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
Requires economic work finding built institutional paint strategies and policies are formulated general economic and clarity in its stated objectives and the involvement of all economic institutions, political and stakeholders to discuss all the issues of economic, financial, monetary and analyzed for the purpose of renewal energies and determine the duties and responsibilities, leaving full freedom to the private sector in the formation of institutions to carry out his duties economic, and that the institutional structures to create the right climate for the implementation of its economic policies, which would facilitate the task of the private sector, and this h
... Show MoreThe achievement of world peace is a humanitarian demand that humanity has sought since its existence. Despite the international and regional efforts to achieve this demand, it is still reaching its desired ambitions if conflicts, contradictions, and internal and external wars continue to justify us clearly in terms of ethnic, religious and sectarian conflict. The revolution of informatics and the impact of globalization opened a new era of communication and openness and the negative and positive impact of others, which re-published and distributed values, ideas and new cultures Some of them carries extremist ideas urging violence and destruction and other abolition, it became necessary to follow policies and reward The culture of peace,
... Show MoreMost of the theorists and researchers and also those interested in cinema and television attributed the fact of the existence of the dramatic works to the directors may be due to a historical justification. At the same time, the existence of the production world came as a result of the emergence of the production city (Hollywood). This is also a historic fact. The research would tackle all the formative truths to prove the relation and the timeline, i.e., before and after and the synergy that resulted in the existence of the dramatic works that benefited the humanity and those interested in this giving art. The objective of the research is to uncover the formative truth of the dramatic work between direction and production.
The s
... Show MoreThe political participation of the Iraqi woman, gains a big importance equivalent to its role in all other fields. Therefore , it represents a higher value in the democratic orientation in addition to the importance of rising the reality of the woman specifically in the fields that are considered as a scale of the human development like the income, health, and education . The weakness of womenʹs political participation, is something that can't be ignored or neglected if we are looking forward to the rising of the country᾽s reality and achieving the required development in its all aspects. The woman is half of society or more than that due to the burden of raising the generations tasks. This can be achieved by taking part in th
... Show MoreThe traditional city suffers from the decline of the urban image due to urban development and homogeneity with the urban context of the city, and because of the lack of determinants governing the urban image, it is that the center of the city of traditional Kadhimiya suffers from a break in the urban image, Therefore, the research included how to build a distinctive urban image of the center of the traditional city of Kadhimiya and achieve the visual pleasure and comfort of the recipient and the urban image here means is an image not picture which are related to several aspects, including physical, social and psychological as well as the collective memory of individuals and their rela
Abstract
Experimental work from Magnetic Abrasive Finishing (MAF) tests was carried out design parameters (amplitude, and number of cycle which are formed the shape of electromagnetic pole), and technological parameters (current, cutting speed, working gap, and finishing time) all have an influence on the mechanical properties of the surface layer in MAF process. This research has made to study the effect of design and technological parameters on the surface roughness (Ra), micro hardness (Hv) and material removal (MR) in working zone. A set of experimental tests has been planned using response surface methodology according to Taguchi matrix (36) with three levels and six factors
... Show MoreJudaism followed the approach of monotheism after God Almighty sent Moses (peace be upon him) to convey to them the messages of their Lord, so that they might be on a right guidance and path, but the people did not follow that path.” Love of matter and faith in what is witnessed, so they portrayed the Lord in several images in line with what their souls drew upon them.