IJCS | Volume 31, Nº3, May/ June 2018

213 Table 2 - Anthropometric data Anthropometric data Military (n = 17) Initial Final p value Weight, kg 75.2 ± 7.8 77.4 ± 6.6 < 0.01* Lean mass, % 41.3 ± 2.1 44.4 ± 1.8 < 0.01* Fat mass, % 19.1 ± 3.3 13.1 ± 3.5 < 0.01* Systolic blood pressure, mmHg 128 ± 10 122 ± 7 < 0.01* Diastolic blood pressure, mmHg 73 ± 7 66 ± 5 < 0.01* Heart rate, bpm 62 (57-73) 60 (53-62) < 0.01 + *Paired Student's t-test; + Paired Wilcoxon test. Results Population description The sample characteristics, anthropometric data, the sports history and the different modalities practiced are shown in Table 1. The sample consisted of young Caucasian males, with a median age of 20 (20-24) years and body mass index (BMI) of 25.3 ± 2.7 kg/m 2 . Almost a fifth of the sample (20.6%) had at least one CVRF, with smoking being the most frequent (17.6%), followed by dyslipidemia (5.9%). None of the subjects included in the study had a family history of cardiovascular disease, hypertension or diabetesmellitus. Anthropometric data variations After the special operations course, the military had significant increase in body weight, with gain of LM and decrease in FM. There were also differences in relation to the blood pressure profile, with a decrease in mean SBP, DBP and HR (Table 2). Electrocardiographic evaluation All ECGs showed sinus rhythm and were considered normal or with only physiological alterations. The most prevalent physiological alteration was the early repolarization pattern (41.2%), followed by LV hypertrophy (29.4%), sinus bradycardia (17.6%) and incomplete right bundle branch block (17.6%). Echocardiographic evaluation The echocardiographic data are shown in Table 3. There was an increase, with statistical significance, in the left cavity dimensions, both in the LV diastolic diameter and in the LA volume, in addition to an increase in LV mass and a decrease in RWT. In the functional variables, there was reduction in the LVEF at rest and increase in the S’ wave. Although the GLS did not show any significant differences, there was a tendency to decrease its absolute value. Percentage differences between the beginning and end of the course The differences in remodeling observed between the beginning and end of the special operations course in relation to anthropometric and echocardiographic data are shown in Figure 2. It was observed an increase in weight (3.1 ± 3.3%, p < 0.01) and LM (7.7 ± 4.1%, p < 0.01) and a decrease in FM (-30 ± 15.7%, p < 0.01). The pressure profile was altered with a decrease in SBP (-4.8 ± 3.0%, p < 0.01) and DBP (-8.6 ± 7.4%, p < 0.01). Among the echocardiographic findings, there was an increase in LV mass (10.2 ± 10.8%, p < 0.01) and LVDD (6.4 ± 14.3%, p < 0.01) and LA volume (10.6 ± 21.1%, p = 0.02), and a decrease in RWP (-7.0 ± 14.3%, p = 0.05). Functionally, there was a decrease in LVEF (-11.0 ± 12.8%, p < 0.01) and an increase in S’ [13.3 (6.3-19.4)%; p < 0.01]. Discussion In the present study, carried out in athletes undergoing a challenging military training program in a special operations course, additional cardiac remodeling was observed, as well as structural, functional and anthropometric changes. Dinis et al. Cardiac Remodeling Induced by MilitaryTraining International Journal of Cardiovascular Sciences. 2018;31(3)209-217 Original Article