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
Described the Arabic language being of genius sets by top models of eloquence , rhetoric and clarity of sounds and developments Moreover , it is an important element of our existence and our identity and our survival . That my methods and best in teaching Arabic language what has pursued the easiest ways to learning and teaching and helped learners to be aware of the function linguistic information , and they need it and its impact on their lives , and contributed to unleashing the potential of activism and led them to make the effort to apply them in the form of examples and uses of new life , as well as fits are the capabilities and tendencies of different learners , so the goal of current research into the importance of the curriculum
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The concept of aesthetics dealt with several studies in general (and in the field of architecture in particular), and the problem of aesthetics is in the blurring of the relationship between aesthetics and architectural criticism, based on the research hypothesis which states that there is a relationship between aesthetics and architectural criticism. The importance of the research in accommodating aesthetic standards and bases of evaluation that increases the possi
Abstract:
Federico Garcia Lorca is considered in european and american literary circles as revolutionary symbol of contemporary literature writer through close association with the concerns of his country and the world, and also through the violent propensity to freedom, emancipation and innovation. This personal multi-talent has a significant impact in the spanish literary movement, in particularly, and in world, in general. If Lorca has andalusia blood, is no stranger to contemporary arab man to read to him, and contemplates his experience analyst and literary critic. This research is serious study of this character. There is no doubt the reader will put in front of many facts about personali
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The research sought to reach through the problem of research, which is in the question of: What is the modeling of the
... Show MoreOur research which is under the name "Polarization and Communication mechanism in the formation of green industrial products " The problem of the research focuses in identifying what is polarization and its function mechanisms , by displaying the inventive and creative cases of the designer in how to exploit the industrial products and its recycling process to attract the user and recipient by asserting on the values of beauty of the appearance of the industrial product with the attraction Of the user and the recipient with the new function of that product and how its different from the function achieved by the old product , with consideration of nature and its preservation . The results of the research were as following : The designer e
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The weak and strong forms are so called because it is not their lexical content that primary matter, but the role they have in the sentence. The problematic confusion, our students encounter, in recognizing and producing the correct pronunciation of weak and strong forms of the English function words is the main incentive behind conducting this study. In order to gather the data, this paper used two types of tests: a recognition test and a production test. The general results reached through the analysis of the students' answers seem to conform to the researcher's assumption: students face a critical problem in recognizing and producing correct pronunciation of the weak and strong forms of the English funct
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