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
The reactions of ozone with 2,3-Dimethyl-2-Butene (CH3)2C=C(CH3)2 and 1,3-Butadiene CH2=CHCH=CH2 have been investigated under atmospheric conditions at 298±3K in air using both relative and absolute rate techniques, and the measured rate coefficients are found to be in good agreement in both techniques used. The obtained results show the addition of ozone to the double bond in these compounds and how it acts as function of the methyl group substituent situated on the double bond. The yields of all the main products have been determined using FTIR and GC-FID and the product studies of these reactions establish a very good idea for the decomposition pathways for the primary formed compounds (ozonides) and give a good information for the effe
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... Show MoreIn this paper, we establish the conditions of the occurrence of the local bifurcations, such as saddle node, transcritical and pitchfork, of all equilibrium points of an eco-epidemiological model consisting of a prey-predator model with SI (susceptible-infected) epidemic diseases in prey population only and a refuge-stage structure in the predators. It is observed that there is a transcritical bifurcation near the axial and free predator equilibrium points, near disease-free equilibrium point is a saddle-node bifurcation and near positive (coexistence) equilibrium point is a saddle-node bifurcation, a transcritical bifurcation and a pitchfork bifurcation. Further investigations for Hopf bifurcation near coexistence equilibrium point
... Show MoreIn this study, geopolymer mortar was designed in various experimental combinations employing 1% micro steel fibers and was subjected to different temperatures, according to the prior works of other researchers. The geopolymer mortar was developed using a variety of sustainable material proportions (fly ash and slag) to examine the influence of fibers on its strength. The fly ash weight percentage was 50%, 60%, and 70% by slag weight to study its effect on the geopolymer mortar's properties. The optimal ratio produced the most significant results when mixed at a 50:50 ratio of fly ash and slag with 1% micro steel fibers at curing temperature 240oC for 4 hours through two days. The compressive strength of the geopolymer mortar increas
... Show MoreThe influence of fear on the dynamics of harvested prey-predator model with intra-specific competition is suggested and studied, where the fear effect from the predation causes decreases of growth rate of prey. We suppose that the predator attacks the prey under the Holling type IV functional response. he existence of the solution is investigated and the bounded-ness of the solution is studied too. In addition, the dynamical behavior of the system is established locally and globally. Furthermore, the persistence conditions are investigated. Finally, numerical analysis of the system is carried out.