array:24 [
  "pii" => "S087025512200066X"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2021.03.014"
  "estado" => "S300"
  "fechaPublicacion" => "2022-06-01"
  "aid" => "1912"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2022"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Port Cardiol. 2022;41:455-61"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0870255122000725"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2022.02.005"
    "estado" => "S300"
    "fechaPublicacion" => "2022-06-01"
    "aid" => "1918"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "dis"
    "cita" => "Rev Port Cardiol. 2022;41:463-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
      "titulo" => "Myocardial performance index&#58; Is it time to revisit this old parameter in COVID-19 patients&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "463"
          "paginaFinal" => "464"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "&#205;ndice de Performance Mioc&#225;rdica&#58; Ser&#225; tempo de revisitar este par&#226;metro em doentes com COVID-19&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Teresa Tim&#243;teo"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Ana Teresa"
              "apellidos" => "Tim&#243;teo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255122000725?idApp=UINPBA00004E"
    "url" => "/08702551/0000004100000006/v3_202206160259/S0870255122000725/v3_202206160259/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0870255122000695"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2022.02.002"
    "estado" => "S300"
    "fechaPublicacion" => "2022-06-01"
    "aid" => "1915"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "dis"
    "cita" => "Rev Port Cardiol. 2022;41:453-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
      "titulo" => "Estimating the pre-test probability of coronary artery disease according to the ESC guidelines&#58; Are we getting there&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "453"
          "paginaFinal" => "454"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Probabilidade pr&#233;-teste de doen&#231;a coron&#225;ria obstrutiva&#58; o ajustar da mira&#33;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Nuno Bettencourt"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Nuno"
              "apellidos" => "Bettencourt"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255122000695?idApp=UINPBA00004E"
    "url" => "/08702551/0000004100000006/v3_202206160259/S0870255122000695/v3_202206160259/en/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Evaluation of myocardial performance index in patients with COVID-19&#58; An echocardiographic follow-up study"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "455"
        "paginaFinal" => "461"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Hakan Kaya, Ramazan Asoglu, Abdulmecit Afsin, Hakan Tibilli, Ercan Kurt, Safiye Kafadar, Umut Gulacti, Huseyin Kafadar"
        "autores" => array:8 [
          0 => array:4 [
            "nombre" => "Hakan"
            "apellidos" => "Kaya"
            "email" => array:1 [
              0 => "kardiyolog02@gmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Ramazan"
            "apellidos" => "Asoglu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Abdulmecit"
            "apellidos" => "Afsin"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Hakan"
            "apellidos" => "Tibilli"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Ercan"
            "apellidos" => "Kurt"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Safiye"
            "apellidos" => "Kafadar"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Umut"
            "apellidos" => "Gulacti"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Huseyin"
            "apellidos" => "Kafadar"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:6 [
          0 => array:3 [
            "entidad" => "Department of Cardiology&#44; Adiyaman Training and Research Hospital&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Cardiology&#44; Kahta State Hospital&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Department of Otorhinolaryngology&#44; Adiyaman Training and Research Hospital&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Department of Radiology&#44; Adiyaman Training and Research Hospital&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Department of Emergency&#44; Adiyaman Training and Research Hospital&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Department of Foresic Medicine&#44; Faculty of Medicine&#44; Adiyaman University&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Avalia&#231;&#227;o do &#237;ndice de performance mioc&#225;rdico em doentes com COVID-19&#58; um estudo de seguimento ecocardiogr&#225;fico"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1341
            "Ancho" => 1508
            "Tamanyo" => 266358
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Calculation of tissue Doppler-derived left ventricular myocardial performance index&#46; ET&#58; ejection time&#59; ICT&#58; isovolumic contraction time&#59; IRT&#58; isovolumic relaxation time&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Wuhan&#44; China&#44; became the center of an epidemic of &#8220;unknown pneumonia&#8221; detected in December 2019&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;2</span></a> Blood samples&#44; oral swabs&#44; bronchoalveolar lavage fluid&#44; and anal swabs collected from patients with severe pneumonia were analyzed&#46; This novel pathogen&#44; an enveloped RNA beta-coronavirus&#44; was named severe acute respiratory syndrome coronavirus 2 &#40;SARS-CoV-2&#41;&#44; and the disease caused by this virus was called coronavirus disease 2019 &#40;COVID-19&#41;&#46; The COVID-19 pandemic has emerged as a public health crisis of global proportions&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> COVID-19 typically presents with respiratory tract symptoms including fever&#44; dry cough&#44; and dyspnea&#46; The disease can progress to pneumonia and acute respiratory distress syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> The pathophysiology of COVID-19 infection is not clear&#46; However&#44; an extreme immune response and cytokine storm are thought to play pivotal roles in severe cases of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Our knowledge of the cardiovascular effects of COVID-19 is limited&#46; Studies have reported that left and right ventricular ejection fraction may be reduced by a cytokine-mediated systemic response to infection through increases in the end-diastolic and end-systolic volumes of both ventricles&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> However&#44; it is not known whether left ventricular &#40;LV&#41; systolic and diastolic dysfunction develops in patients with COVID-19&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Two-dimensional and Doppler echocardiography provide important information about LV diastolic and systolic function&#46; The myocardial performance index &#40;MPI&#41; is a reliable echocardiographic index that combines diastolic and systolic measurements&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> In this study&#44; we aimed to assess left ventricular systolic and diastolic function in COVID-19 patients using MPI&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study population</span><p id="par0020" class="elsevierStylePara elsevierViewall">The present study enrolled 40 healthy control subjects and 40 patients diagnosed with COVID-19 who had mild pneumonia &#40;hospitalized&#44; requiring supplemental oxygen but not needing intensive care&#44; invasive or non-invasive ventilation or high-flow oxygen devices&#41;&#46; Patients with atrioventricular conduction disturbances&#44; non-sinus rhythm on ECG&#44; ventricular extrasystoles&#44; valvular heart disease&#44; or a history of chronic heart failure&#44; chronic rheumatic heart disease&#44; atrial dysrhythmia&#44; permanent cardiac pacemaker&#44; or acute coronary syndrome&#44; were excluded from the study&#46; The clinical history and laboratory data of patients and results of reverse transcription-polymerase chain reaction &#40;RT-PCR&#41; of oropharyngeal swabs were assessed&#46; All patients had a positive RT-PCR result&#46; All patients with COVID-19 were treated with vitamin C&#44; hydroxychloroquine&#44; and&#47;or favipiravir&#46; All participants were recruited from our hospital&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">This study was conducted prospectively according to the principles of the Declaration of Helsinki and the study protocol was approved by the institutional medical ethics committee &#40;2020&#47;5-25&#41;&#46; Written informed consent was obtained from all participants&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Echocardiographic examination</span><p id="par0030" class="elsevierStylePara elsevierViewall">Transthoracic echocardiographic examinations were performed in all subjects using a Vivid 5S &#40;GE Healthcare Systems&#44; Horten&#44; Norway&#41; with a 2&#46;0-3&#46;5 MHz transducer&#46; The exam was performed at the acute stage of infection and after clinical recovery in patients with COVID-19&#46; The recovery echocardiography exam was performed on patients who were still hospitalized but had recovered both symptomatically and according to laboratory findings&#46; The mean time between baseline and recovery echocardiography exams was 28&#177;3&#46;4 days&#46; Doppler and two-dimensional echocardiography were performed in standard views according to the guidelines of the American Society of Echocardiography&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a> The modified Simpson&#39;s method was used to calculate left ventricular ejection fraction &#40;LVEF&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> Apical 4-chamber views were obtained by positioning the sample volume between the tips of the mitral leaflets for pulsed wave Doppler recordings of mitral inflow velocities&#46; Peak late &#40;A&#41; and early &#40;E&#41; transmitral filling velocities and the E&#47;A ratio were measured as conventional Doppler indices&#46; Isovolumic relaxation time &#40;IRT&#41; was defined as the time between closure of the aortic valve and opening of the mitral valve&#46; Isovolumic contraction time &#40;ICT&#41; was defined as the time between closure of the mitral valve and opening of the aortic valve&#46; Ejection time &#40;ET&#41; was defined as the time between aortic valve opening and closure on the LV outflow velocity profile&#46; Pulsed wave tissue Doppler imaging was performed in apical 4-chamber view with a sample volume of 2 mm placed on the medial wall of the mitral annulus&#46; High-frequency signals were excluded by adjusting filter settings&#46; Doppler ultrasound scanning intervals were measured from the mitral annular velocity intervals&#46; MPI was calculated using the equation&#58; MPI&#61;&#40;ICT&#43;IRT&#41;&#47;ET&#44; where IRT is isovolumic relaxation time&#44; ICT is isovolumic contraction time&#44; and ET is ejection time&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> Tissue Doppler measurements were obtained from a mean of five consecutive cardiac cycles&#46; The calculation of tissue Doppler-derived MPI is presented in <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Laboratory parameters</span><p id="par0035" class="elsevierStylePara elsevierViewall">Blood samples were studied on day 0 for controls and patients in the acute period of infection and on days 7&#44; 14&#44; and 28 for RT-PCR testing and other laboratory parameters in patients with COVID-19&#46; An immunofluorescence assay was used to obtain COVID-19 antibody titers and respiratory secretions were sent for RT-PCR testing&#46; Cardiac troponin I &#40;cTnI&#41; was studied with Immulate &#40;DPC&#44; Bio&#41; from blood samples&#46; Lactate dehydrogenase &#40;LDH&#41;&#44; creatinine kinase &#40;CK&#41;&#44; and creatinine levels were analyzed using an Architect c8000 Chemistry analyzer &#40;Abbott Diagnostics&#44; Abbott Park&#44; IL&#44; USA&#41; with commercial kits &#40;Abbott Diagnostics&#41;&#46; Hemoglobin and complete white blood cell counts &#40;WBC&#41;&#44; including neutrophil and lymphocyte counts&#44; were determined using an automated CELL-DYN Ruby Hematology Analyzer &#40;Abbott Diagnostics&#41; and expressed as &#215;10<span class="elsevierStyleSup">3</span> cells&#47;mm<span class="elsevierStyleSup">3</span>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">IBM SPSS v&#46; 22&#46;0 &#40;Chicago&#44; IL&#44; USA&#41; was used for the analyses&#46; Categorical variables are presented as numbers and percentages&#44; and were compared with the chi-square test&#46; Continuous variables were tested for normality of distribution with the Kolmogorov-Smirnov test&#46; Continuous variables are presented as mean &#177; standard deviation&#46; An independent t test or Mann-Whitney U test was used to compare variables between controls and patients in the acute infection period&#46; Similarly&#44; an independent t test or Mann-Whitney U test was used to compare variables between the acute infection period and after clinical recovery&#44; as appropriate&#46; The acute period of infection and clinical recovery values were compared using the paired t test if the data were normally distributed&#46; A p-value below 0&#46;05 was considered statistically significant&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">This study enrolled 40 consecutive patients &#40;26 males &#40;65&#37;&#41;&#59; mean age&#44; 54&#177;11 years&#41; and 40 healthy control subjects &#40;24 males &#40;60&#37;&#41;&#59; mean age&#44; 52&#177;13 years&#41;&#46; The patients were admitted to the hospital with fever &#62;38<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; cough&#44; sore throat&#44; rhinorrhea&#44; shortness of breath&#44; headache&#44; myalgia&#44; and&#47;or diarrhea&#46; The PCR test was positive in all patients&#46; The mean interval between the first echocardiogram and symptom onset was 9&#46;3&#177;5&#46;5 days&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Clinical characteristics including age&#44; gender&#44; smoking status&#44; hypertension&#44; diabetes&#44; systolic blood pressure&#44; diastolic blood pressure&#44; and heart rate were similar between patients and controls &#40;p&#62;0&#46;05 for all&#41;&#46; Compared with controls&#44; COVID-19 patients had a significantly higher MPI &#40;0&#46;56&#177;0&#46;09 vs&#46; 0&#46;41&#177;0&#46;06&#44; p&#60;0&#46;001&#41;&#44; longer IRT &#40;112&#46;3&#177;13&#46;4 vs&#46; 90&#46;6&#177;11&#46;2 ms&#44; p&#60;0&#46;001&#41;&#44; longer deceleration time &#40;182&#46;1&#177;30&#46;6 vs&#46; 160&#46;8&#177;42&#46;7 ms&#44; p&#61;0&#46;003&#41;&#44; shorter ET &#40;279&#46;6&#177;20&#46;3 vs&#46; 299&#46;6&#177;34&#46;7 ms&#44; p&#60;0&#46;001&#41; and higher E&#47;A ratio &#40;1&#46;53&#177;0&#46;7 vs&#46; 1&#46;21&#177;0&#46;3&#44; p&#60;0&#46;001&#41;&#46; LVEF was similar in COVID-19 patients and controls &#40;60&#46;3&#177;3&#46;2&#37; vs&#46; 61&#46;9&#177;4&#46;8&#37;&#44; p&#62;0&#46;05&#41;&#44; as was ICT &#40;44&#46;3&#177;7&#46;8 vs&#46; 41&#46;8&#177;8&#46;7 ms&#44; p&#62;0&#46;05&#41;&#46; Compared with controls&#44; patients in the acute infection period had significantly higher cTnI &#40;0&#46;96&#177;0&#46;12 vs&#46; 0&#46;10&#177;0&#46;01 ng&#47;ml&#44; p&#60;0&#46;001&#41;&#44; LDH &#40;486&#46;8&#177;118&#46;6 vs&#46; 316&#46;4&#177;108&#46;9 IU&#47;l&#44; p&#61;0&#46;002&#41;&#44; WBC &#40;12&#46;3&#177;4&#46;7 vs&#46; 7&#46;0&#177;2&#46;6 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41; and neutrophil count &#40;9&#46;7&#177;6&#46;2 vs&#46; 4&#46;2&#177;1&#46;5 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41;&#44; and lower lymphocyte count &#40;0&#46;9&#177;0&#46;2 vs&#46; 2&#46;8&#177;0&#46;6 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41;&#46; Creatinine&#44; CK and hemoglobin levels were similar in patients and controls &#40;p&#62;0&#46;05 for all&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the clinical characteristics&#44; laboratory and echocardiographic findings of patients in the acute period of COVID-19 infection and controls&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Systolic and diastolic blood pressure and heart rate were similar between the acute period of infection and after clinical recovery &#40;p&#62;0&#46;05 for all&#41;&#46; Compared with the acute infection period&#44; after clinical recovery there was significantly lower MPI &#40;0&#46;44&#177;0&#46;07 vs&#46; 0&#46;56&#177;0&#46;09&#44; p&#60;0&#46;001&#41;&#44; shorter IRT &#40;91&#46;8&#177;12&#46;1 vs&#46; 112&#46;3&#177;13&#46;4 ms&#44; p&#60;0&#46;001&#41;&#44; shorter deceleration time &#40;161&#46;5&#177;43&#46;5 vs&#46; 182&#46;1&#177;30&#46;6 ms&#44; p&#61;0&#46;003&#41;&#44; longer ET &#40;298&#46;8&#177;36&#46;8 vs&#46; 279&#46;6&#177;20&#46;3 ms&#44; p&#60;0&#46;001&#41; and lower E&#47;A ratio &#40;1&#46;22&#177;0&#46;6 vs&#46; 1&#46;53&#177;0&#46;7&#44; p&#60;0&#46;001&#41;&#46; LVEF was similar in the acute period of infection and after clinical recovery &#40;60&#46;3&#177;3&#46;2&#37; vs&#46; 60&#46;7&#177;3&#46;8&#37;&#44; p&#62;0&#46;05&#41;&#44; as was ICT &#40;44&#46;3&#177;7&#46;8 vs&#46; 40&#46;6&#177;9&#46;7ms&#44; p&#62;0&#46;05&#41;&#46; Compared with the acute period of COVID-19 infection&#44; after clinical recovery there was significantly lower cTnI &#40;0&#46;11&#177;0&#46;08 vs&#46; 0&#46;96&#177;0&#46;12 ng&#47;ml&#44; p&#60;0&#46;001&#41;&#44; LDH &#40;334&#46;5&#177;110&#46;9 vs&#46; 486&#46;8&#177;118&#46;6 IU&#47;l&#44; p&#61;0&#46;004&#41;&#44; WBC &#40;7&#46;2&#177;3&#46;1 vs&#46; 12&#46;3&#177;4&#46;7 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41; and neutrophil count &#40;4&#46;5&#177;1&#46;8 vs&#46; 9&#46;7&#177;6&#46;2 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41; and higher lymphocyte count &#40;2&#46;1&#177;0&#46;4 vs&#46; 0&#46;9&#177;0&#46;2 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41;&#46; Creatinine&#44; CK and hemoglobin levels were similar between the acute period of infection and after clinical recovery &#40;p&#62;0&#46;05 for all&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the clinical characteristics&#44; laboratory and echocardiographic findings of patients in the acute period of COVID-19 infection and after clinical recovery&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">This is the first echocardiographic follow-up study to assess left ventricular systolic and diastolic function in COVID-19 patients&#46; Our data showed that LV performance was impaired subclinically during the acute period of COVID-19 and that this impaired performance recovered with clinical improvement&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Since the first case was reported at the end of 2019&#44; the COVID-19 outbreak has become a pandemic&#46; The high transmission ratio of the virus has made it a threat to public health globally&#46; Coronaviruses are non-segmented positive-sense RNA viruses that are broadly distributed in humans and other mammals&#44; such as camels&#44; bats&#44; mice&#44; dogs&#44; and cats&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> Coronaviruses can cause respiratory&#44; enteric&#44; cardiovascular&#44; and neurological disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11&#8211;14</span></a> A 2020 report by the China Medical Treatment Expert Group for COVID-19 showed the spectrum of clinical and diagnostic features associated with SARS-CoV-2 infection among Chinese patients&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> According to this report&#44; the most common symptoms in patients with COVID-19 were fever &#40;in 88&#46;7&#37; of patients during hospitalization&#41; and cough &#40;in 67&#46;8&#37; of patients&#41;&#44; as well as headache&#44; fatigue&#44; or shortness of breath&#46; In our study&#44; in agreement with previous data&#44; fever was present in 84&#46;2&#37; of the patients on admission&#46; The second most common symptom was cough &#40;60&#46;4&#37; of patients&#41;&#46; The overall mortality rate is 2&#46;3&#37; and those with pre-existing comorbid conditions have higher case mortality rates&#58; diabetes 7&#46;3&#37;&#44; chronic respiratory disease 6&#46;3&#37;&#44; hypertension 6&#46;0&#37; cardiovascular disease 10&#46;5&#37;&#44; and cancer 5&#46;6&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">We assessed left ventricular diastolic and systolic function using several echocardiographic parameters&#46; Although systolic and diastolic dysfunction appear together&#44; there are few Doppler echocardiographic variables that combine systolic and diastolic measurements&#46; We used the MPI&#44; which includes the LV systolic contraction and diastolic relaxation periods&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> This index was first used by Tei et al&#46; to predict LV systolic and diastolic function noninvasively&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> MPI is not significantly affected by preload&#44; afterload&#44; sample volume location&#44; age&#44; or rhythm<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">18&#44;19</span></a> and is therefore a reliable index&#46; The value of MPI in LV dysfunction has been confirmed in patients with symptomatic heart failure of non-ischemic or ischemic etiology and idiopathic dilated cardiomyopathy&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17&#44;18</span></a> We aimed to assess LV systolic and diastolic function in COVID-19 patients using MPI&#46; In the present study&#44; MPI was higher in the acute disease period in patients with COVID-19&#44; but regressed significantly after clinical recovery&#46; Previous reports showed that systolic function is affected in COVID-19 patients&#46; However&#44; there is limited information about LV diastolic function in these patients&#46; Our study showed that not only systolic but also diastolic function may be impaired in COVID-19 patients&#46; In other words&#44; COVID-19 patients may develop subclinical diastolic impairment without systolic involvement&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The pathophysiological and cardiovascular effects of COVID-19 are not clear&#46; However&#44; the disease is thought to be associated with an excessive immune response triggered by the virus&#46; Studies have found that COVID-19 patients have high levels of interleukin &#40;IL&#41;-1 beta&#44; IL-6&#44; interferon gamma&#44; and monocyte chemoattractant protein-1&#44; which probably leads to an activated type 1 helper T cell response&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> Studies of coronavirus and influenza outbreaks suggest that viral infections can trigger a systemic inflammatory response that causes acute coronary syndromes&#44; arrhythmias&#44; and heart failure&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">20&#8211;23</span></a> Similarly&#44; underlying cardiovascular disease may be exacerbated or new cardiac disease may be induced during COVID-19&#46; Acute coronary events may be due to increased myocardial demand triggered by infections that accelerate myocardial damage or infarction&#46; Alternatively&#44; circulating cytokines released during severe systemic inflammatory stress may cause instability and rupture of atherosclerotic plaque&#46; Patients with heart failure are also prone to hemodynamic decompensation during the stress of severe infections&#46; During most influenza outbreaks&#44; more patients die of cardiovascular causes than from pneumonia&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> COVID-19 causes myocardial inflammation and myocarditis&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">25&#44;26</span></a> The elevated cTnI in our patients might reflect myocardial damage&#46; cTnI is part of the contractile apparatus in cardiomyocytes and is expressed only in the heart&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">27-29</span></a> As a result of its organ specificity&#44; cTnI can be used to diagnose cardiomyocyte damage&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">28&#44;29</span></a> The elevated LDH observed may reflect tissue damage and inflammation&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">We assumed that the temporary impairment in echocardiographic parameters in the acute phase was caused by proinflammatory mediators&#44; such as tumor necrosis factor &#40;TNF&#41; and the IL-1 and -6 families of cytokines&#44; which have significant negative inotropic effects&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> Myocardial function may also be impaired through direct COVID-19 infection of myocytes&#44; leading to active myocarditis&#46; Reported data on the severity&#44; extent&#44; and short- and long-term cardiovascular effects of COVID-19 are limited&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Our study has some limitations&#44; the main one of which is its small sample size&#46; Another limitation is that circulating levels of cytokines such as IL-1&#44; IL-6&#44; and TNF could not be measured&#46; In addition&#44; the lack of clarity concerning the effects of hydroxychloroquine and favipiravir on cardiac function are also limitations of the study&#46; Further studies that measure the circulating levels of these cytokines and echocardiographic variables are needed based on the current hypothesis of cytokine-mediated temporary impairment of left ventricular performance&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In conclusion&#44; subclinical diastolic impairment without systolic involvement may be observed in patients with COVID-19&#46; This could be due to isolated subclinical diastolic dysfunction&#46; The underlying mechanism and its clinical significance can be established by further studies&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Funding</span><p id="par0095" class="elsevierStylePara elsevierViewall">This study received no grant funding from any agency in the public&#44; commercial or not-for-profit sectors&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1733208"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction and Objectives"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1529470"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1733207"
          "titulo" => "Resumo"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introduc&#227;o e objetivos"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclus&#227;o"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1529471"
          "titulo" => "Palavras-chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Study population"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Echocardiographic examination"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Laboratory parameters"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Funding"
        ]
        9 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2021-01-26"
    "fechaAceptado" => "2021-03-16"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1529470"
          "palabras" => array:3 [
            0 => "COVID-19"
            1 => "Echocardiography"
            2 => "Myocardial performance index"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec1529471"
          "palabras" => array:3 [
            0 => "COVID-19"
            1 => "Ecocardiografia"
            2 => "&#205;ndice de performance mioc&#225;rdico"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Myocardial performance may be impaired in cytokine-mediated immune reactions&#46; The myocardial performance index &#40;MPI&#41; is a practical parameter that reflects systolic and diastolic cardiac function&#46; We aimed to assess the MPI in patients with COVID-19&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The study population consisted of 40 healthy controls and 40 patients diagnosed with COVID-19 who had mild pneumonia and did not need intensive care treatment&#46; All participants underwent echocardiographic examination&#46; First&#44; the MPI and laboratory parameters were compared between healthy controls and patients in the acute period of infection&#46; Second&#44; the MPI and laboratory parameters were compared between the acute infection period and after clinical recovery&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Compared with healthy controls&#44; patients with COVID-19 had a significantly higher MPI &#40;0&#46;56&#177;0&#46;09 vs&#46; 0&#46;41&#177;0&#46;06&#44; p&#60;0&#46;001&#41;&#44; longer isovolumic relaxation time &#40;IRT&#41; &#40;112&#46;3&#177;13&#46;4 vs&#46; 90&#46;6&#177;11&#46;2 ms&#44; p&#60;0&#46;001&#41;&#44; longer deceleration time &#40;DT&#41; &#40;182&#46;1&#177;30&#46;6 vs&#46; 160&#46;8&#177;42&#46;7 ms&#44; p&#61;0&#46;003&#41;&#44; shorter ejection time &#40;ET&#41; &#40;279&#46;6&#177;20&#46;3 vs&#46; 299&#46;6&#177;34&#46;7 ms&#44; p&#60;0&#46;001&#41; and higher E&#47;A ratio &#40;1&#46;53&#177;0&#46;7 vs&#46; 1&#46;21&#177;0&#46;3&#44; p&#60;0&#46;001&#41;&#46; Statistically significantly higher MPI &#40;0&#46;56&#177;0&#46;09 vs&#46; 0&#46;44&#177;0&#46;07&#44; p&#60;0&#46;001&#41;&#44; longer IRT &#40;112&#46;3&#177;13&#46;4 vs&#46; 91&#46;8&#177;12&#46;1 ms&#44; p&#60;0&#46;001&#41;&#44; longer DT &#40;182&#46;1&#177;30&#46;6 vs&#46; 161&#46;5&#177;43&#46;5 ms&#44; p&#61;0&#46;003&#41;&#44; shorter ET 279&#46;6&#177;20&#46;3 vs&#46; 298&#46;8&#177;36&#46;8 ms&#44; p&#60;0&#46;001&#41; and higher E&#47;A ratio &#40;1&#46;53&#177;0&#46;7 vs&#46; 1&#46;22&#177;0&#46;4&#44; p&#60;0&#46;001&#41; were observed during the acute infection period than after clinical recovery&#46; Left ventricular ejection fraction was similar in the controls&#44; during the acute infection period and after clinical recovery&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Subclinical diastolic impairment without systolic involvement may be observed in patients with COVID-19&#46; This impairment may be reversible on clinical recovery&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction and Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduc&#227;o e objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">O desempenho mioc&#225;rdico pode ser prejudicado em rea&#231;&#245;es imunes mediadas por citocinas&#46; O &#237;ndice de performance mioc&#225;rdico &#40;IPM&#41; &#233; um par&#226;metro que reflete a fun&#231;&#227;o card&#237;aca sist&#243;lica e diast&#243;lica&#46; O nosso objetivo foi avaliar o IPM em doentes com COVID-19&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">O presente estudo consistiu em analisar 40 casos controlo saud&#225;veis e 40 doentes com diagn&#243;stico de COVID-19 que apresentavam pneumonia ligeira e n&#227;o necessitavam de tratamento intensivo&#46; Todos os participantes foram submetidos a avalia&#231;&#227;o ecocardiogr&#225;fica&#46; Primeiro&#44; o IPM e os par&#226;metros laboratoriais foram comparados entre os casos controlo saud&#225;veis e os doentes com per&#237;odo agudo de infe&#231;&#227;o&#46; Em segundo lugar&#44; o IPM e os par&#226;metros laboratoriais foram comparados entre o per&#237;odo agudo de infe&#231;&#227;o e ap&#243;s a recupera&#231;&#227;o cl&#237;nica&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Em compara&#231;&#227;o com os casos controlo saud&#225;veis&#44; os doentes com COVID-19 tiveram um IPM significativamente maior &#40;0&#44;56&#177;0&#44;09 <span class="elsevierStyleItalic">versus</span> 0&#44;41&#177;0&#44;06&#44; p&#60;0&#44;001&#41;&#44; tempo de relaxamento isovolum&#233;trico &#40;TRI&#41; mais longo &#40;112&#44;3&#177;13&#44;4 <span class="elsevierStyleItalic">versus</span> 90&#44;6&#177;11&#44; 2 ms&#44; p&#60;0&#44;001&#41;&#44; tempo de desacelera&#231;&#227;o maior &#40;TD&#41; &#40;182&#44;1&#177;30&#44;6 <span class="elsevierStyleItalic">versus</span> 160&#44;8&#177;42&#44; 7 ms&#44; p&#61;0&#44;003&#41;&#44; tempo de eje&#231;&#227;o &#40;TE&#41; menor &#40;279&#44;6&#177;20&#44;3 <span class="elsevierStyleItalic">versus</span> 299&#44;6&#177;34&#44; 7 ms&#44; p&#60;0&#44;001&#41; e raz&#227;o E&#47;A maior &#40;1&#44;53&#177;0&#44;7 <span class="elsevierStyleItalic">versus</span> 1&#44;21&#177;0&#44;3&#44; p&#60;0&#44;001&#41;&#46; Um IPM superior estatisticamente significativo &#40;0&#44;56&#177;0&#44;09 <span class="elsevierStyleItalic">versus</span> 0&#44;44&#177;0&#44;07&#44; p&#60;0&#44;001&#41;&#44; um TRI mais longo &#40;112&#44;3&#177;13&#44;4 <span class="elsevierStyleItalic">versus</span> 91&#44;8&#177;12&#44; 1 ms&#44; p&#60;0&#44;001&#41;&#44; um TD mais longo &#40;182&#44;1&#177;30&#44;6 <span class="elsevierStyleItalic">versus</span> 161&#44;5&#177;43&#44;5 ms&#44; p&#61;0&#44;003&#41;&#44; um TE mais curto &#40;279&#44;6&#177;20&#44;3 <span class="elsevierStyleItalic">versus</span> 298&#44;8&#177;36&#44;8 ms&#44; p&#60;0&#44;001&#41; e raz&#227;o E&#47;A mais elevada &#40;1&#44;53&#177;0&#44;7 <span class="elsevierStyleItalic">versus</span> 1&#44;22&#177;0&#44;4&#44; p&#60;0&#44;001&#41; foram observados durante o per&#237;odo agudo de infe&#231;&#227;o em compara&#231;&#227;o com aqueles ap&#243;s a recupera&#231;&#227;o cl&#237;nica&#46; A fra&#231;&#227;o de eje&#231;&#227;o do ventr&#237;culo esquerdo foi semelhante nos casos controlo saud&#225;veis&#44; per&#237;odo agudo de infe&#231;&#227;o e ap&#243;s a recupera&#231;&#227;o cl&#237;nica&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A disfun&#231;ao diast&#243;lica subcl&#237;nica sem difun&#231;&#227;o sist&#243;lica pode ser observada em doentes com COVID-19&#46; Esta defici&#234;ncia pode ser revers&#237;vel na recupera&#231;&#227;o cl&#237;nica&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introduc&#227;o e objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#227;o"
          ]
        ]
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1341
            "Ancho" => 1508
            "Tamanyo" => 266358
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Calculation of tissue Doppler-derived left ventricular myocardial performance index&#46; ET&#58; ejection time&#59; ICT&#58; isovolumic contraction time&#59; IRT&#58; isovolumic relaxation time&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">BP&#58; blood pressure&#59; CK&#58; creatinine kinase&#59; cTnI&#58; cardiac troponin I&#59; DT&#58; deceleration time&#59; E&#47;A&#58;transmitral early to late peak velocity ratio&#59; ET&#58; ejection time&#59; ICT&#58; isovolumic contraction time&#59; IRT&#58; isovolumic relaxation time&#59; Hb&#58; hemoglobin&#59; LDH&#58; lactate dehydrogenase&#59; LVEF&#58; left ventricular ejection fraction&#59; MPI&#58; myocardial performance index&#59; NS&#58; not significant&#59; WBC&#58; white blood cell count&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "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="\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" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">COVID-19 patients &#40;n&#61;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">Control group &#40;n&#61;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#44; years&nbsp;\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">54&#177;11&nbsp;\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">52&#177;13&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gender&#44; male&#44; n &#40;&#37;&#41;&nbsp;\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">26 &#40;65&#41;&nbsp;\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">24 &#40;60&#41;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Smoking&#44; n &#40;&#37;&#41;&nbsp;\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">12 &#40;30&#41;&nbsp;\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">10 &#40;25&#41;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hypertension&#44; n &#40;&#37;&#41;&nbsp;\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">8 &#40;20&#41;&nbsp;\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">6 &#40;15&#41;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&#44; n &#40;&#37;&#41;&nbsp;\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">6 &#40;15&#41;&nbsp;\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">4 &#40;10&#41;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Systolic BP&#44; mmHg&nbsp;\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">124&#46;6&#177;8&#46;2&nbsp;\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">123&#46;6&#177;6&#46;8&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diastolic BP&#44; mmHg&nbsp;\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">73&#46;6&#177; 6&#46;0&nbsp;\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">72&#46;5&#177;4&#46;6&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heart rate&#44; beats&#47;min&nbsp;\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">75&#46;4&#177;12&nbsp;\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">73&#46;6&#177; 16&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LVEF&#44; &#37;&nbsp;\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">60&#46;3&#177; 3&#46;2&nbsp;\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">61&#46;9&#177;4&#46;8&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MPI&nbsp;\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&#46;56&#177;0&#46;09&nbsp;\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&#46;41&#177;0&#46;06&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IRT&#44; ms&nbsp;\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">112&#46;3&#177;13&#46;4&nbsp;\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">90&#46;6&#177;11&#46;2&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ICT&#44; ms&nbsp;\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">44&#46;3&#177;7&#46;8&nbsp;\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">41&#46;8&#177;8&#46;7&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">E&#47;A&nbsp;\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">1&#46;53&#177;0&#46;7&nbsp;\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">1&#46;21&#177;0&#46;3&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ET&#44; ms&nbsp;\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">279&#46;6&#177;20&#46;3&nbsp;\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">299&#46;6&#177;34&#46;7&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DT&#44; ms&nbsp;\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">182&#46;1&#177;30&#46;6&nbsp;\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">160&#46;8&#177;42&#46;7&nbsp;\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&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hb&#44; g&#47;dl&nbsp;\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">13&#46;2&#177;1&#46;6&nbsp;\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">13&#46;8&#177;1&#46;7&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CK&#44; IU&#47;l&nbsp;\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">216&#46;3&#177;125&#46;4&nbsp;\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">198&#46;2&#177;113&#46;6&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LDH&#44; IU&#47;l&nbsp;\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">486&#46;8&#177;118&#46;6&nbsp;\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">316&#46;4&#177;108&#46;9&nbsp;\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&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">cTnI&#44; ng&#47;ml&nbsp;\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&#46;96&#177;0&#46;12&nbsp;\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&#46;10&#177;0&#46;01&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinine&#44; mg&#47;dl&nbsp;\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">1&#46;2&#177;0&#46;6&nbsp;\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">1&#46;0&#177;0&#46;7&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">WBC&#44; 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&nbsp;\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">12&#46;3&#177;4&#46;7&nbsp;\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">7&#46;0&#177;2&#46;6&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neutrophil count&#44; 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&nbsp;\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">9&#46;7&#177;6&#46;2&nbsp;\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">4&#46;2&#177;1&#46;5&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lymphocyte count&#44; 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&nbsp;\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&#46;9&#177;0&#46;2&nbsp;\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">2&#46;8&#177;0&#46;6&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Clinical characteristics and laboratory and echocardiographic findings of the groups&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">BP&#58; blood pressure&#59; CK&#58; creatinine kinase&#59; cTnI&#58; cardiac troponin I&#59; DT&#58; deceleration time&#59; E&#47;A&#58;transmitral early to late peak velocity ratio&#59; ET&#58; ejection time&#59; Hb&#58; hemoglobin&#59; ICT&#58; isovolumic contraction time&#59; IRT&#58; isovolumic relaxation time&#59; LDH&#58; lactate dehydrogenase&#59; LVEF&#58; left ventricular ejection fraction&#59; MPI&#58; myocardial performance index&#59; NS&#58; not significant&#59; WBC&#58; white blood cell count&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "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="\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" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">Acute period of infection &#40;n&#61;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">After clinical recovery &#40;n&#61;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Systolic BP&#44; mmHg&nbsp;\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">124&#46;6&#177;8&#46;2&nbsp;\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">126&#46;5&#177;7&#46;1&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diastolic BP&#44; mmHg&nbsp;\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">73&#46;6&#177;6&#46;0&nbsp;\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">74&#46;7&#177;4&#46;2&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heart rate&#44; beats&#47;min&nbsp;\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">75&#46;4&#177;12&nbsp;\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">72&#46;8&#177;14&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LVEF&#44; &#37;&nbsp;\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">60&#46;3&#177;3&#46;2&nbsp;\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">60&#46;7&#177;3&#46;8&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MPI&nbsp;\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&#46;56&#177;0&#46;09&nbsp;\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&#46;44&#177;0&#46;07&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IRT&#44; ms&nbsp;\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">112&#46;3&#177;13&#46;4&nbsp;\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">91&#46;8&#177;12&#46;1&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ICT&#44; ms&nbsp;\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">44&#46;3&#177;7&#46;8&nbsp;\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">40&#46;6&#177;9&#46;7&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">E&#47;A&nbsp;\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">1&#46;53&#177;0&#46;7&nbsp;\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">1&#46;22&#177;0&#46;6&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ET&#44; ms&nbsp;\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">279&#46;6&#177;20&#46;3&nbsp;\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">298&#46;8&#177;36&#46;8&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DT&#44; ms&nbsp;\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">182&#46;1&#177;30&#46;6&nbsp;\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">161&#46;5&#177;43&#46;5&nbsp;\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&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hb&#44; g&#47;dl&nbsp;\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">13&#46;2&#177;1&#46;6&nbsp;\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">13&#46;4&#177;1&#46;8&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CK&#44; IU&#47;l&nbsp;\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">216&#46;3&#177;125&#46;4&nbsp;\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">195&#46;7&#177;115&#46;2&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LDH&#44; IU&#47;l&nbsp;\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">486&#46;8&#177;118&#46;6&nbsp;\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">334&#46;5&#177;110&#46;9&nbsp;\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&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">cTnI&#44; ng&#47;ml&nbsp;\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&#46;96&#177;0&#46;12&nbsp;\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&#46;11&#177;0&#46;08&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinine&#44; mg&#47;dl&nbsp;\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">1&#46;2&#177;0&#46;6&nbsp;\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">1&#46;1&#177;0&#46;4&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">WBC&#44; 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&nbsp;\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">12&#46;3&#177;4&#46;7&nbsp;\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">7&#46;2&#177;3&#46;1&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neutrophil count&#44; 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&nbsp;\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">9&#46;7&#177;6&#46;2&nbsp;\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">4&#46;5&#177;1&#46;8&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lymphocyte count&#44; 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&nbsp;\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&#46;9&#177;0&#46;2&nbsp;\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">2&#46;1&#177;0&#46;4&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Clinical characteristics and laboratory and echocardiographic findings&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:30 [
            0 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A novel coronavirus outbreak of global health concern"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Wang"
                            1 => "P&#46;W&#46; Horby"
                            2 => "F&#46;G&#46; Hayden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(20)30185-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2020"
                        "volumen" => "395"
                        "paginaInicial" => "470"
                        "paginaFinal" => "473"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31986257"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Genomic characterisation and epidemiology of 2019 novel coronavirus&#58; implications for virus origins and receptor binding"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Lu"
                            1 => "X&#46; Zhao"
                            2 => "J&#46; Li"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2020"
                        "volumen" => "395"
                        "paginaInicial" => "565"
                        "paginaFinal" => "574"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A novel coronavirus associated with severe acute respiratory syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46;G&#46; Ksiazek"
                            1 => "D&#46; Erdman"
                            2 => "C&#46;S&#46; Goldsmith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2003"
                        "volumen" => "348"
                        "paginaInicial" => "1953"
                        "paginaFinal" => "1966"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical features of patients infected with 2019 novel coronavirus in Wuhan&#44; China"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Huang"
                            1 => "Y&#46; Wang"
                            2 => "X&#46; Li"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(20)30183-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2020"
                        "volumen" => "395"
                        "paginaInicial" => "497"
                        "paginaFinal" => "506"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31986264"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathogenetic mechanisms of septic shock"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;E&#46; Parrillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1993"
                        "volumen" => "328"
                        "paginaInicial" => "1471"
                        "paginaFinal" => "1477"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "New non-invasive index for combined systolic and diastolic ventricular function"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46; Tei"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cardiol"
                        "fecha" => "1995"
                        "volumen" => "26"
                        "paginaInicial" => "135"
                        "paginaFinal" => "136"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7674144"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations for the evaluation of left ventricular diastolic function by echocardiography&#58; an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;F&#46; Nagueh"
                            1 => "O&#46;A&#46; Smiseth"
                            2 => "C&#46;P&#46; Appleton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "2016"
                        "volumen" => "29"
                        "paginaInicial" => "277"
                        "paginaFinal" => "314"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations for cardiac chamber quantification by echocardiography in adults&#58; an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;M&#46; Lang"
                            1 => "L&#46;P&#46; Badano"
                            2 => "V&#46; Mor-Avi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.echo.2014.10.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "2015"
                        "volumen" => "28"
                        "paginaInicial" => "1"
                        "paginaFinal" => "39"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25559473"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninvasive Doppler derived myocardial performance index&#58; correlation with simultaneous measurements of cardiac catheterization measurements"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Tei"
                            1 => "R&#46;A&#46; Nishimura"
                            2 => "J&#46;B&#46; Seward"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0894-7317(97)70090-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "1997"
                        "volumen" => "10"
                        "paginaInicial" => "169"
                        "paginaFinal" => "178"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9083973"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology&#44; genetic recombination&#44; and pathogenesis of coronaviruses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Su"
                            1 => "G&#46; Wong"
                            2 => "W&#46; Shi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.tim.2016.03.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Trends Microbiol"
                        "fecha" => "2016"
                        "volumen" => "24"
                        "paginaInicial" => "490"
                        "paginaFinal" => "502"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27012512"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MERS SARS and other coronaviruses as causes of pneumonia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Y&#46; Yin"
                            1 => "R&#46;G&#46; Wunderink"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/resp.13196"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respirology"
                        "fecha" => "2018"
                        "volumen" => "23"
                        "paginaInicial" => "130"
                        "paginaFinal" => "137"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29052924"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification of a novel coronavirus in patients with severe acute respiratory syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Drosten"
                            1 => "S&#46; G&#252;nther"
                            2 => "W&#46; Preiser"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa030747"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2003"
                        "volumen" => "348"
                        "paginaInicial" => "1967"
                        "paginaFinal" => "1976"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12690091"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Zaki"
                            1 => "S&#46; van Boheemen"
                            2 => "T&#46;M&#46; Bestebroer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2012"
                        "volumen" => "367"
                        "paginaInicial" => "1814"
                        "paginaFinal" => "1820"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coronavirus pathogenesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;R&#46; Weiss"
                            1 => "J&#46;L&#46; Leibowitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/B978-0-12-385885-6.00009-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Adv Virus Res"
                        "fecha" => "2011"
                        "volumen" => "81"
                        "paginaInicial" => "85"
                        "paginaFinal" => "164"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22094080"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics of coronavirus disease 2019 in China"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "China Medical Treatment Expert Group for COVID-19"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "W&#46;J&#46; Guan"
                            1 => "Z&#46;Y&#46; Ni"
                            2 => "Y&#46; Hu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa2002032"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2020"
                        "volumen" => "382"
                        "paginaInicial" => "1708"
                        "paginaFinal" => "1720"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32109013"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics of and important lessons from the coronavirus disease 2019 outbreak in China&#58; summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Z&#46; Wu"
                            1 => "J&#46;M&#46; McGoogan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2020.2648"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2020"
                        "volumen" => "323"
                        "paginaInicial" => "1239"
                        "paginaFinal" => "1242"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32091533"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognostic value of a Doppler index combining systolic and diastolic performance in idiopathic-dilated cardiomyopathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "K&#46;S&#46; Dujardin"
                            1 => "C&#46; Tei"
                            2 => "T&#46;C&#46; Yeo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0002-9149(98)00559-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "1998"
                        "volumen" => "82"
                        "paginaInicial" => "1071"
                        "paginaFinal" => "1076"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9817484"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Tei index&#58; a new prognostic index for patients with symptomatic heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "K&#46;J&#46; Harjai"
                            1 => "L&#46; Scott"
                            2 => "K&#46; Vivekananthan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mje.2002.120892"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "2002"
                        "volumen" => "15"
                        "paginaInicial" => "864"
                        "paginaFinal" => "868"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12221401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influenza epidemics and acute respiratory disease activity are associated with a surge in autopsy-confirmed coronary heart disease death&#58; results from 8 years of autopsies in 34&#44;892 subjects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Madjid"
                            1 => "C&#46;C&#46; Miller"
                            2 => "V&#46;V&#46; Zarubaev"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehm035"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2007"
                        "volumen" => "28"
                        "paginaInicial" => "1205"
                        "paginaFinal" => "1210"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17440221"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute myocardial infarction after laboratory-confirmed influenza infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;C&#46; Kwong"
                            1 => "K&#46;L&#46; Schwartz"
                            2 => "M&#46;A&#46; Campitelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2018"
                        "volumen" => "378"
                        "paginaInicial" => "345"
                        "paginaFinal" => "353"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of high influenza activity on risk of ventricular arrhythmias requiring therapy in patients with implantable cardiac defibrillators and cardiac resynchronization therapy defibrillators"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Madjid"
                            1 => "A&#46;T&#46; Connolly"
                            2 => "Y&#46; Nabutovsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2019.04.011"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2019"
                        "volumen" => "124"
                        "paginaInicial" => "44"
                        "paginaFinal" => "50"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31047651"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of influenza-like illness activity with hospitalizations for heart failure&#58; the Atherosclerosis Risk in Communities Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Kyt&#246;maa"
                            1 => "S&#46; Hegde"
                            2 => "B&#46; Claggett"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamacardio.2019.0549"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Cardiol"
                        "fecha" => "2019"
                        "volumen" => "4"
                        "paginaInicial" => "363"
                        "paginaFinal" => "369"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30916717"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Of birds and men&#58; cardiologists&#8217; role in influenza pandemics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Madjid"
                            1 => "S&#46;W&#46; Casscells"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2004"
                        "volumen" => "364"
                        "paginaInicial" => "1309"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute myocarditis presenting as a reverse Tako-Tsubo syndrome in a patient with SARS-CoV-2 respiratory infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Sala"
                            1 => "G&#46; Peretto"
                            2 => "M&#46; Gramegna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehaa286"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2020"
                        "volumen" => "41"
                        "paginaInicial" => "1861"
                        "paginaFinal" => "1862"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32267502"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Does SARS-CoV-2 cause viral myocarditis in COVID-19 patients&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46; Zhou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehaa392"
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2020"
                        "volumen" => "41"
                        "paginaInicial" => "2123"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32363381"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan&#44; China"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Shi"
                            1 => "M&#46; Qin"
                            2 => "B&#46; Shen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamacardio.2020.0950"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Cardiol"
                        "fecha" => "2020"
                        "volumen" => "5"
                        "paginaInicial" => "802"
                        "paginaFinal" => "810"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32211816"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early diagnosis of myocardial infarction with sensitive cardiac troponin assays"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; Reichlin"
                            1 => "W&#46; Hochholzer"
                            2 => "S&#46; Bassetti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2009"
                        "volumen" => "361"
                        "paginaInicial" => "858"
                        "paginaFinal" => "867"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serial changes in highly sensitive troponin I assay and early diagnosis of myocardial infarction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; Keller"
                            1 => "T&#46; Zeller"
                            2 => "F&#46; Ojeda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2011.1896"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2011"
                        "volumen" => "306"
                        "paginaInicial" => "2684"
                        "paginaFinal" => "2693"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22203537"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A major outbreak of SARS in Hong Kong"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Lee"
                            1 => "D&#46; Hui"
                            2 => "A&#46; Wu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa030685"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2003"
                        "volumen" => "348"
                        "paginaInicial" => "1986"
                        "paginaFinal" => "1994"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12682352"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inflammatory mediators and the failing heart&#58; past&#44; present and the foreseeable future"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;L&#46; Mann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.res.0000043825.01705.1b"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ Res"
                        "fecha" => "2002"
                        "volumen" => "91"
                        "paginaInicial" => "988"
                        "paginaFinal" => "998"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12456484"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/08702551/0000004100000006/v3_202206160259/S087025512200066X/v3_202206160259/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "92834"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08702551/0000004100000006/v3_202206160259/S087025512200066X/v3_202206160259/en/main.pdf?idApp=UINPBA00004E&text.app=https://www.revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025512200066X?idApp=UINPBA00004E"
]
Partilhar
Informação da revista

Estatísticas

Siga este link para acessar o texto completo do artigo

Original Article
Evaluation of myocardial performance index in patients with COVID-19: An echocardiographic follow-up study
Avaliação do índice de performance miocárdico em doentes com COVID-19: um estudo de seguimento ecocardiográfico
Hakan Kayaa,
Autor para correspondência
kardiyolog02@gmail.com

Corresponding author.
, Ramazan Asoglua, Abdulmecit Afsinb, Hakan Tibillib, Ercan Kurtc, Safiye Kafadard, Umut Gulactie, Huseyin Kafadarf
a Department of Cardiology, Adiyaman Training and Research Hospital, Adiyaman, Turkey
b Department of Cardiology, Kahta State Hospital, Adiyaman, Turkey
c Department of Otorhinolaryngology, Adiyaman Training and Research Hospital, Adiyaman, Turkey
d Department of Radiology, Adiyaman Training and Research Hospital, Adiyaman, Turkey
e Department of Emergency, Adiyaman Training and Research Hospital, Adiyaman, Turkey
f Department of Foresic Medicine, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
Lido
6635
Vezes
que se leu este artigo
1853
Total PDF
4782
Total HTML
Compartilhar estatísticas
 array:24 [
  "pii" => "S087025512200066X"
  "issn" => "08702551"
  "doi" => "10.1016/j.repc.2021.03.014"
  "estado" => "S300"
  "fechaPublicacion" => "2022-06-01"
  "aid" => "1912"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2022"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Port Cardiol. 2022;41:455-61"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0870255122000725"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2022.02.005"
    "estado" => "S300"
    "fechaPublicacion" => "2022-06-01"
    "aid" => "1918"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "dis"
    "cita" => "Rev Port Cardiol. 2022;41:463-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
      "titulo" => "Myocardial performance index&#58; Is it time to revisit this old parameter in COVID-19 patients&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "463"
          "paginaFinal" => "464"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "&#205;ndice de Performance Mioc&#225;rdica&#58; Ser&#225; tempo de revisitar este par&#226;metro em doentes com COVID-19&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Teresa Tim&#243;teo"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Ana Teresa"
              "apellidos" => "Tim&#243;teo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255122000725?idApp=UINPBA00004E"
    "url" => "/08702551/0000004100000006/v3_202206160259/S0870255122000725/v3_202206160259/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0870255122000695"
    "issn" => "08702551"
    "doi" => "10.1016/j.repc.2022.02.002"
    "estado" => "S300"
    "fechaPublicacion" => "2022-06-01"
    "aid" => "1915"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "dis"
    "cita" => "Rev Port Cardiol. 2022;41:453-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
      "titulo" => "Estimating the pre-test probability of coronary artery disease according to the ESC guidelines&#58; Are we getting there&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "453"
          "paginaFinal" => "454"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Probabilidade pr&#233;-teste de doen&#231;a coron&#225;ria obstrutiva&#58; o ajustar da mira&#33;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Nuno Bettencourt"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Nuno"
              "apellidos" => "Bettencourt"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255122000695?idApp=UINPBA00004E"
    "url" => "/08702551/0000004100000006/v3_202206160259/S0870255122000695/v3_202206160259/en/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Evaluation of myocardial performance index in patients with COVID-19&#58; An echocardiographic follow-up study"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "455"
        "paginaFinal" => "461"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Hakan Kaya, Ramazan Asoglu, Abdulmecit Afsin, Hakan Tibilli, Ercan Kurt, Safiye Kafadar, Umut Gulacti, Huseyin Kafadar"
        "autores" => array:8 [
          0 => array:4 [
            "nombre" => "Hakan"
            "apellidos" => "Kaya"
            "email" => array:1 [
              0 => "kardiyolog02@gmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Ramazan"
            "apellidos" => "Asoglu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Abdulmecit"
            "apellidos" => "Afsin"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Hakan"
            "apellidos" => "Tibilli"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Ercan"
            "apellidos" => "Kurt"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Safiye"
            "apellidos" => "Kafadar"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Umut"
            "apellidos" => "Gulacti"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Huseyin"
            "apellidos" => "Kafadar"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:6 [
          0 => array:3 [
            "entidad" => "Department of Cardiology&#44; Adiyaman Training and Research Hospital&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Cardiology&#44; Kahta State Hospital&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Department of Otorhinolaryngology&#44; Adiyaman Training and Research Hospital&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Department of Radiology&#44; Adiyaman Training and Research Hospital&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Department of Emergency&#44; Adiyaman Training and Research Hospital&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Department of Foresic Medicine&#44; Faculty of Medicine&#44; Adiyaman University&#44; Adiyaman&#44; Turkey"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Avalia&#231;&#227;o do &#237;ndice de performance mioc&#225;rdico em doentes com COVID-19&#58; um estudo de seguimento ecocardiogr&#225;fico"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1341
            "Ancho" => 1508
            "Tamanyo" => 266358
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Calculation of tissue Doppler-derived left ventricular myocardial performance index&#46; ET&#58; ejection time&#59; ICT&#58; isovolumic contraction time&#59; IRT&#58; isovolumic relaxation time&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Wuhan&#44; China&#44; became the center of an epidemic of &#8220;unknown pneumonia&#8221; detected in December 2019&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;2</span></a> Blood samples&#44; oral swabs&#44; bronchoalveolar lavage fluid&#44; and anal swabs collected from patients with severe pneumonia were analyzed&#46; This novel pathogen&#44; an enveloped RNA beta-coronavirus&#44; was named severe acute respiratory syndrome coronavirus 2 &#40;SARS-CoV-2&#41;&#44; and the disease caused by this virus was called coronavirus disease 2019 &#40;COVID-19&#41;&#46; The COVID-19 pandemic has emerged as a public health crisis of global proportions&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> COVID-19 typically presents with respiratory tract symptoms including fever&#44; dry cough&#44; and dyspnea&#46; The disease can progress to pneumonia and acute respiratory distress syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> The pathophysiology of COVID-19 infection is not clear&#46; However&#44; an extreme immune response and cytokine storm are thought to play pivotal roles in severe cases of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Our knowledge of the cardiovascular effects of COVID-19 is limited&#46; Studies have reported that left and right ventricular ejection fraction may be reduced by a cytokine-mediated systemic response to infection through increases in the end-diastolic and end-systolic volumes of both ventricles&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> However&#44; it is not known whether left ventricular &#40;LV&#41; systolic and diastolic dysfunction develops in patients with COVID-19&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Two-dimensional and Doppler echocardiography provide important information about LV diastolic and systolic function&#46; The myocardial performance index &#40;MPI&#41; is a reliable echocardiographic index that combines diastolic and systolic measurements&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> In this study&#44; we aimed to assess left ventricular systolic and diastolic function in COVID-19 patients using MPI&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study population</span><p id="par0020" class="elsevierStylePara elsevierViewall">The present study enrolled 40 healthy control subjects and 40 patients diagnosed with COVID-19 who had mild pneumonia &#40;hospitalized&#44; requiring supplemental oxygen but not needing intensive care&#44; invasive or non-invasive ventilation or high-flow oxygen devices&#41;&#46; Patients with atrioventricular conduction disturbances&#44; non-sinus rhythm on ECG&#44; ventricular extrasystoles&#44; valvular heart disease&#44; or a history of chronic heart failure&#44; chronic rheumatic heart disease&#44; atrial dysrhythmia&#44; permanent cardiac pacemaker&#44; or acute coronary syndrome&#44; were excluded from the study&#46; The clinical history and laboratory data of patients and results of reverse transcription-polymerase chain reaction &#40;RT-PCR&#41; of oropharyngeal swabs were assessed&#46; All patients had a positive RT-PCR result&#46; All patients with COVID-19 were treated with vitamin C&#44; hydroxychloroquine&#44; and&#47;or favipiravir&#46; All participants were recruited from our hospital&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">This study was conducted prospectively according to the principles of the Declaration of Helsinki and the study protocol was approved by the institutional medical ethics committee &#40;2020&#47;5-25&#41;&#46; Written informed consent was obtained from all participants&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Echocardiographic examination</span><p id="par0030" class="elsevierStylePara elsevierViewall">Transthoracic echocardiographic examinations were performed in all subjects using a Vivid 5S &#40;GE Healthcare Systems&#44; Horten&#44; Norway&#41; with a 2&#46;0-3&#46;5 MHz transducer&#46; The exam was performed at the acute stage of infection and after clinical recovery in patients with COVID-19&#46; The recovery echocardiography exam was performed on patients who were still hospitalized but had recovered both symptomatically and according to laboratory findings&#46; The mean time between baseline and recovery echocardiography exams was 28&#177;3&#46;4 days&#46; Doppler and two-dimensional echocardiography were performed in standard views according to the guidelines of the American Society of Echocardiography&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a> The modified Simpson&#39;s method was used to calculate left ventricular ejection fraction &#40;LVEF&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> Apical 4-chamber views were obtained by positioning the sample volume between the tips of the mitral leaflets for pulsed wave Doppler recordings of mitral inflow velocities&#46; Peak late &#40;A&#41; and early &#40;E&#41; transmitral filling velocities and the E&#47;A ratio were measured as conventional Doppler indices&#46; Isovolumic relaxation time &#40;IRT&#41; was defined as the time between closure of the aortic valve and opening of the mitral valve&#46; Isovolumic contraction time &#40;ICT&#41; was defined as the time between closure of the mitral valve and opening of the aortic valve&#46; Ejection time &#40;ET&#41; was defined as the time between aortic valve opening and closure on the LV outflow velocity profile&#46; Pulsed wave tissue Doppler imaging was performed in apical 4-chamber view with a sample volume of 2 mm placed on the medial wall of the mitral annulus&#46; High-frequency signals were excluded by adjusting filter settings&#46; Doppler ultrasound scanning intervals were measured from the mitral annular velocity intervals&#46; MPI was calculated using the equation&#58; MPI&#61;&#40;ICT&#43;IRT&#41;&#47;ET&#44; where IRT is isovolumic relaxation time&#44; ICT is isovolumic contraction time&#44; and ET is ejection time&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> Tissue Doppler measurements were obtained from a mean of five consecutive cardiac cycles&#46; The calculation of tissue Doppler-derived MPI is presented in <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Laboratory parameters</span><p id="par0035" class="elsevierStylePara elsevierViewall">Blood samples were studied on day 0 for controls and patients in the acute period of infection and on days 7&#44; 14&#44; and 28 for RT-PCR testing and other laboratory parameters in patients with COVID-19&#46; An immunofluorescence assay was used to obtain COVID-19 antibody titers and respiratory secretions were sent for RT-PCR testing&#46; Cardiac troponin I &#40;cTnI&#41; was studied with Immulate &#40;DPC&#44; Bio&#41; from blood samples&#46; Lactate dehydrogenase &#40;LDH&#41;&#44; creatinine kinase &#40;CK&#41;&#44; and creatinine levels were analyzed using an Architect c8000 Chemistry analyzer &#40;Abbott Diagnostics&#44; Abbott Park&#44; IL&#44; USA&#41; with commercial kits &#40;Abbott Diagnostics&#41;&#46; Hemoglobin and complete white blood cell counts &#40;WBC&#41;&#44; including neutrophil and lymphocyte counts&#44; were determined using an automated CELL-DYN Ruby Hematology Analyzer &#40;Abbott Diagnostics&#41; and expressed as &#215;10<span class="elsevierStyleSup">3</span> cells&#47;mm<span class="elsevierStyleSup">3</span>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">IBM SPSS v&#46; 22&#46;0 &#40;Chicago&#44; IL&#44; USA&#41; was used for the analyses&#46; Categorical variables are presented as numbers and percentages&#44; and were compared with the chi-square test&#46; Continuous variables were tested for normality of distribution with the Kolmogorov-Smirnov test&#46; Continuous variables are presented as mean &#177; standard deviation&#46; An independent t test or Mann-Whitney U test was used to compare variables between controls and patients in the acute infection period&#46; Similarly&#44; an independent t test or Mann-Whitney U test was used to compare variables between the acute infection period and after clinical recovery&#44; as appropriate&#46; The acute period of infection and clinical recovery values were compared using the paired t test if the data were normally distributed&#46; A p-value below 0&#46;05 was considered statistically significant&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">This study enrolled 40 consecutive patients &#40;26 males &#40;65&#37;&#41;&#59; mean age&#44; 54&#177;11 years&#41; and 40 healthy control subjects &#40;24 males &#40;60&#37;&#41;&#59; mean age&#44; 52&#177;13 years&#41;&#46; The patients were admitted to the hospital with fever &#62;38<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; cough&#44; sore throat&#44; rhinorrhea&#44; shortness of breath&#44; headache&#44; myalgia&#44; and&#47;or diarrhea&#46; The PCR test was positive in all patients&#46; The mean interval between the first echocardiogram and symptom onset was 9&#46;3&#177;5&#46;5 days&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Clinical characteristics including age&#44; gender&#44; smoking status&#44; hypertension&#44; diabetes&#44; systolic blood pressure&#44; diastolic blood pressure&#44; and heart rate were similar between patients and controls &#40;p&#62;0&#46;05 for all&#41;&#46; Compared with controls&#44; COVID-19 patients had a significantly higher MPI &#40;0&#46;56&#177;0&#46;09 vs&#46; 0&#46;41&#177;0&#46;06&#44; p&#60;0&#46;001&#41;&#44; longer IRT &#40;112&#46;3&#177;13&#46;4 vs&#46; 90&#46;6&#177;11&#46;2 ms&#44; p&#60;0&#46;001&#41;&#44; longer deceleration time &#40;182&#46;1&#177;30&#46;6 vs&#46; 160&#46;8&#177;42&#46;7 ms&#44; p&#61;0&#46;003&#41;&#44; shorter ET &#40;279&#46;6&#177;20&#46;3 vs&#46; 299&#46;6&#177;34&#46;7 ms&#44; p&#60;0&#46;001&#41; and higher E&#47;A ratio &#40;1&#46;53&#177;0&#46;7 vs&#46; 1&#46;21&#177;0&#46;3&#44; p&#60;0&#46;001&#41;&#46; LVEF was similar in COVID-19 patients and controls &#40;60&#46;3&#177;3&#46;2&#37; vs&#46; 61&#46;9&#177;4&#46;8&#37;&#44; p&#62;0&#46;05&#41;&#44; as was ICT &#40;44&#46;3&#177;7&#46;8 vs&#46; 41&#46;8&#177;8&#46;7 ms&#44; p&#62;0&#46;05&#41;&#46; Compared with controls&#44; patients in the acute infection period had significantly higher cTnI &#40;0&#46;96&#177;0&#46;12 vs&#46; 0&#46;10&#177;0&#46;01 ng&#47;ml&#44; p&#60;0&#46;001&#41;&#44; LDH &#40;486&#46;8&#177;118&#46;6 vs&#46; 316&#46;4&#177;108&#46;9 IU&#47;l&#44; p&#61;0&#46;002&#41;&#44; WBC &#40;12&#46;3&#177;4&#46;7 vs&#46; 7&#46;0&#177;2&#46;6 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41; and neutrophil count &#40;9&#46;7&#177;6&#46;2 vs&#46; 4&#46;2&#177;1&#46;5 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41;&#44; and lower lymphocyte count &#40;0&#46;9&#177;0&#46;2 vs&#46; 2&#46;8&#177;0&#46;6 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41;&#46; Creatinine&#44; CK and hemoglobin levels were similar in patients and controls &#40;p&#62;0&#46;05 for all&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the clinical characteristics&#44; laboratory and echocardiographic findings of patients in the acute period of COVID-19 infection and controls&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Systolic and diastolic blood pressure and heart rate were similar between the acute period of infection and after clinical recovery &#40;p&#62;0&#46;05 for all&#41;&#46; Compared with the acute infection period&#44; after clinical recovery there was significantly lower MPI &#40;0&#46;44&#177;0&#46;07 vs&#46; 0&#46;56&#177;0&#46;09&#44; p&#60;0&#46;001&#41;&#44; shorter IRT &#40;91&#46;8&#177;12&#46;1 vs&#46; 112&#46;3&#177;13&#46;4 ms&#44; p&#60;0&#46;001&#41;&#44; shorter deceleration time &#40;161&#46;5&#177;43&#46;5 vs&#46; 182&#46;1&#177;30&#46;6 ms&#44; p&#61;0&#46;003&#41;&#44; longer ET &#40;298&#46;8&#177;36&#46;8 vs&#46; 279&#46;6&#177;20&#46;3 ms&#44; p&#60;0&#46;001&#41; and lower E&#47;A ratio &#40;1&#46;22&#177;0&#46;6 vs&#46; 1&#46;53&#177;0&#46;7&#44; p&#60;0&#46;001&#41;&#46; LVEF was similar in the acute period of infection and after clinical recovery &#40;60&#46;3&#177;3&#46;2&#37; vs&#46; 60&#46;7&#177;3&#46;8&#37;&#44; p&#62;0&#46;05&#41;&#44; as was ICT &#40;44&#46;3&#177;7&#46;8 vs&#46; 40&#46;6&#177;9&#46;7ms&#44; p&#62;0&#46;05&#41;&#46; Compared with the acute period of COVID-19 infection&#44; after clinical recovery there was significantly lower cTnI &#40;0&#46;11&#177;0&#46;08 vs&#46; 0&#46;96&#177;0&#46;12 ng&#47;ml&#44; p&#60;0&#46;001&#41;&#44; LDH &#40;334&#46;5&#177;110&#46;9 vs&#46; 486&#46;8&#177;118&#46;6 IU&#47;l&#44; p&#61;0&#46;004&#41;&#44; WBC &#40;7&#46;2&#177;3&#46;1 vs&#46; 12&#46;3&#177;4&#46;7 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41; and neutrophil count &#40;4&#46;5&#177;1&#46;8 vs&#46; 9&#46;7&#177;6&#46;2 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41; and higher lymphocyte count &#40;2&#46;1&#177;0&#46;4 vs&#46; 0&#46;9&#177;0&#46;2 10<span class="elsevierStyleSup">3</span>&#47;&#956;l&#44; p&#60;0&#46;001&#41;&#46; Creatinine&#44; CK and hemoglobin levels were similar between the acute period of infection and after clinical recovery &#40;p&#62;0&#46;05 for all&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the clinical characteristics&#44; laboratory and echocardiographic findings of patients in the acute period of COVID-19 infection and after clinical recovery&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">This is the first echocardiographic follow-up study to assess left ventricular systolic and diastolic function in COVID-19 patients&#46; Our data showed that LV performance was impaired subclinically during the acute period of COVID-19 and that this impaired performance recovered with clinical improvement&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Since the first case was reported at the end of 2019&#44; the COVID-19 outbreak has become a pandemic&#46; The high transmission ratio of the virus has made it a threat to public health globally&#46; Coronaviruses are non-segmented positive-sense RNA viruses that are broadly distributed in humans and other mammals&#44; such as camels&#44; bats&#44; mice&#44; dogs&#44; and cats&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> Coronaviruses can cause respiratory&#44; enteric&#44; cardiovascular&#44; and neurological disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11&#8211;14</span></a> A 2020 report by the China Medical Treatment Expert Group for COVID-19 showed the spectrum of clinical and diagnostic features associated with SARS-CoV-2 infection among Chinese patients&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> According to this report&#44; the most common symptoms in patients with COVID-19 were fever &#40;in 88&#46;7&#37; of patients during hospitalization&#41; and cough &#40;in 67&#46;8&#37; of patients&#41;&#44; as well as headache&#44; fatigue&#44; or shortness of breath&#46; In our study&#44; in agreement with previous data&#44; fever was present in 84&#46;2&#37; of the patients on admission&#46; The second most common symptom was cough &#40;60&#46;4&#37; of patients&#41;&#46; The overall mortality rate is 2&#46;3&#37; and those with pre-existing comorbid conditions have higher case mortality rates&#58; diabetes 7&#46;3&#37;&#44; chronic respiratory disease 6&#46;3&#37;&#44; hypertension 6&#46;0&#37; cardiovascular disease 10&#46;5&#37;&#44; and cancer 5&#46;6&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">We assessed left ventricular diastolic and systolic function using several echocardiographic parameters&#46; Although systolic and diastolic dysfunction appear together&#44; there are few Doppler echocardiographic variables that combine systolic and diastolic measurements&#46; We used the MPI&#44; which includes the LV systolic contraction and diastolic relaxation periods&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> This index was first used by Tei et al&#46; to predict LV systolic and diastolic function noninvasively&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> MPI is not significantly affected by preload&#44; afterload&#44; sample volume location&#44; age&#44; or rhythm<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">18&#44;19</span></a> and is therefore a reliable index&#46; The value of MPI in LV dysfunction has been confirmed in patients with symptomatic heart failure of non-ischemic or ischemic etiology and idiopathic dilated cardiomyopathy&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17&#44;18</span></a> We aimed to assess LV systolic and diastolic function in COVID-19 patients using MPI&#46; In the present study&#44; MPI was higher in the acute disease period in patients with COVID-19&#44; but regressed significantly after clinical recovery&#46; Previous reports showed that systolic function is affected in COVID-19 patients&#46; However&#44; there is limited information about LV diastolic function in these patients&#46; Our study showed that not only systolic but also diastolic function may be impaired in COVID-19 patients&#46; In other words&#44; COVID-19 patients may develop subclinical diastolic impairment without systolic involvement&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The pathophysiological and cardiovascular effects of COVID-19 are not clear&#46; However&#44; the disease is thought to be associated with an excessive immune response triggered by the virus&#46; Studies have found that COVID-19 patients have high levels of interleukin &#40;IL&#41;-1 beta&#44; IL-6&#44; interferon gamma&#44; and monocyte chemoattractant protein-1&#44; which probably leads to an activated type 1 helper T cell response&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> Studies of coronavirus and influenza outbreaks suggest that viral infections can trigger a systemic inflammatory response that causes acute coronary syndromes&#44; arrhythmias&#44; and heart failure&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">20&#8211;23</span></a> Similarly&#44; underlying cardiovascular disease may be exacerbated or new cardiac disease may be induced during COVID-19&#46; Acute coronary events may be due to increased myocardial demand triggered by infections that accelerate myocardial damage or infarction&#46; Alternatively&#44; circulating cytokines released during severe systemic inflammatory stress may cause instability and rupture of atherosclerotic plaque&#46; Patients with heart failure are also prone to hemodynamic decompensation during the stress of severe infections&#46; During most influenza outbreaks&#44; more patients die of cardiovascular causes than from pneumonia&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> COVID-19 causes myocardial inflammation and myocarditis&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">25&#44;26</span></a> The elevated cTnI in our patients might reflect myocardial damage&#46; cTnI is part of the contractile apparatus in cardiomyocytes and is expressed only in the heart&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">27-29</span></a> As a result of its organ specificity&#44; cTnI can be used to diagnose cardiomyocyte damage&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">28&#44;29</span></a> The elevated LDH observed may reflect tissue damage and inflammation&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">We assumed that the temporary impairment in echocardiographic parameters in the acute phase was caused by proinflammatory mediators&#44; such as tumor necrosis factor &#40;TNF&#41; and the IL-1 and -6 families of cytokines&#44; which have significant negative inotropic effects&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> Myocardial function may also be impaired through direct COVID-19 infection of myocytes&#44; leading to active myocarditis&#46; Reported data on the severity&#44; extent&#44; and short- and long-term cardiovascular effects of COVID-19 are limited&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Our study has some limitations&#44; the main one of which is its small sample size&#46; Another limitation is that circulating levels of cytokines such as IL-1&#44; IL-6&#44; and TNF could not be measured&#46; In addition&#44; the lack of clarity concerning the effects of hydroxychloroquine and favipiravir on cardiac function are also limitations of the study&#46; Further studies that measure the circulating levels of these cytokines and echocardiographic variables are needed based on the current hypothesis of cytokine-mediated temporary impairment of left ventricular performance&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In conclusion&#44; subclinical diastolic impairment without systolic involvement may be observed in patients with COVID-19&#46; This could be due to isolated subclinical diastolic dysfunction&#46; The underlying mechanism and its clinical significance can be established by further studies&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Funding</span><p id="par0095" class="elsevierStylePara elsevierViewall">This study received no grant funding from any agency in the public&#44; commercial or not-for-profit sectors&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1733208"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction and Objectives"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1529470"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1733207"
          "titulo" => "Resumo"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introduc&#227;o e objetivos"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclus&#227;o"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1529471"
          "titulo" => "Palavras-chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Study population"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Echocardiographic examination"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Laboratory parameters"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Funding"
        ]
        9 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2021-01-26"
    "fechaAceptado" => "2021-03-16"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1529470"
          "palabras" => array:3 [
            0 => "COVID-19"
            1 => "Echocardiography"
            2 => "Myocardial performance index"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec1529471"
          "palabras" => array:3 [
            0 => "COVID-19"
            1 => "Ecocardiografia"
            2 => "&#205;ndice de performance mioc&#225;rdico"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Myocardial performance may be impaired in cytokine-mediated immune reactions&#46; The myocardial performance index &#40;MPI&#41; is a practical parameter that reflects systolic and diastolic cardiac function&#46; We aimed to assess the MPI in patients with COVID-19&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The study population consisted of 40 healthy controls and 40 patients diagnosed with COVID-19 who had mild pneumonia and did not need intensive care treatment&#46; All participants underwent echocardiographic examination&#46; First&#44; the MPI and laboratory parameters were compared between healthy controls and patients in the acute period of infection&#46; Second&#44; the MPI and laboratory parameters were compared between the acute infection period and after clinical recovery&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Compared with healthy controls&#44; patients with COVID-19 had a significantly higher MPI &#40;0&#46;56&#177;0&#46;09 vs&#46; 0&#46;41&#177;0&#46;06&#44; p&#60;0&#46;001&#41;&#44; longer isovolumic relaxation time &#40;IRT&#41; &#40;112&#46;3&#177;13&#46;4 vs&#46; 90&#46;6&#177;11&#46;2 ms&#44; p&#60;0&#46;001&#41;&#44; longer deceleration time &#40;DT&#41; &#40;182&#46;1&#177;30&#46;6 vs&#46; 160&#46;8&#177;42&#46;7 ms&#44; p&#61;0&#46;003&#41;&#44; shorter ejection time &#40;ET&#41; &#40;279&#46;6&#177;20&#46;3 vs&#46; 299&#46;6&#177;34&#46;7 ms&#44; p&#60;0&#46;001&#41; and higher E&#47;A ratio &#40;1&#46;53&#177;0&#46;7 vs&#46; 1&#46;21&#177;0&#46;3&#44; p&#60;0&#46;001&#41;&#46; Statistically significantly higher MPI &#40;0&#46;56&#177;0&#46;09 vs&#46; 0&#46;44&#177;0&#46;07&#44; p&#60;0&#46;001&#41;&#44; longer IRT &#40;112&#46;3&#177;13&#46;4 vs&#46; 91&#46;8&#177;12&#46;1 ms&#44; p&#60;0&#46;001&#41;&#44; longer DT &#40;182&#46;1&#177;30&#46;6 vs&#46; 161&#46;5&#177;43&#46;5 ms&#44; p&#61;0&#46;003&#41;&#44; shorter ET 279&#46;6&#177;20&#46;3 vs&#46; 298&#46;8&#177;36&#46;8 ms&#44; p&#60;0&#46;001&#41; and higher E&#47;A ratio &#40;1&#46;53&#177;0&#46;7 vs&#46; 1&#46;22&#177;0&#46;4&#44; p&#60;0&#46;001&#41; were observed during the acute infection period than after clinical recovery&#46; Left ventricular ejection fraction was similar in the controls&#44; during the acute infection period and after clinical recovery&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Subclinical diastolic impairment without systolic involvement may be observed in patients with COVID-19&#46; This impairment may be reversible on clinical recovery&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction and Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduc&#227;o e objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">O desempenho mioc&#225;rdico pode ser prejudicado em rea&#231;&#245;es imunes mediadas por citocinas&#46; O &#237;ndice de performance mioc&#225;rdico &#40;IPM&#41; &#233; um par&#226;metro que reflete a fun&#231;&#227;o card&#237;aca sist&#243;lica e diast&#243;lica&#46; O nosso objetivo foi avaliar o IPM em doentes com COVID-19&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">O presente estudo consistiu em analisar 40 casos controlo saud&#225;veis e 40 doentes com diagn&#243;stico de COVID-19 que apresentavam pneumonia ligeira e n&#227;o necessitavam de tratamento intensivo&#46; Todos os participantes foram submetidos a avalia&#231;&#227;o ecocardiogr&#225;fica&#46; Primeiro&#44; o IPM e os par&#226;metros laboratoriais foram comparados entre os casos controlo saud&#225;veis e os doentes com per&#237;odo agudo de infe&#231;&#227;o&#46; Em segundo lugar&#44; o IPM e os par&#226;metros laboratoriais foram comparados entre o per&#237;odo agudo de infe&#231;&#227;o e ap&#243;s a recupera&#231;&#227;o cl&#237;nica&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Em compara&#231;&#227;o com os casos controlo saud&#225;veis&#44; os doentes com COVID-19 tiveram um IPM significativamente maior &#40;0&#44;56&#177;0&#44;09 <span class="elsevierStyleItalic">versus</span> 0&#44;41&#177;0&#44;06&#44; p&#60;0&#44;001&#41;&#44; tempo de relaxamento isovolum&#233;trico &#40;TRI&#41; mais longo &#40;112&#44;3&#177;13&#44;4 <span class="elsevierStyleItalic">versus</span> 90&#44;6&#177;11&#44; 2 ms&#44; p&#60;0&#44;001&#41;&#44; tempo de desacelera&#231;&#227;o maior &#40;TD&#41; &#40;182&#44;1&#177;30&#44;6 <span class="elsevierStyleItalic">versus</span> 160&#44;8&#177;42&#44; 7 ms&#44; p&#61;0&#44;003&#41;&#44; tempo de eje&#231;&#227;o &#40;TE&#41; menor &#40;279&#44;6&#177;20&#44;3 <span class="elsevierStyleItalic">versus</span> 299&#44;6&#177;34&#44; 7 ms&#44; p&#60;0&#44;001&#41; e raz&#227;o E&#47;A maior &#40;1&#44;53&#177;0&#44;7 <span class="elsevierStyleItalic">versus</span> 1&#44;21&#177;0&#44;3&#44; p&#60;0&#44;001&#41;&#46; Um IPM superior estatisticamente significativo &#40;0&#44;56&#177;0&#44;09 <span class="elsevierStyleItalic">versus</span> 0&#44;44&#177;0&#44;07&#44; p&#60;0&#44;001&#41;&#44; um TRI mais longo &#40;112&#44;3&#177;13&#44;4 <span class="elsevierStyleItalic">versus</span> 91&#44;8&#177;12&#44; 1 ms&#44; p&#60;0&#44;001&#41;&#44; um TD mais longo &#40;182&#44;1&#177;30&#44;6 <span class="elsevierStyleItalic">versus</span> 161&#44;5&#177;43&#44;5 ms&#44; p&#61;0&#44;003&#41;&#44; um TE mais curto &#40;279&#44;6&#177;20&#44;3 <span class="elsevierStyleItalic">versus</span> 298&#44;8&#177;36&#44;8 ms&#44; p&#60;0&#44;001&#41; e raz&#227;o E&#47;A mais elevada &#40;1&#44;53&#177;0&#44;7 <span class="elsevierStyleItalic">versus</span> 1&#44;22&#177;0&#44;4&#44; p&#60;0&#44;001&#41; foram observados durante o per&#237;odo agudo de infe&#231;&#227;o em compara&#231;&#227;o com aqueles ap&#243;s a recupera&#231;&#227;o cl&#237;nica&#46; A fra&#231;&#227;o de eje&#231;&#227;o do ventr&#237;culo esquerdo foi semelhante nos casos controlo saud&#225;veis&#44; per&#237;odo agudo de infe&#231;&#227;o e ap&#243;s a recupera&#231;&#227;o cl&#237;nica&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A disfun&#231;ao diast&#243;lica subcl&#237;nica sem difun&#231;&#227;o sist&#243;lica pode ser observada em doentes com COVID-19&#46; Esta defici&#234;ncia pode ser revers&#237;vel na recupera&#231;&#227;o cl&#237;nica&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introduc&#227;o e objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#227;o"
          ]
        ]
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1341
            "Ancho" => 1508
            "Tamanyo" => 266358
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Calculation of tissue Doppler-derived left ventricular myocardial performance index&#46; ET&#58; ejection time&#59; ICT&#58; isovolumic contraction time&#59; IRT&#58; isovolumic relaxation time&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">BP&#58; blood pressure&#59; CK&#58; creatinine kinase&#59; cTnI&#58; cardiac troponin I&#59; DT&#58; deceleration time&#59; E&#47;A&#58;transmitral early to late peak velocity ratio&#59; ET&#58; ejection time&#59; ICT&#58; isovolumic contraction time&#59; IRT&#58; isovolumic relaxation time&#59; Hb&#58; hemoglobin&#59; LDH&#58; lactate dehydrogenase&#59; LVEF&#58; left ventricular ejection fraction&#59; MPI&#58; myocardial performance index&#59; NS&#58; not significant&#59; WBC&#58; white blood cell count&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "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="\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" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">COVID-19 patients &#40;n&#61;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">Control group &#40;n&#61;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th 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" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#44; years&nbsp;\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">54&#177;11&nbsp;\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">52&#177;13&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gender&#44; male&#44; n &#40;&#37;&#41;&nbsp;\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">26 &#40;65&#41;&nbsp;\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">24 &#40;60&#41;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Smoking&#44; n &#40;&#37;&#41;&nbsp;\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">12 &#40;30&#41;&nbsp;\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">10 &#40;25&#41;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hypertension&#44; n &#40;&#37;&#41;&nbsp;\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">8 &#40;20&#41;&nbsp;\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">6 &#40;15&#41;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&#44; n &#40;&#37;&#41;&nbsp;\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">6 &#40;15&#41;&nbsp;\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">4 &#40;10&#41;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Systolic BP&#44; mmHg&nbsp;\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">124&#46;6&#177;8&#46;2&nbsp;\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">123&#46;6&#177;6&#46;8&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diastolic BP&#44; mmHg&nbsp;\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">73&#46;6&#177; 6&#46;0&nbsp;\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">72&#46;5&#177;4&#46;6&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heart rate&#44; beats&#47;min&nbsp;\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">75&#46;4&#177;12&nbsp;\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">73&#46;6&#177; 16&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LVEF&#44; &#37;&nbsp;\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">60&#46;3&#177; 3&#46;2&nbsp;\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">61&#46;9&#177;4&#46;8&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MPI&nbsp;\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&#46;56&#177;0&#46;09&nbsp;\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&#46;41&#177;0&#46;06&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IRT&#44; ms&nbsp;\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">112&#46;3&#177;13&#46;4&nbsp;\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">90&#46;6&#177;11&#46;2&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ICT&#44; ms&nbsp;\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">44&#46;3&#177;7&#46;8&nbsp;\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">41&#46;8&#177;8&#46;7&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">E&#47;A&nbsp;\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">1&#46;53&#177;0&#46;7&nbsp;\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">1&#46;21&#177;0&#46;3&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ET&#44; ms&nbsp;\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">279&#46;6&#177;20&#46;3&nbsp;\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">299&#46;6&#177;34&#46;7&nbsp;\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">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DT&#44; ms&nbsp;\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">182&#46;1&#177;30&#46;6&nbsp;\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">160&#46;8&#177;42&#46;7&nbsp;\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&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hb&#44; g&#47;dl&nbsp;\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">13&#46;2&#177;1&#46;6&nbsp;\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">13&#46;8&#177;1&#46;7&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CK&#44; IU&#47;l&nbsp;\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">216&#46;3&#177;125&#46;4&nbsp;\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">198&#46;2&#177;113&#46;6&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LDH&#44; IU&#47;l&nbsp;\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">486&#46;8&#177;118&#46;6&nbsp;\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">316&#46;4&#177;108&#46;9&nbsp;\t\t\t\t\t\t\n