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
Research Summary
In The Name of Allah Most Gracious Most Merciful
The word injustice and its derivatives were repeated in the Holy Qur’an in several places, approximately (154) times. This is due to the severity of its danger, and that the most dangerous thing that our Islamic nation suffers from in our time is; It is injustice in all its forms and types, so we should all have an honest review of the sincere change in the right direction, and uncover cases of injustice and explain their causes and causes, and work to treat them and rid the wrongdoers of their injustice, and help them to correct their condition. To reveal their grievances and explain their causes and causes, and work to remedy them, and support them and mi
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... Show MoreGermination and field emergence are delayed and their duration is prolonged due to the declining soil temperature during the spring season, which is reflected in the subsequent stages of crop growth, therefore, this study aimed to improve germination. Under a wide range of environmental conditions, a laboratory factorial experiment was carried out to study the effect of seed stimulation with potassium nitrate (distilled water only (0), 2, 4, and 6 mg L-1) and with an aqueous extract of licorice roots (distilled water only (0), 3, 6, and 9 g L-1) on the seed viability and vigor. The laboratory experiment was carried out according to the Completely Randomized Design (CRD) with four repetitions. The results showed the superiority of the intera
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In this paper, an eco-epidemiological prey-predator system when the predator is subjected to the weak Allee effect, and harvesting was proposed and studied. The set of ordinary differential equations that simulate the system’s dynamic is constructed. The impact of fear and Allee’s effect on the system's dynamic behavior is one of our main objectives. The properties of the solution of the system were studied. All possible equilibrium points were determined, and their local, as well as global stabilities, were investigated. The possibility of the occurrence of local bifurcation was studied. Numerical simulation was used to further evaluate the global dynamics and understood the effects of varying parameters on the asymptotic behavior of t
... Show MoreThe historic cities in the Arab and Islamic world (including the cities of the holy shrines in Iraq) suffer from many and varied problems and most notably it is clear in its origin functional structure. It had been transformed from a basic place to live for a few thousand of the population to the center or part of the main center of large city populations of more than one million. Functional structure of the ancient city have been change with the beginning of the twentieth century and accelerated rate of change in the second half of the last century. The research aims to analyze the problems of the historic centers of holy cities and analyze the methods of dealing with these problems, leading to discrimination method could be the
... Show MoreOsteoarthritis is the most prevalent arthritic disease and a leading cause of disability. The pathogenesis of osteoarthritis involves multiple etiologies, including variable degree of synovial inflammation. Metformin and pioglitazone could potentially reduce the levels and activity of inflammatory mediators. This may consider as a new therapeutic approach added to the current used drugs in an attempt to decrease the pain, inflammation, and improve daily activity and quality of life in patients with knee osteoarthritis.
This study designed to evaluate the clinical utility of using metformin or pioglitazone as anti-inflammatory agents in combination with non-steroidal anti-inflammatory drugs (NSAID) of selective type of cyclooxygen
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