IJCS | Volume 31, Nº3, May/ June 2018

212 Figure 1 - Heart with left ventricular parietal thickness and dimension within limits considered to be normal, with supranormal values of diastolic function and normal global longitudinal strain. longitudinal strain (GLS). The images were acquired in apical four-, two- and three-chamber windows, with electrocardiographic monitoring. In the off-line mode, with dedicated software (EchoPAC 9.0, GE Healthcare ® , Horten, Norway), myocardial tracking and subsequent conversion to Lagrangian were performed using a semiautomatic endocardial edge detection program. This system allowed manual corrections to be performed to ensure the correct tracing between the cavity and the LV wall. Using the three apical windows of four, two and three chambers, the regional longitudinal strain mean was calculated, so that, subsequently, it was possible to calculate the GLS mean. The exam quality was considered good when up to two segments were excluded and excellent when all segments were analyzed. The following variables were calculated: ΔIVS, ΔLV mass, ΔRWT, ΔLVDD, ΔLA volume, ΔLVEF, ΔS’, Delta of the TricuspidAnnular Plane Systolic Excursion (ΔTAPSE) and ΔGLS. The calculation of each of these variables was performed by the formula [(final parameter – initial parameter)/initial parameter x 100]. Figure 1 depicts the TTE of a military after the special operations course. Statistical analysis The distribution of the continuous variables was verified by the Kolmogorov-Smirnov test. The homogeneity of the individual variables was evaluated by the Levene test. Variables with normal distribution were expressed as mean and standard deviation, and paired Student’s t-test with two-tailed analysis was used to compare groups. Variables with non-normal distribution were expressed as median and interquartile ranges, and the groups were compared using the paired Wilcoxon’s test. Categorical variables were shown as frequency and percentage, and chi-square test and Fisher’s test were used when appropriate. Ap value < 0.05was considered statistically significant, with a 95% confidence interval. The software Statistical Package for Social Science (SPSS), version 20 (SPSS ® Inc., Chicago, IL, USA) was used for the calculation and analysis of all data. Dinis et al. Cardiac Remodeling Induced by MilitaryTraining International Journal of Cardiovascular Sciences. 2018;31(3)209-217 Original Article