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
Abstract
The term public budget defects became nowadays a chronic, economical phenomenon, almost all the countries weather advanced or development country suffered from it, despite the different visions to economic schools of a thought to accept or reject the deficit in public budget but the prevailed opinion that is needed to rule the role of the state by reducing the public spending which led to continuous deficits in public budget and the consequent upon increase in government borrowing, increase taxes on income and wealth, thus weakening the in contrive for private investment which contributed to the increase of in flationary stagnation, it became a duty to state covered by the lack of financial sources
... Show MoreThe social networking sites have brought about fundamental changes and a qualitative shift in the marketing industry and its strategies. The Iraqi ministries have used this site i.e. Facebook to spread and disseminate values in order to consolidate it in Iraqi society which has witnessed many changes in all aspects of life.
The researcher studies the pages of both ministries to know the values contained in the publications of the pages of these two ministries, the quality of grooming as well as the forms in which these values are marketed.
The researcher uses a survey method and content analysis for the publications of these two pages during the study period starting from January 1, 2
... Show MoreBackground: Secretory Immunoglobulin A (SIgA) is a subclass of Immunoglobulin A (IgA), It is an antibody that plays an important role in mucosal immunity. It is the main immunoglobulin found in mucous secretions from mammary glands, tear glands and salivary glands, every pathologic process in the body involves the immune system, and periodontal inflammation is one of them and is not an exception. Material and methods: this study was consisted of 60 healthy male participants of an age ranged between (35-50) years old ; 25 of them with generalized moderate chronic periodontists(Clinical Attachment Loss equal to 3-4mm at ≥ 30% of the sites; 20 participants with plaque induced gingivitis and 15 participants had clinically healthy pe
... Show MoreA charge transfer complex formed by interaction between nitron as electron donor with curcumin(1 ) as electron acceptor in ethanol at the temperature of theroom to form a colored complex. The optimum conditions of complex formation were investigated by Univariate method. The linearity range of complex was (3.124– 53.11) μg.mL-1 at 442 nm with molar absorptivity (1858.33) L.mol-1.cm-1, Sandell's sensitivity (0.1681μg.cm-2), and with a correlation coefficient (0.9935). Both modified attapulgite and modified attapulgite – complex have been characterized by using , FTIR, SEM, AFM, and XRD. Theadsorption behaviourof complex onto the modified attapulgite has been researchedthrough the variation of the parameters like the adsorbent weight, p
... Show MoreThis paper demonstrates an experimental and numerical study aimed at comparing the influence of openings of different configurations on the flexural behavior of reinforced concrete gable roof beams. The experimental program consisted of testing six simply supported gable beams subjected to mid-point concentrated load. The variable which has been investigated in this work was opening's configuration (quadrilateral or circular) with the same upper and lower chords depth. The results indicate improvement in the beams’ flexural behavior when circular openings were used compared with that of quadrilateral openings, represented by an increase in ultimate load capacity and a decrease in deflection at the service limit. Also, there was an
... Show MoreIn this research, dynamical study of an SIR epidemical model with nonlinear direct incidence rate (Beddington-De Angelis ) type, and regress of treatment investigated .An analytical study to the model shows that there are two equilibrium points appear, the discussed successfully with sufficient condition, the existence of local bifurcation and Hopf bifurcation was analyzed, finally numerical simulations are done to explain the analytic studies.