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Quinn TD, Lane A, Pettee Gabriel K, Sternfeld B, Jacobs DR, Smith P, Barone Gibbs B. Associations between occupational physical activity and left ventricular structure and function over 25 years in CARDIA. Eur J Prev Cardiol 2024; 31:425-433. [PMID: 37950421 PMCID: PMC10911945 DOI: 10.1093/eurjpc/zwad349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/23/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
AIMS Leisure time physical activity (LTPA) confers cardiovascular health benefits, while occupational physical activity (OPA) may have paradoxically negative health associations. This study tested the explanatory hypothesis that unfavourable cardiac remodelling may result from chronic OPA-induced cardiovascular strain. METHODS AND RESULTS Longitudinal associations of OPA and left ventricular (LV) structure and function were examined in 1462 participants {50.0% female, 56.4% White, aged 30.4 ± 3.4 years at baseline [Year 5 exam (1990-91)]} from the Coronary Artery Risk Development in Young Adults study. Left ventricular structure and function were measured as LV mass (LVMi), end-diastolic volume (LVEDVi), end-systolic volume (LVESVi), ejection fraction (LVEF), stroke volume (LVSVi), and e/a-wave ratio (EA ratio) via echocardiography at baseline and 25 years later. Occupational physical activity was reported at seven exams during the study period as months/year with 'vigorous job activities such as lifting, carrying, or digging' for ≥5 h/week. The 25-year OPA patterns were categorized into three trajectories: no OPA (n = 770), medium OPA (n = 410), and high OPA (n = 282). Linear regression estimated associations between OPA trajectories and echocardiogram variables at follow-up after adjusting for baseline values, individual demographic/health characteristics, and LTPA. Twenty-five-year OPA exposure was not significantly associated with LVMi, LVEDVi, LVSVi, or EA ratio (P > 0.05). However, higher LVESVi (β = 1.84, P < 0.05) and lower LVEF (β = -1.94, P < 0.05) were observed at follow-up among those in the high- vs. no-OPA trajectories. CONCLUSION The paradoxically adverse association of OPA with cardiovascular health was partially supported by null or adverse associations between high OPA and echocardiogram outcomes. Confirmation is needed using more precise OPA measures.
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Affiliation(s)
- Tyler D Quinn
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, 1 Medical Drive, Morgantown, WV 26506, USA
| | - Abbi Lane
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29201, USA
- Department of Applied Exercise Science, School of Kinesiology, University of Michigan, 830 N University Ave, Ann Arbor, MI 48130, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, The University of Alabama at Birmingham, 170 2nd Ave. South, RPHB 230J, Birmingham, AL 35294, USA
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94611, USA
| | - David R Jacobs
- Mayo Professor of Public Health, Division of Epidemiology and Community Health, University of Minnesota, 1300 2nd Streetm Suite 300, Minneapolis, MN 55454, USA
| | - Peter Smith
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
- Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, 1 Medical Drive, Morgantown, WV 26506, USA
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Torun A, Erdem A, Doğan S, Orhan AL, Acar B, Simsek U, Sahin T. Comparison of the effects of resistance, aerobic and mixed exercise on athlete's heart. J Sports Med Phys Fitness 2024; 64:88-93. [PMID: 37902808 DOI: 10.23736/s0022-4707.23.15446-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND There are various changes in cardiac physiology in athletes compared to the normal population. These physiological changes may differ according to the exercise content. The aim of this study was to compare the effects of different exercise methods on the heart. METHODS A total of 122 male athletes from various sports were evaluated. Depending on the sorts of sports, these participants were split into aerobic, mixed, and resistance groups. Each athlete had to meet the inclusion criteria of having participated in the present sport for at least a year and having trained for at least 600 minutes per week over the previous three months. Transthoracic echocardiography was used to investigate the effects of different exercise types. RESULTS The aerobic group's heart rate and ejection fraction were found to be lower than those of the resistance and mixed groups (F(2.105)=23.487, P=0.001). The end-diastolic thicknesses of the interventricular septum (8.7 SD 0.8 vs. 10.0 SD 0.7), interventricular septum (11.3 SD 0.9 vs. 13.0 SD 0.9), left ventricular posterior wall (8.6 SD 0.7 vs. 9.9 SD 0.8), and interventricular septum (11.1 SD 0.9 vs. 13.3 SD 0.9) were all found to be lower in the aerobic group than in the resistance group (P=0.0001). The effect of resistance exercise on heart rate was not observed as clearly as other groups. CONCLUSIONS Resistance exercise has a more dominant effect on ventricular thickness than aerobic exercise. In mixed exercise groups, this increase in thickness is similar to resistance exercise. The content of the training should be considered in the evaluation of the athlete's heart. Identifying the subgroups of the athlete's heart will be useful in the differentiation of pathologies and also in the follow-up of the athletes.
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Affiliation(s)
- Akin Torun
- Department of Cardiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - Almina Erdem
- Department of Cardiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - Selami Doğan
- Department of Cardiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye -
| | - Ahmet L Orhan
- Department of Cardiology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - Burak Acar
- Department of Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
| | - Uygur Simsek
- Department of Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
| | - Tayfun Sahin
- Department of Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
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Marzlin N, Hays AG, Peters M, Kaminski A, Roemer S, O'Leary P, Kroboth S, Harland DR, Khandheria BK, Tajik AJ, Jain R. Myocardial Work in Echocardiography. Circ Cardiovasc Imaging 2023; 16:e014419. [PMID: 36734221 DOI: 10.1161/circimaging.122.014419] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Myocardial work is an emerging tool in echocardiography that incorporates left ventricular afterload into global longitudinal strain analysis. Myocardial work correlates with myocardial oxygen consumption, and work efficiency can also be assessed. Myocardial work has been evaluated in a variety of clinical conditions to assess the added value of myocardial work compared to left ventricular ejection fraction and global longitudinal strain. This review showcases the current use of myocardial work in adult echocardiography and its possible role in cardiac pathologies.
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Affiliation(s)
- Nathan Marzlin
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health, Milwaukee, WI (N.M., M.P., A.K., S.R., P.O., D.R.H., B.K.K., A.J.T., R.J.)
| | - Allison G Hays
- Johns Hopkins School of Medicine, Baltimore, MD (A.G.H.)
| | - Matthew Peters
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health, Milwaukee, WI (N.M., M.P., A.K., S.R., P.O., D.R.H., B.K.K., A.J.T., R.J.)
| | - Abigail Kaminski
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health, Milwaukee, WI (N.M., M.P., A.K., S.R., P.O., D.R.H., B.K.K., A.J.T., R.J.)
| | - Sarah Roemer
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health, Milwaukee, WI (N.M., M.P., A.K., S.R., P.O., D.R.H., B.K.K., A.J.T., R.J.)
| | - Patrick O'Leary
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health, Milwaukee, WI (N.M., M.P., A.K., S.R., P.O., D.R.H., B.K.K., A.J.T., R.J.)
| | - Stacie Kroboth
- Academic Affairs, Cardiovascular Research, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health, Milwaukee, Wisconsin (S.K.)
| | - Daniel R Harland
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health, Milwaukee, WI (N.M., M.P., A.K., S.R., P.O., D.R.H., B.K.K., A.J.T., R.J.)
| | - Bijoy K Khandheria
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health, Milwaukee, WI (N.M., M.P., A.K., S.R., P.O., D.R.H., B.K.K., A.J.T., R.J.)
| | - A Jamil Tajik
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health, Milwaukee, WI (N.M., M.P., A.K., S.R., P.O., D.R.H., B.K.K., A.J.T., R.J.)
| | - Renuka Jain
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health, Milwaukee, WI (N.M., M.P., A.K., S.R., P.O., D.R.H., B.K.K., A.J.T., R.J.)
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Weberruß H, Baumgartner L, Mühlbauer F, Shehu N, Oberhoffer-Fritz R. Training intensity influences left ventricular dimensions in young competitive athletes. Front Cardiovasc Med 2022; 9:961979. [PMID: 36277759 PMCID: PMC9582149 DOI: 10.3389/fcvm.2022.961979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/22/2022] [Indexed: 01/11/2023] Open
Abstract
Background In young athletes, exercise causes changes in the heart that include growth in wall thickness and mass of the left ventricle and expansion of the heart’s chambers. The heart’s function is either preserved or enhanced, but this may change to the opposite over time. Objective This study aimed to assess structural and functional cardiac adaptations in relation to exercise training time, intensity, and performance in young competitive athletes. Methods A total of 404 children and adolescents (14.23 ± 2.0 years, 97 females) were enrolled in the Munich Cardiovascular Adaptations in Young Athletes Study (MuCAYA-Study). Eighty-five participants were examined two times a year. Two-dimensional echocardiography was performed to assess left ventricular structure and function. Training time and intensity was measured with the MoMo physical activity questionnaire, maximum aerobic capacity by cardiopulmonary exercise testing, and strength with the handgrip strength test. Results Maximum aerobic capacity significantly influenced interventricular septal thickness in diastole. Training intensity significantly influenced left ventricular internal diameter in diastole and systole, and left ventricular mass indexed to body surface area. Within one year, interventricular wall thickness, relative wall thickness and left ventricular mass, indexed to body surface area and height, increased significantly. Training intensity and aerobic capacity contributed to cardiac adaptations in young competitive athletes, as represented by altered structural parameters but preserved cardiac function. Within a year, however, structural changes and a decline in diastolic performance were observed within the longitudinal sub-sample. Conclusion Our results confirm the hypothesis that cardiac adaptations to exercise occur at a young age. Cardiac adaptation in our cohort was influenced by exercise intensity and maximum aerobic capacity.
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Affiliation(s)
- Heidi Weberruß
- Department of Preventive Pediatrics, TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany,*Correspondence: Heidi Weberruß,
| | - Lisa Baumgartner
- Department of Preventive Pediatrics, TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Frauke Mühlbauer
- Department of Preventive Pediatrics, TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Nerejda Shehu
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Renate Oberhoffer-Fritz
- Department of Preventive Pediatrics, TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany,Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University of Munich, Munich, Germany
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Hosatte‐Ducassy C, Correa JA, Lalonde F, Mohindra R, Marton G, Chetrit M, Marcotte A, Tournoux F, Bridges E. Electrocardiographic changes after completion of a triathlon. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - José A. Correa
- Department of Mathematics and Statistics McGill University Montreal QC Canada
| | - François Lalonde
- Département de cardiologie Axe cardio‐métabolique Centre de Recherche du Centre Hospitalier de l'Université de Montréal Montréal QC Canada
- Département des sciences de l'activité physique Faculté des sciences Université du Québec à Montréal Montréal QC Canada
| | - Rohit Mohindra
- Department of Emergency Medicine McGill University Health Center Montreal QC Canada
| | - Gregory Marton
- Department of Emergency Medicine McGill University Health Center Montreal QC Canada
| | - Michael Chetrit
- Department of Cardiology McGilll University Health Center Montreal QC Canada
| | - Audrey Marcotte
- Department of Emergency Medicine McGill University Health Center Montreal QC Canada
| | - François Tournoux
- Département de cardiologie Axe cardio‐métabolique Centre de Recherche du Centre Hospitalier de l'Université de Montréal Montréal QC Canada
| | - Eileen Bridges
- Department of Emergency Medicine McGill University Health Center Montreal QC Canada
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Left Ventricular Speckle Tracking-Derived Cardiac Strain and Cardiac Twist Mechanics in Athletes: A Systematic Review and Meta-Analysis of Controlled Studies. Sports Med 2018; 47:1145-1170. [PMID: 27889869 PMCID: PMC5432587 DOI: 10.1007/s40279-016-0644-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background The athlete’s heart is associated with physiological remodeling as a consequence of repetitive cardiac loading. The effect of exercise training on left ventricular (LV) cardiac strain and twist mechanics are equivocal, and no meta-analysis has been conducted to date. Objective The objective of this systematic review and meta-analysis was to review the literature pertaining to the effect of different forms of athletic training on cardiac strain and twist mechanics and determine the influence of traditional and contemporary sporting classifications on cardiac strain and twist mechanics. Methods We searched PubMed/MEDLINE, Web of Science, and ScienceDirect for controlled studies of aged-matched male participants aged 18–45 years that used two-dimensional (2D) speckle tracking with a defined athlete sporting discipline and a control group not engaged in training programs. Data were extracted independently by two reviewers. Random-effects meta-analyses, subgroup analyses, and meta-regressions were conducted. Results Our review included 13 studies with 945 participants (controls n = 355; athletes n = 590). Meta-analyses showed no athlete–control differences in LV strain or twist mechanics. However, moderator analyses showed greater LV twist in high-static low-dynamic athletes (d = –0.76, 95% confidence interval [CI] –1.32 to –0.20; p < 0.01) than in controls. Peak untwisting velocity (PUV) was greater in high-static low-dynamic athletes (d = –0.43, 95% CI –0.84 to –0.03; p < 0.05) but less than controls in high-static high-dynamic athletes (d = 0.79, 95% CI 0.002–1.58; p = 0.05). Elite endurance athletes had significantly less twist and apical rotation than controls (d = 0.68, 95% CI 0.19–1.16, p < 0.01; d = 0.64, 95% CI 0.27–1.00, p = 0.001, respectively) but no differences in basal rotation. Meta-regressions showed LV mass index was positively associated with global longitudinal (b = 0.01, 95% CI 0.002–0.02; p < 0.05), whereas systolic blood pressure was negatively associated with PUV (b = –0.06, 95% CI –0.13 to –0.001; p = 0.05). Conclusion Echocardiographic 2D speckle tracking can identify subtle physiological differences in adaptations to cardiac strain and twist mechanics between athletes and healthy controls. Differences in speckle tracking echocardiography-derived parameters can be identified using suitable sporting categorizations.
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Deloux R, Vitiello D, Mougenot N, Noirez P, Li Z, Mericskay M, Ferry A, Agbulut O. Voluntary Exercise Improves Cardiac Function and Prevents Cardiac Remodeling in a Mouse Model of Dilated Cardiomyopathy. Front Physiol 2017; 8:899. [PMID: 29187823 PMCID: PMC5694775 DOI: 10.3389/fphys.2017.00899] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/24/2017] [Indexed: 01/14/2023] Open
Abstract
Objective: Despite the indubitable beneficial effect of exercise to prevent of cardiovascular diseases, there is still a lack of studies investigating the impact of exercise in non-ischemic dilated cardiomyopathy. Here, we investigated the impact of voluntary exercise on cardiac function in a mouse model of non-ischemic dilated cardiomyopathy (αMHC-MerCreMer:Sf/Sf), induced by cardiac-specific inactivation of the Serum Response Factor. Materials and Methods: Seven days after tamoxifen injection, 20 αMHC-MerCreMer:Sf/Sf mice were assigned to sedentary (n = 8) and exercise (n = 12) groups. Seven additional αMHC-MerCreMer:Sf/Sf mice without tamoxifen injection were used as control. The exercise group performed 4 weeks of voluntary running on wheel (1.8 ± 0.12 km/day). Cardiac function, myocardial fibrosis, and mitochondrial energetic pathways were then blindly assessed. Results: Exercised mice exhibited a smaller decrease of left ventricular (LV) fractional shortening and ejection fraction compared to control mice. This was associated with a lower degree of LV remodeling in exercised mice, as shown by a lower LV end-systolic intrerventricular septal and posterior wall thickness decrease from baseline values compared to sedentary mice. Moreover, exercised mice displayed a reduced gene expression of atrial and brain natriuretic factors. These benefits were associated by a reduced level of myocardial fibrosis. In addition, exercised mice exhibited a higher mitochondrial aconitase, voltage-dependent anion-selective channel 1 and PPAR gamma coactivators-1 alpha proteins levels suggesting that the increase of mitochondrial biogenesis and/or metabolism slowed the progression of dilated cardiomyopathy in exercised animals. Conclusions: In conclusion, our results support the role of voluntary exercise to improve outcomes in non-ischemic dilated heart failure (HF) and also support its potential for a routine clinical use in the future.
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Affiliation(s)
- Robin Deloux
- Sorbonne Universités, UPMC University Paris 06, Institut de Biologie Paris-Seine, UMR Centre National de la Recherche Scientifique 8256, Biological Adaptation and Aging, Paris, France.,UMR-S 1180, National Institute for Health and Medical Research, University Paris-Sud, Université Paris-Saclay, Châtenay-Malabry, France
| | - Damien Vitiello
- Sorbonne Universités, UPMC University Paris 06, Institut de Biologie Paris-Seine, UMR Centre National de la Recherche Scientifique 8256, Biological Adaptation and Aging, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Institute for Research in Medicine and Epidemiology of Sport, EA7329, National Institute of Sport, Expertise and Performance, Université Paris Descartes, Paris, France
| | - Nathalie Mougenot
- Sorbonne Universités, UPMC University Paris 06, UMS28, Plateforme d'Expérimentation Coeur, Muscles, Vaisseaux, Paris, France
| | - Philippe Noirez
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Institute for Research in Medicine and Epidemiology of Sport, EA7329, National Institute of Sport, Expertise and Performance, Université Paris Descartes, Paris, France
| | - Zhenlin Li
- Sorbonne Universités, UPMC University Paris 06, Institut de Biologie Paris-Seine, UMR Centre National de la Recherche Scientifique 8256, Biological Adaptation and Aging, Paris, France
| | - Mathias Mericskay
- Sorbonne Universités, UPMC University Paris 06, Institut de Biologie Paris-Seine, UMR Centre National de la Recherche Scientifique 8256, Biological Adaptation and Aging, Paris, France.,UMR-S 1180, National Institute for Health and Medical Research, University Paris-Sud, Université Paris-Saclay, Châtenay-Malabry, France
| | - Arnaud Ferry
- Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Sorbonne Universités, UPMC University Paris 06, Institut de Myologie, UMR-S 794, National Institute for Health and Medical Research, UMR Centre National De La Recherche Scientifique 7215, Paris, France
| | - Onnik Agbulut
- Sorbonne Universités, UPMC University Paris 06, Institut de Biologie Paris-Seine, UMR Centre National de la Recherche Scientifique 8256, Biological Adaptation and Aging, Paris, France
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