Normal sex and age-specific parameters in a multi-ethnic population: a cardiovascular magnetic resonance study of the Canadian Alliance for Healthy Hearts and Minds cohort

Background Despite the growing utility of cardiovascular magnetic resonance (CMR) for cardiac morphology and function, sex and age-specific normal reference values derived from large, multi-ethnic data sets are lacking. Furthermore, most available studies use a simplified tracing methodology. Using a large cohort of participants without history of cardiovascular disease (CVD) or risk factors from the Canadian Alliance for Healthy Heart and Minds, we sought to establish a robust set of reference values for ventricular and atrial parameters using an anatomically correct contouring method, and to determine the influence of age and sex on ventricular parameters. Methods and results Participants (n = 3206, 65% females; age 55.2 ± 8.4 years for females and 55.1 ± 8.8 years for men) underwent CMR using standard methods for quantitative measurements of cardiac parameters. Normal ventricular and atrial reference values are provided: (1) for males and females, (2) stratified by four age categories, and (3) for different races/ethnicities. Values are reported as absolute, indexed to body surface area, or height. Ventricular volumes and mass were significantly larger for males than females (p < 0.001). Ventricular ejection fraction was significantly diminished in males as compared to females (p < 0.001). Indexed left ventricular (LV) end-systolic, end-diastolic volumes, mass and right ventricular (RV) parameters significantly decreased as age increased for both sexes (p < 0.001). For females, but not men, mean LV and RVEF significantly increased with age (p < 0.001). Conclusion Using anatomically correct contouring methodology, we provide accurate sex and age-specific normal reference values for CMR parameters derived from the largest, multi-ethnic population free of CVD to date. Clinical trial registration ClinicalTrials.gov, NCT02220582. Registered 20 August 2014—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02220582.

Assessing the haematology and serum chemistry of Uda rams fed different Kanwa based mineral licks

This study was conducted at the Department of Animal Science’s Teaching and Research farm of Usmanu Danfodiyo University, Sokoto to evaluate the effect of feeding different kanwa based mineral licks on blood profile of Uda rams. Blood of twenty (20) yearlings Uda rams aged by dentition were used to evaluate the effect of Kanwa¬-based mineral blocks. Four (4) animals were allotted to each treatment (Kanwa block) with each animal serving as a replicate. The Kanwa used were Kanwan Bai-Bai, Kanwan Kolo, Hogga, Balma and conventional mineral lick to represent treatment 1, 2, 3, 4 and 5 respectively. Data was collected at the end of the experiment. The result of haematological analysis showed significant (p<0.05) differences in all the parameters analysed except PCV, MCH, WBC and eosinophil; the result indicated that all the values where within the normal reference range except in MCHC where animals placed in T2 and T3 shows values slightly above the normal range. The result of serum biochemistry showed that all the values measured were within the normal reference range for sheep except the albumin of animals placed in T3 which had values slightly above the normal range. The serum mineral composition showed that Potassium levels were higher in T2 and lower in T4; however, there was no difference between animals placed in treatments 1, 2 and 3, so also between treatments 1, 3 and 4. The study concluded that Kanwa positively affected sheep production with no adverse effect on both haematological and serum chemistry, hence little health hazard is associated with feeding Kanwa-based blocks on growing Uda rams.

Assessment of the Size and Shape of the 4-Chamber View and the Right and Left Ventricles using Fetal Speckle Tracking in Normal Fetuses at 17-24 Gestational Weeks

Introduction: The aim of the study was to establish normal reference values obtained by fetal speckle tracking analysis of the fetal heart between 17-24 weeks of gestation among Thai fetuses and compare the nomograms with previous studies. Methods: The 4-chamber view of the fetal heart in 79 normal fetuses was analyzed by speckle tracking analysis to determine the best-fit regression model. The 95% reference intervals and Z-score equations of fetal cardiac parameters were computed. Results: The end-diastolic length, width, area, and circumference of the 4-chamber view (4CV) as well as the ventricular end-diastolic length, 24-segment widths, and area were all increased as a function of gestational age (GA) and 5 fetal biometric parameters. In contrast, the global sphericity index (SI), 24-segment SI, and right ventricle/left ventricle width and area ratios did not change with GA or fetal biometric measurements. There were few differences in Z-score reference ranges of fetal cardiac measurements between the current study and previous studies conducted in different patient populations. Conclusion: Our study provided z-score and corresponding centile calculators, 5th and 95th centile reference tables, and corresponding graphs for evaluating the size and shape of the 4CV and the right and left ventricles using 6 independent variables between 17 and 24 weeks of gestation. These results provide normal reference ranges for future studies of fetuses with pathologies that may alter the size and shape of the 4-chamber view and ventricles.

Normal Reference Values of Complete Blood Count in Healthy Adult Population of Pakistan; A Multicentre Study

Aim: To establish the reference values of hematological parameters in blood donors of all the four provinces of Pakistan as a general population. Methods: This was a multicenter cross-sectional study conducted from Jan 2017-Oct 2017 in the blood bank and the Dept. of Haematology, The CH&ICH, Lahore, Fatimid Foundation, Karachi, Bolan medical college, Quetta, Armed Forces Institute of Transfusion, Rawalpindi & Ayub medical college, Abbottabad, KPK. Blood samples of 1060 male and female blood donors were collected from the blood banks of all the centers mentioned above. CBC and differential were performed using an automated hematology analyzer in the respective departments. Results: The mean and 95% reference values (2.5th-97.5th) for males WBC 7.752+4.506×109 cells/L, RBC 4.958 +1.331, HB 14.258 +3.423 g/dl, HCT 41.967 +16.345, MCV 84.584 +15.933, PLT 219.485 +197.331, LYM 3.346 +10.112, NEUT 6.843+23.557, MONO 0.811 +3.601, EO 0.327 +0.995. For females WBC 7.174+3.037, RBC4.567 +1.086, HB 12.972 +2.752, HCT39.647 +48.186, PLT 264.07+175.079, LYM 2.537+5.005, NEUT 4.769+11.314, MONO 0.460 +0.909, EO 0.188+0.39 Conclusion: The hematological profile of the population in all four provinces of Pakistan differed from the reports of other countries and the standard reference ranges described in the textbook. So, our own hematological parameters must be followed. More studies must be carried out on other age groups and even on adults to strengthen our results. Keywords: Normal reference values, Complete blood count, Healthy adults of Pakistan

Multidetector computed tomography study to measure thoracic aorta diameters in Egyptian population

Background The aorta is the largest and strongest artery in the body that plays an important role in the control of systemic vascular resistance and heart rate. Aortic diseases contribute to the wide spectrum of arterial diseases that may be diagnosed after a long period of subclinical development. Multidetector computed tomographic scanners (≥ 64 detector rows) for aortic imaging remain one of the most preferred imaging techniques for diagnosis and follow-up of aortic conditions in acute as well as chronic presentations. The aim of this study is to establish a normal reference values for aortic diameters among Egyptian population and to find which of the cardiovascular risk factors could be an independent determinant of the aortic diameters. Results Five hundred and sixteen Egyptian individuals were enrolled in our study, the mean age was 53.5 ± 10.9, and males comprised 61.4% of the study population. Aortic root diameters measured at the annulus, sinus and STJ were 23.09 ± 2.55 mm, 33.75 ± 3.93 mm and 26.13 ± 3.05 mm, respectively. The BSA-indexed diameters were 11.70 ± 1.39, 17.10 ± 2.10 and 13.25 ± 1.65, respectively. The diameter of the tubular part of ascending aorta was 30.97 ± 4.16 mm, and the BSA-indexed diameter was 15.71 ± 2.28. The aortic diameters measured at the level of the pulmonary bifurcation were 24.56 ± 2.95 mm and 23.79 ± 2.96 mm at systolic and diastolic phases, respectively. The BSA-indexed diameters were 12.44 ± 1.52 and 12.05 ± 1.52 at systolic and diastolic phases, respectively. At the diaphragmatic level, the mean diameters were 22.39 ± 2.72 mm and 21.49 ± 2.79 mm at systolic and diastolic phases, respectively. The BSA-indexed diameters were 11.34 ± 1.43 and 10.98 ± 1.48 at systolic and diastolic phases, respectively. Age, gender, BSA, BMI and hypertension were statistically significant independent predictors of ascending and descending aortic diameters. Conclusions Our study established a normal reference value for thoracic aortic diameters among Egyptians using contrast enhanced MSCT aortography. Age, Gender, BSA, BMI and hypertension are the major determinants of aortic diameters.

Sex- and age- specific normal values of left ventricular functional and myocardial mass parameters using threshold-based trabeculae quantification

Background The threshold-based (TB) trabeculated and papillary muscle mass (TPM) quantification method for cardiac MRI (CMR) calculates different values than conventional contouring techniques. We aimed to identify the sex- and age-related normal reference ranges for left ventricular (LV) myocardial mass values, volumetric and functional parameters and the correspondence of these parameters using the TB method. Methods Healthy European adults (n = 200, age: 39.4 ± 12 years, males: 100) were examined with CMR and evaluated with a TB postprocessing method. They were stratified by sex and age (Group A: 18–29, Group B: 30–39, Group C: 40–49, Group D: >50 years). The calculated parameters were indexed to body surface area (i). Results The normal reference ranges for the studied parameters were assessed in each age group. Significant biometric differences in LV parameters and mass-to-volume ratios were found between males and females, and the left ventricular compacted myocardial mass (LVCMi) and TPMi differences remained significant after stratification by age. Unlike other LV volumetric and functional parameters and mass-to-volume ratios, the TPMi, the LVCMi and the TPMi-to-LVCMi ratio did not differ among age groups in males or females. This finding was strengthened by the lack of correlation between TPMi and age. Conclusions Age- and sex-related normal reference ranges for LV volumetric and functional parameters and LVCMi and TPMi values were established using a TB postprocessing method. TPMi, LVCMi and their ratio did not change over time. The TPMi-to-LVCMi and the mass-to-volume ratios might have clinical utility in the differential diagnosis of conditions with LV hypertrabeculation.