Cardiac size appraisals in thoracic radiographs of Nigerian Indigenous dogs: reference guides in clinical practice

The application of radiologic measurement methods has provided very sensitive and more accurate evaluation, compared with subjective assessment, especially in subtle cases of thoracic organ size anomaly. The objective of the study was to determine radiologic ratios for diagnostic and biometric cardiothoracic evaluations in the Nigerian Indigenous Dog. Thirty healthy dogs (average body weight: 8.2 kg; range: 4.0 – 15.6 kg) consisting of equal number of males and females were recruited for the investigation. Sixty dorsoventral versus ventrodorsal thoracic projections of each of the research dogs were acquired. Parameters in each radiograph were objectively evaluated, as follows: thoracic diameter, cardiac diameter in views, cardiac length and cardiac width. Indices generated in the views were the cardiothoracic ratios (CTR) and the cardiac indices (CI). Mean ± standard error of mean CTR and CI values were 0.50±0.01/0.56±0.01 and 0.56±0.01/0.61±0.01, between the opposite views, respectively. These results are objective, reproducible and easily applicable to veterinary clinical practice for radiologic cardiac appraisal.

Cardiodynamic variables measured by impedance cardiography during a 6-minute walk test are reliable predictors of peak oxygen consumption in young healthy adults

Accurate prediction of aerobic capacity is necessary to guide appropriate exercise prescription. It is common to use 6-minute walk distance (6MWD) to predict peak oxygen uptake (VO2peak) in the clinical environment. The aim of this study was to determine whether prediction of VO2peak can be improved by the inclusion of cardiovascular indices derived by impedance cardiography (ICG) during the 6MWT. A total of 62 healthy university students aged 21±1 years completed in separate days, a cardiopulmonary exercise test (CPET) and two 6MWTs (30 min apart), during which heart rate (HR), stroke volume (SV) and cardiac output (CO) were measured by ICG (PhysioFlow® PF07 EnduroTM). The CPET was conducted with the Ergoselect 200 Ergoline and oxygen consumption measured by a MasterScreenTM CPX breath-by-breath metabolic cart. Multiple regression analyses were conducted to generate VO2peak prediction equations using 6MWD with, or without the cardiovascular indices recorded at the end of the best performed 6MWT as predictor variables. The mean peak HR (bpm), SV (ml) and CO (L/min) recorded during 6MWT were 156±18, 95.6±9, 15±2.8 and during CPET were 176±16, 91.3±8, 16.2±2.7, respectively. Analyses revealed the following VO2peak prediction equation: VO2peak = 100.297+(0.019x6MWD)+(-0.598xHR6MWT)+(-1.236xSV6MWT) + (8.671 x CO6MWT). This equation has a squared multiple correlation (R2) of 0.866, standard error of the estimate (SEE) of 2.28 mL/kg/min and SEE:VO2peak (SEE%) of 7.2%. Cross-validation of equation stability using predicted residual sum of squares (PRESS) statistics showed a R2 (Rp2), SEE (SEEp) and SEEp% of 0.842, 2.38 mL/kg/min and 7.6% respectively. The minimal shrinkage of R2 implied regression model stability. Correlation between measured and predicted VO2peak using this equation was strong (r = 0.931, p<0.001). When 6MWD alone was used as the predictor for VO2peak, the generated equation had a lower R2 (0.549), and a higher SEE (4.08 mL/kg/min) and SEE% (12.9%). This is the first study which included cardiac indices during a 6MWT as variables for VO2peak prediction. Our results suggest that inclusion of cardiac indices measured during the 6MWT more accurately predicts VO2peak than using 6MWD data alone.

CHANGES IN CARDIOVASCULAR AND RESPIRATORY SYSTEMS IN YOUNG ATHLETES

Changes in cardiorespiratory complex of adult athletes are the subject of scientific researches. However, there is a lack of researches that would assess such changes in children and adolescents involved in intensive physical training. The purpose of the study was to evaluate functional and morphological changes of cardiovascular and respiratory systems in boys of primary school age engaged in football. Materials and methods. 109 male children aged 10-11 years were enrolled in the study, among which 81 children have been attending sports football schools, 28 children didn’t have regular physical activity. The study design included a general clinical examination, a spirometry, the condition of cardiovascular system was assessed with echocardiography, and ambulatory blood pressure monitoring (ABPM). Results. The boys 10-11 years of age who play sports have higher values of minute respiratory volume and cardiac indices, which may support the hypothesis of the myocardial hypertrophy development, although they correspond to normal Z-score values. According to ABPM results the duration of physical activity may influence on transition from vasodilation to vasoconstriction. Conclusions. We obtained statistically significant quantitative differences in the functional state of the cardiovascular and respiratory systems in children-athletes. The changes found in young athletes may result to further supervision of a pediatric cardiologist, but decision should be made individually.

Maternal Cardiac Assessment at 35 to 37 Weeks Improves Prediction of Development of Preeclampsia

Preeclampsia at term accounts for half of maternal deaths from hypertensive disorders. We aimed to assess differences in maternal cardiac indices at 35 +0 to 36 +6 weeks’ gestation between women who subsequently developed preeclampsia at term compared with those with uncomplicated pregnancy and to evaluate whether cardiac indices offer incremental prognostic value to the available screening algorithm for preeclampsia. We recruited 1602 women with singleton pregnancies who attended for a routine hospital visit at 35 +0 to 36 +6 weeks’ gestation between April and November 2018. We recorded maternal characteristics and preeclampsia-risk-score derived from a competing risks model and measured cardiac indices. Preeclampsia developed in 3.12% (50/1602) of participants. Women with preeclampsia, compared with those without, had increased mean arterial pressure (97.6, SD, 5.53 versus 87.9, SD, 6.82 mm Hg), systemic vascular resistance (1500, interquartile range, 1393–1831 versus 1400, interquartile range, 1202–1630 PRU) and preeclampsia-risk-score (23.4, interquartile range, 9.13–40 versus 0.9, interquartile range, 0.32–3.25). Multivariable analysis demonstrated independent association between the incidence of preeclampsia and E/e′ (hazard ratio, 1.19/unit [95% CI, 1.03–1.37]; P =0.018) as well as left ventricular mass indexed for body surface area (hazard ratio, 1.03/[g·m 2 ] [95% CI, 1.003–1.051]; P =0.029). Women with E/e′ ≥7.3 and left ventricular mass indexed for body surface area ≥63.2 g/m 2 had an increased risk for developing preeclampsia, despite low preeclampsia-risk-score <5% (hazard ratio, 20.1 [95% CI, 10.5–38.7], P <0.001). Increased left ventricular mass and E/e′ offer incremental information to available scoring systems and better stratify women at risk of developing preeclampsia at term.