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Association of Echocardiographic Epicardial Fat Thickness and Carotid Intima Media Thickness with the Severity of Coronary Artery Disease
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Background: Coronary artery disease remains the main cause of death despite several preventive programs. Epicardial adipose tissue is a visceral fat depot of the heart located along the large coronary arteries and on the surface of ventricles and apex. Intima media thickness is commonly recognized as the initial stage in the development of atherosclerosis. The development of ultrasound machines, advances in echocardiographic devices and high resolution transducers facilitate comprehensive analysis of epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT).
Aim: To investigate the relationship of echocardiographic epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT) with the severity of coronary artery disease.
Methods: A cross sectional multicenter diagnostic accuracy study carried out at Ibn Al-Nafis Cardiovascular Hospital, Ibn Al- Bitar Cardiology Center and Ghazi Al-Hariri Hospital –Iraqi Center for Cardiology during the period between October 2016 and May 2017 assessing. History regarding demographic data and risk factors was taken. Two dimensional transthoracic echocardiographic measurements were done. EFT was measured from parasternal long axis view perpendicular to the right ventricular free wall. C-IMT was measured according to that recommended by the American society of echocardiography (ASE).
Results: The current study demonstrated that the EFT has a direct and significant correlation with the number of involved vessels (P value ˂ 0.001, r= 0.770). The validity of EFT to discriminate between multiple vessels disease and no vessel involvement is excellent (AUC= 0.984, cut point > 8mm, sensitivity=92.9%, specificity= 93.3%). There is inverse and significant correlation between ejection fraction (EF) and three vessels disease (P value ˂ 0.001, r= -0.507). Also there is a direct and significant correlation between C-IMT and severity of CAD. ROC analysis for validity of C-IMT to discriminate between multiple vessels disease and no vessel involvement is excellent (AUC= 0.961, cut point > 1.04mm, sensitivity=92.9%. specificity=86.7%). C-IMT is fair to discriminate between single vessel disease and no vessel involvement (AUC=0.738, cut point ˃ 0.84mm, sensitivity 100%), so if correlated with age, C-IMT above 0.84 can be used as a cut off point for the prediction of CAD. Finally, EFT and C-IMT are more likely to reflect severity of CAD than their ratio.
Conclusions: C-IMT and EFT are simple and reproducible parameters that can be used as a screening tool for the presence and severity of CAD especially before symptoms appearance in high risk patients

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Publication Date
Sun Oct 02 2011
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Carotid Intima-Media Thickness in 100 Iraqi Patients with Hand Osteoarthritis
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Background: Hand osteoarthritis (HOA) is a common joint disorder leading to considerable pain and with substantial impact on hand function. Carotid intima-media thickness (CIMT) is a measurable index of the presence of atherosclerosis. Increased CIMT is associated with increased cardiovascular mortality and morbidity, so early diagnosis and management may improve quality of life.
Objective: To assess the relationship between carotid intima-media thickness (CIMT) and hand osteoarthritis (HOA), and to evaluate the predictors of this relationship.
Patients and Methods: One hundred Iraqi HOA patients and 100 healthy controls were included in this study. Full history was taken and complete clinical examination was done for all patients

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Publication Date
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Carotid Intima-Media Thickness in Rheumatoid Arthritis Detected by Doppler Ultrasound
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Background: The excess mortality associated with
rheumatoid arthritis is largely due to
cardiovascular disease. Rheumatoid arthritis is of
primary importance in atherogenesis. The intimamedia thickness of extracranial carotid arteries is a
measurable index of the presence of
atherosclerosis.
Objective: To assess carotid intima-media
thickness in rheumatoid arthritis by Doppler
ultrasound.
Methods: Fifty two Iraqi patients with rheumatoid
arthritis were studied and compared with another
fifty two, healthy individuals matched for age and
sex as a control group. Full history was taken and
complete clinical examination was done for all
individuals in both groups. Rheumatoid arthritis
diagnosis was

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Publication Date
Mon Apr 01 2013
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Evaluation of Ankle-Brachial Pressure Index and Carotid Intima Media Thickness by Doppler Ultrasound in type two Diabetics.
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Background: Atherosclerosis causes thickening of the artery walls. The intima-media thickness (IMT) of the common carotid artery (CCA) is widely used as an early indicator of the development of coronary artery disease, atherosclerosis, and independently cardiovascular disease (CVD). Diabetes increased the risk of cardiovascular disease, also accelerates the common IMT progression. The Sonographic measurement of carotid intima-media thickness is used as a valid simple and noninvasive method for the assessment of atherosclerosis disease.

Also the ankle brachial index (ABI) is considered as a strong predictor for future cardiovascular events, and a golden standard for the diagnosis of peripheral arterial disease (PA

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Publication Date
Sun May 30 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology,
Effect of Diabetes and Hypertension on Right Carotid Artery Intima Media Thickness and Variable Spectral Waveform Indices And Parameters in Relation To Age for Iraqi Patients
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Background: Arterial stiffness is related with atherosclerosis and cardiovascular disease events. Patients with atherosclerotic disease show to have larger diameters, reduced arterial compliance and lower flow velocities. Aim of study : To compare between patients of two age groups with concomitant diseases diabetes and hypertension in regard to intima media thickness and blood flow characteristics in order to estimate the blood perfusion to the brain via the common and internal carotid arteries. Subject and Methods : 40 patients with (diabetic and hypertension) diseases were enrolled , they were classified according to age. Color Doppler and B mode ultrasound was used to determine lumen Diameter (D), Intima – media thickness (IMT)

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Publication Date
Mon Sep 09 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Association of hsCRP and Serum Kalirin Levels with the Development and Severity of Premature Coronary Artery Disease in Iraqi Patients
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Background: Coronary artery disease (CAD) is a major contributor to morbidity and mortality worldwide. Early-onset CAD, also known as PCAD, is a severe form of CAD associated with high mortality and a poor prognosis. Early diagnosis is crucial to reducing complications. While hsCRP is an established biomarker for CAD, kalirin is a potential novel biomarker due to its role in promoting smooth muscle proliferation and endothelial dysfunction. Objective: To evaluate the relationship between serum kalirin and hsCRP levels with the presence and severity of PCAD and to compare the diagnostic value of both biomarkers. Method: The study recruited 92 participants into two groups: the PCAD group (46) included patients with confirmed CAD by an

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Publication Date
Sun Oct 03 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Status of Some Trace Elementsin Idiopathic and Ischemic Cardiomyopathy and Coronary Artery Disease: Echocardiographic Correlation
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Background:The most principal mechanisms of cardiomyopathies are;high preload and afterload and low myocardial contractility, imbalance of trace elements may cause myocardial metabolic dysfunction and may have a role in aetiology of cardiomyopathy, particulary in IDC. Trace elements are being increasingly recognized as essential mediators of the development and progression of heart diseases.
Methods: Study design Multi case-control study and single center estimation of trace elements concentrations in a number of volunteer settings this study was conducted in the Department of Cardiology, Ibn Albitar Hospital, and in the Physiological Chemistry Department of the College of Medicine, Baghdad University, fr

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Publication Date
Thu Oct 01 2009
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The Ankle- Brachial Pressure Index AS A Predictor of Coronary Artery Disease Severity
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Background: Atherosclerosis is a diffuse disease process, being present in one vascular bed predicts its presence in the others. Ankle –brachial pressure index (ABI) is a non invasive test proved to be sensitive and specific in detecting and assessing the severity of peripheral arterial disease.
Patients and Methods: One hundred fifty patients (150) were enrolled in this study, from January - June 2007; all were referred to the Iraqi Centre for Heart Diseases (I.C.H.D.) for further evaluation, with request for further assessment of CAD or lower extremity peripheral arterial disease. Clinical data and physical examination were performed; ABI was calculated by measurement of systolic pressure on both ankl

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Publication Date
Wed Mar 11 2020
Journal Name
Journal Of Cardiovascular Disease Research
Resistive Index is an Early Indicator for Flow Deterioration in Comparison with Intima Media Thickness for Patients with Hypertension and Diabetes in Relation to Age
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Background: Atherosclerosis is well known related to age and certain cardiovascular diseases. Aging is one reason of arteries function deterioration which can cause loss of compliance and plaque accumulation, this effect increases by the presence of certain diseases such as hypertension and diabetes disease. Aim: To investigate the reduction of blood supply to the brain in patients with diabetes and hypertension with age and the role of resistive index in the diagnosis of reduced blood flow. Method: Patients with both diseases diabetic and hypertension were classified according to their age to identify the progression of the disease and factors influencing the carotid artery blood flow. By using ultrasound and standard Doppler techniq

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Publication Date
Sat Jul 01 2017
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Prevalence, risk factors and association of renal artery stenosis with coronary artery disease in patients undergoing coronary angiography in Ibn-Al Bitar center for cardiac surgery
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Background:-Atherosclerosis is a systemic disease that often affects multiple vascular distributions in a single patient. The increased prevalence of renal artery stenosis in association with coronary artery disease has been well documented.
Objectives:-To examine in detail the prevalence of renal artery stenosis in patients undergoing cardiac catheterization for suspected coronary artery disease.
Patients &methods:-Between April 2010 and February 2011, two hundred patients underwent coronary and renal angiography at the same session in Ibn Al-bitar Hospital for Cardiac Surgery. Clinical and procedural data for patients undergoing renal angiography were prospectively collected and entered into database specially designed for th

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Publication Date
Sun Oct 01 2006
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The Impact Of Severity Of Ischaemia In Acute Coronary Syndrome On The Extent Of Coronary Artery Disease At Angiography The Role Of Past Ischaemia
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Background: Clinical classification of patients with acute coronary syndrome is essential step in identifying severe cases before referring them, fairly quickly, for the ultimate investigation of coronary angiography .Hence it is important to find out the extent at which the severity of the disease, based on clinical classification, agrees with its severity at angiography and to see whether traditional Risk factors or pas ischaemia played a role.
Patients and Methods : The angiographer data of 178 consecutive pts with Acute Coronary Syndrome (ACS) were retrospectively analyzed. The pts consisted of 114 with Unstable Angina (UA)  and 64 pts with Non-ST-Segment Elevation Myocardial Infarction (NSTEMI). Pati

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