37; on the baseline or final echocardiogram&#59; however&#44; 12 soldiers &#40;70&#37; of the population&#41; had an LVEF of 50-55&#37; on the final exam&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Both the soldiers and the basketball players had GLS values within normal limits&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">7</span></a> with a trend toward reduction after the exercise program&#46; This decrease was not significant when the two groups were analyzed separately&#46; However&#44; when they were compared&#44; GLS decreased significantly&#46; This behavior is consistent with that described in the literature&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">7</span></a> and may represent an exercise-induced physiological adaptation and another characteristic that distinguishes &#8216;athlete&#39;s heart&#8217; from heart disease&#44; particularly hypertrophic cardiomyopathy&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">24&#44;25</span></a> However&#44; the current scarcity of data in this area indicates a need for further studies designed to study the effect of physical exercise on this parameter&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Limitations</span><p id="par0235" class="elsevierStylePara elsevierViewall">The main limitation of this study is the small sample size for both special forces soldiers and athletes&#46; The heterogeneity of the populations with regard to gender and race also limits the results&#44; mainly because no female soldiers participated in the special forces course&#46; Another limitation is the inability to objectively quantify unscheduled physical exercise performed by the soldiers during the course&#46; These individuals are constantly involved in activities and assessments&#44; in which the physical component is central&#44; even when they are not performing conventional or scheduled exercise&#46; Finally&#44; although all of the participants strongly denied using stimulants&#44; the study protocol did not enable this denial to be confirmed&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Conclusion</span><p id="par0240" class="elsevierStylePara elsevierViewall">In this study&#44; anthropometric and cardiac remodeling occurred in both special forces soldiers and competitive basketball players following a military course or sports season&#46; This remodeling had different characteristics in the two groups&#44; being predominantly eccentric in the soldiers and concentric in the basketball players&#46; New echocardiographic techniques&#44; particularly myocardial strain analysis&#44; may reveal patterns that are compatible with physiological adaptation to exercise&#44; and may help to differentiate between &#8216;athlete&#39;s heart&#8217; and heart disease&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Conflicts of interest</span><p id="par0245" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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          "identificador" => "sec0045"
          "titulo" => "Results"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Population characteristics"
            ]
            1 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Changes in anthropometric data"
            ]
            2 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Electrocardiographic assessment"
            ]
            3 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Echocardiographic assessment"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Limitations"
        ]
        9 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Conclusion"
        ]
        10 => array:2 [
          "identificador" => "sec0085"
          "titulo" => "Conflicts of interest"
        ]
        11 => array:2 [
          "identificador" => "xack343874"
          "titulo" => "Acknowledgments"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2017-04-07"
    "fechaAceptado" => "2017-06-26"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec976624"
          "palabras" => array:3 [
            0 => "Physical exercise"
            1 => "Cardiac remodeling"
            2 => "Myocardial mechanics"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec976623"
          "palabras" => array:3 [
            0 => "Exerc&#237;cio f&#237;sico"
            1 => "Remodelagem card&#237;aca"
            2 => "Deforma&#231;&#227;o mioc&#225;rdica"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Exercise-induced cardiac remodeling is frequent in athletes&#46; This adaptation is structurally manifested by an increase in cardiac dimensions and mass&#46; Soldiers are also subject to intense physical exercise&#44; although with different characteristics&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To compare exercise-induced cardiac remodeling in competitive athletes and in soldiers on a special forces training course&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We studied 17 soldiers &#40;all male and Caucasian&#44; mean age 21&#177;3 years&#41; who completed a special forces course and 17 basketball players &#40;47&#46;3&#37; male&#44; 64&#46;7&#37; Caucasian&#44; mean age 21&#177;3 years&#41;&#46; Assessment included a transthoracic echocardiogram and analysis of myocardial mechanics&#46; This assessment was performed at the beginning and end of the military course and the sports season&#44; respectively&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cardiac remodeling was observed in both groups&#46; The soldiers presented a predominantly eccentric pattern&#44; with increased left ventricular &#40;LV&#41; size &#40;49&#46;7&#177;3&#46;2 vs&#46; 52&#46;8&#177;3&#46;4 mm&#59; p&#60;0&#46;01&#41;&#44; increased LV mass &#40;93&#46;1&#177;7&#46;7 vs&#46; 100&#46;2&#177;11&#46;4 g&#47;m<span class="elsevierStyleSup">2</span>&#59; p&#60;0&#46;01&#41; and decreased relative wall thickness &#40;0&#46;40&#177;0&#46;1 vs&#46; 0&#46;36&#177;0&#46;1&#59; p&#61;0&#46;05&#41;&#46; The basketball players showed a concentric pattern&#44; with decreased LV size &#40;52&#46;0&#177;4&#46;7 vs&#46; 50&#46;4&#177;4&#46;7 mm&#59; p&#61;0&#46;05&#41;&#44; and increased relative wall thickness &#40;0&#46;33&#177;0&#46;1 vs&#46; 0&#46;36&#177;0&#46;1&#59; p&#61;0&#46;05&#41;&#46; Although there was no significant difference in LV myocardial strain in the groups separately&#44; when compared there was a significant decrease &#40;-20&#46;2&#177;1&#46;6&#37; vs&#46; -19&#46;4&#177;2&#46;1&#37;&#59; p&#61;0&#46;03&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Cardiac remodeling was frequent&#44; with an eccentric pattern in soldiers and a concentric pattern in basketball players&#46; Myocardial deformation may represent a physiological adaptation to physical exercise&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objective"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introdu&#231;&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A remodelagem card&#237;aca induzida pelo exerc&#237;cio f&#237;sico &#233; frequente em atletas&#46; Esta adapta&#231;&#227;o manifesta-se a n&#237;vel estrutural com o aumento das dimens&#245;es e massa card&#237;acas&#46; Os militares tamb&#233;m s&#227;o sujeitos a exerc&#237;cio f&#237;sico intenso&#44; com especificidades distintas&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Comparar a remodelagem card&#237;aca induzida pelo exerc&#237;cio f&#237;sico em atletas de competi&#231;&#227;o e pelo treino militar em militares a frequentar um curso de for&#231;as especiais&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Metodologia</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Estud&#225;mos 17 militares &#40;g&#233;nero masculino e caucasianos&#44; idade m&#233;dia 21 &#177; 3 anos&#41; que ingressaram no curso de Comandos e 17 basquetebolistas &#40;47&#44;3&#37; do g&#233;nero masculino&#44; 64&#44;7&#37; caucasianos&#44; idade m&#233;dia 21 &#177; 3 anos&#41;&#46; A avalia&#231;&#227;o incluiu um ecocardiograma transtor&#225;cico com an&#225;lise da mec&#226;nica mioc&#225;rdica&#46; Esta avalia&#231;&#227;o foi realizada no in&#237;cio e no final do curso militar e da &#233;poca desportiva&#44; respetivamente&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A remodelagem card&#237;aca teve caracter&#237;sticas distintas&#58; os militares apresentaram um padr&#227;o predominantemente exc&#234;ntrico&#44; com aumento das dimens&#245;es do ventr&#237;culo esquerdo &#40;49&#44;7 &#177; 3&#44;2 <span class="elsevierStyleItalic">versus</span> 52&#44;8 &#177; 3&#44;4 mm&#59; p &#60; 0&#44;01&#41; e da massa &#40;93&#44;1 &#177; 7&#44;7 <span class="elsevierStyleItalic">versus</span> 100&#44;2 &#177; 11&#44;4 g&#47;m<span class="elsevierStyleSup">2</span>&#59; p &#60; 0&#44;01&#41; e diminui&#231;&#227;o da espessura relativa das paredes &#40;0&#44;40 &#177; 0&#44;1 <span class="elsevierStyleItalic">versus</span> 0&#44;36 &#177; 0&#44;1&#59; p &#61; 0&#44;05&#41;&#59; os basquetebolistas apresentaram um padr&#227;o conc&#234;ntrico&#44; com diminui&#231;&#227;o das dimens&#245;es do ventr&#237;culo esquerdo &#40;52&#44;0 &#177; 4&#44;7 <span class="elsevierStyleItalic">versus</span> 50&#44;4 &#177; 4&#44;7 mm&#59; p &#61; 0&#44;05&#41; e da espessura relativa das paredes &#40;0&#44;33 &#177; 0&#44;1 <span class="elsevierStyleItalic">versus</span> 0&#44;36 &#177; 0&#44;1&#59; p &#61; 0&#44;05&#41;&#46; Apesar da deforma&#231;&#227;o mioc&#225;rdica global do ventr&#237;culo esquerdo n&#227;o apresentar diferen&#231;as significativas entre os grupos&#44; quando analisados em conjunto o seu valor diminuiu &#40;-20&#44;2 &#177; 1&#44;6&#37; <span class="elsevierStyleItalic">versus</span> -19&#44;4 &#177; 2&#44;1&#37;&#59; p &#61; 0&#44;03&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclus&#227;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">A remodelagem card&#237;aca foi frequente&#44; com padr&#227;o exc&#234;ntrico nos militares e conc&#234;ntrico nos atletas&#46; A mec&#226;nica mioc&#225;rdica poder&#225; representar uma adapta&#231;&#227;o fisiol&#243;gica induzida pelo exerc&#237;cio f&#237;sico&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Introdu&#231;&#227;o"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Metodologia"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclus&#227;o"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Dinis P&#44; Teixeira R&#44; Dores H&#44; Correia P&#44; Lekedal H&#44; Bergman M&#44; et al&#46; Remodelagem card&#237;aca induzida pelo exerc&#237;cio f&#237;sico em atletas de n&#237;vel competitivo e militares de for&#231;as especiais&#46; Rev Port Cardiol&#46; 2018&#59;37&#58;249&#8211;256&#46;</p>"
      ]
    ]
    "nomenclatura" => array:1 [
      0 => array:3 [
        "identificador" => "nom0005"
        "titulo" => "<span class="elsevierStyleSectionTitle" id="sect0075">List of abbreviations</span>"
        "listaDefinicion" => array:1 [
          0 => array:1 [
            "definicion" => array:19 [
              0 => array:2 [
                "termino" => "BMI"
                "descripcion" => "<p id="par0005" class="elsevierStylePara elsevierViewall">body mass index</p>"
              ]
              1 => array:2 [
                "termino" => "BP"
                "descripcion" => "<p id="par0010" class="elsevierStylePara elsevierViewall">blood pressure</p>"
              ]
              2 => array:2 [
                "termino" => "DBP"
                "descripcion" => "<p id="par0015" class="elsevierStylePara elsevierViewall">diastolic blood pressure</p>"
              ]
              3 => array:2 [
                "termino" => "ECG"
                "descripcion" => "<p id="par0020" class="elsevierStylePara elsevierViewall">electrocardiogram</p>"
              ]
              4 => array:2 [
                "termino" => "FM"
                "descripcion" => "<p id="par0025" class="elsevierStylePara elsevierViewall">fat mass</p>"
              ]
              5 => array:2 [
                "termino" => "GLS"
                "descripcion" => "<p id="par0030" class="elsevierStylePara elsevierViewall">global longitudinal strain</p>"
              ]
              6 => array:2 [
                "termino" => "HR"
                "descripcion" => "<p id="par0035" class="elsevierStylePara elsevierViewall">heart rate</p>"
              ]
              7 => array:2 [
                "termino" => "IVS"
                "descripcion" => "<p id="par0040" class="elsevierStylePara elsevierViewall">interventricular septum</p>"
              ]
              8 => array:2 [
                "termino" => "LA"
                "descripcion" => "<p id="par0045" class="elsevierStylePara elsevierViewall">left atrial</p>"
              ]
              9 => array:2 [
                "termino" => "LV"
                "descripcion" => "<p id="par0050" class="elsevierStylePara elsevierViewall">left ventricular</p>"
              ]
              10 => array:2 [
                "termino" => "LVEDD"
                "descripcion" => "<p id="par0055" class="elsevierStylePara elsevierViewall">left ventricular end-diastolic diameter</p>"
              ]
              11 => array:2 [
                "termino" => "LVEF"
                "descripcion" => "<p id="par0060" class="elsevierStylePara elsevierViewall">left ventricular ejection fraction</p>"
              ]
              12 => array:2 [
                "termino" => "LVESD"
                "descripcion" => "<p id="par0065" class="elsevierStylePara elsevierViewall">left ventricular end-systolic diameter</p>"
              ]
              13 => array:2 [
                "termino" => "MM"
                "descripcion" => "<p id="par0070" class="elsevierStylePara elsevierViewall">muscle mass</p>"
              ]
              14 => array:2 [
                "termino" => "RWT"
                "descripcion" => "<p id="par0075" class="elsevierStylePara elsevierViewall">relative wall thickness</p>"
              ]
              15 => array:2 [
                "termino" => "SBP"
                "descripcion" => "<p id="par0080" class="elsevierStylePara elsevierViewall">systolic blood pressure</p>"
              ]
              16 => array:2 [
                "termino" => "TAPSE"
                "descripcion" => "<p id="par0085" class="elsevierStylePara elsevierViewall">tricuspid annular plane systolic excursion</p>"
              ]
              17 => array:2 [
                "termino" => "TTE"
                "descripcion" => "<p id="par0090" class="elsevierStylePara elsevierViewall">transthoracic echocardiography</p>"
              ]
              18 => array:2 [
                "termino" => "&#916;"
                "descripcion" => "<p id="par0095" class="elsevierStylePara elsevierViewall">difference</p>"
              ]
            ]
          ]
        ]
      ]
    ]
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        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "figura" => array:1 [
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            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Transthoracic echocardiographic images of a soldier following the special forces course&#44; showing no left ventricular &#40;LV&#41; wall thickening and LV end-diastolic diameter near the upper normal limit&#44; above-normal diastolic function parameters and normal global longitudinal strain &#40;GLS&#41; values&#59; &#40;B&#41; transthoracic echocardiographic images of a basketball player after the sports season&#44; with LV wall thickening near the upper normal limit and normal diastolic function parameters and GLS&#46;</p>"
        ]
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      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Percentage differences in changes in anthropometric data between the study groups&#46; DBP&#58; diastolic blood pressure&#59; FM&#58; fat mass&#59; MM&#58; muscle mass&#59; SBP&#58; systolic blood pressure&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Percentage differences in echocardiographic parameters between the study groups&#46; GLS&#58; global longitudinal strain&#59; IVS&#58; interventricular septum thickness&#59; LVEDD&#58; left ventricular end-diastolic diameter&#59; LVEF&#58; left ventricular ejection fraction&#59; LVMI&#58; left ventricular mass index&#59; RWT&#58; relative wall thickness&#46;</p>"
        ]
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        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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        "detalles" => array:1 [
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            "identificador" => "at1"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">BMI&#58; body mass index&#59; DBP&#58; diastolic blood pressure&#59; FM&#58; fat mass&#59; HR&#58; heart rate&#59; MM&#58; muscle mass&#59; SBP&#58; systolic blood pressure&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Soldiers &#40;n&#61;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Basketball players &#40;n&#61;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Demographic</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&#177;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&#177;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#47;17 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#47;17 &#40;47&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Caucasian &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#47;17 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#47;17 &#40;64&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Anthropometric</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BMI &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#46;3&#177;2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#46;1&#177;2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FM &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;1&#177;3&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#46;1&#177;12&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>MM &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#46;3&#177;2&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#46;0&#177;7&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>SBP &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">128&#177;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">131&#177;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DBP &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#177;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&#177;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>HR &#40;bpm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#177;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#177;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Sports history</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Years of competition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;4&#177;3&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;4&#177;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hours of training per day &#40;course&#47;season&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;0&#177;0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;9&#177;1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hours of sleep per day &#40;course&#47;season&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;5&#177;0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;4&#177;0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Number of meals per day &#40;course&#47;season&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;0&#177;1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;7&#177;1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">DBP&#58; diastolic blood pressure&#59; FM&#58; fat mass&#59; HR&#58; heart rate&#59; MM&#58; muscle mass&#59; SBP&#58; systolic blood pressure&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Soldiers &#40;n&#61;17&#41;</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Basketball players &#40;n&#61;17&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#46;2&#177;7&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77&#46;4&#177;6&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">MM &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;3&#177;2&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;4&#177;1&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;0&#177;7&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;6&#177;7&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">FM &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;1&#177;3&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;1&#177;3&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;1&#177;12&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;9&#177;11&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">SBP &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">128&#177;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">122&#177;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">132&#177;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">133&#177;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DBP &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#177;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#177;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#177;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74&#177;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HR &#40;bpm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#177;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#177;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#177;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#177;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">GLS&#58; global longitudinal strain&#59; IVS&#58; intraventricular septum thickness&#59; LA&#58; left atrial&#59; LVEDD&#58; left ventricular end-diastolic diameter&#59; LVEF&#58; left ventricular ejection fraction&#59; LVMI&#58; left ventricular mass index&#59; LVESD&#58; left ventricular end-systolic diameter&#59; PW&#58; posterior wall&#59; RWT&#58; relative wall thickness&#59; TAPSE&#58; tricuspid annular plane systolic excursion&#46;</p>"
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              "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"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Soldiers &#40;n&#61;17&#41;</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Basketball players &#40;n&#61;17&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Final&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;9&#177;1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;3&#177;1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;1&#177;1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PW &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;7&#177;0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;6&#177;0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;5&#177;1&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;2&#177;1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVMI &#40;g&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93&#46;1&#177;7&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;1&#177;2&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;6&#177;3&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;1&#177;3&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;47&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#46;2&#177;12&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;02&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;29&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#177;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;34&nbsp;\t\t\t\t\t\t\n
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