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
This research investigates the pre- and post-cracking resistance of steel fiber-reinforced concrete specimens with Glass Fiber Reinforced Polymer (GFRP) bars subjected to flexural loading. The purpose is to modify the ductility and cracking resistance of GFRP-reinforced beams, which are prone to early cracking and excessive deflections instigated by the low modulus of elasticity of GFRP. Six self-compacting concrete specimens (1500×240×200 mm), incorporating steel fibers of two lengths (25 mm and 40 mm) with varying distribution depths, were tested to assess their structural performance. The results indicate significant enhancements in cracking resistance, stiffness, energy absorption, ductility, and flexural strength. Tested beam
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... Show MoreA series of experiments were conducted for the first time in Iraq to evaluate the efficiency of five plant leaves extracts (Ibicella lutea, Nerium oleander, Clerodendron inerme, Allium cepa and Eucalyptus spp.) in treating the common carp (Cyprinus carpio) infected with monogenetic trematodes of genera Dactylogyrus. Five different concentrations of such extracts were used to bathe fishes for 5,10,15,20 and 25 minutes. A concentration of 15% A. cepa for 25 minutes of bath exposure was affective in trematode eradication. Extracts of both Eucalyptus and N. oleander at a concentration of 10% each were also affective for ten minutes exposure. Extracts of C. inerme had no any effect on such parasites. On the otherhand, extracts of 1. hitea caused
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