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
Luqman's story stated that human instinct, if I was brought up properly, reaches wisdom and inflicts the right to everything. It is to go to worship God and adhere to the satisfaction of morals and high morals that are ordered to meet among human beings in this life, because this worship educates in the soul the most beautiful morals needed by human beings of honesty, honesty and modesty, and the work of good and virtues, and distancing the soul from evil and vices.
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Gaining the relationship between the central government and local governments is great importance especially after the expanded functions of the central government and became unable to carry out their works without all that delegate or transfer parts of its powers to lower levels.
The aims of the research is to determine the relationship of the central government with the local government in accordance with the principle of administrative decentralization with the presentation of the competent authorities, the control of local governments, according to the Provincial Council Act No. 21 of 2008 amended.
The research has a problem that has been the relationship of the central
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The aim of the research is to demonstrate the impact of the salary localization service in enhancing banking competitive advantage. In order to achieve this goal, salary localization was chosen as an independent variable and its impact was studied on the dependent variable, which is the competitive advantage. The research problem lies in the fluctuation of the salary localization service from one bank to another and the impact of this on the competitive advantage. The study sample included five private Iraqi banks, namely (the National Bank of Iraq, the International Development Bank, Assyria International Bank, Al Khaleej Commercial Ban
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... Show MorePraise be to Allah, Lord of the Worlds, teach the pen, taught the human what he didn't know, Ihmad - Almighty - and thank him, and repent to him and ask forgiveness, which is the most forgiving, and bear witness that there is no god but Allah alone has no partner, gives and prevents, And I bear witness that Muhammad is a slave to Allah and his Messenger, who called for guidance and good speech and spoke, peace be upon him and his family and companions, and those who followed them until the Day of Judgment.