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
In this research has been the manufacture and study the properties of the solar cell type retail hybrid manner thermal evaporation emptiness were studying the properties of the cell at room temperature showed measurements stream circuit behavior linear cell manufacturers reached were calculated efficiency tool cell manufacturers, as well as the expense of workers filling the cell
The reinforcing effect of emphasizers can hardly be denied, hence their importance , hence the justification for writing this paper. As a particular type of adverbials , emphasizers form part of a major syntactic class. This study, thus, introduces the topic by first discussing a grammatical category characterized by being mobile and optional. The paper duly shows the scaling effect of emphasizers, their kinds and the transformational selectional rules that are operative in moving them to the right or left of the VP. It also handles their syntactic role as modifiers, their syntactic features,their occurrence or non- occurrence with negation and imperative and the position they occupy in the sentence. The paper also dwells on the agr
... Show MoreMany of the signs that the global energy system indicate the start of a period of transition from total dependence on fossil energy sources, especially oil, into a new era in which alternative energy sources play an important role in meeting the growing needs of energy demand, so sought many of the developed countries through research the studies carried out to try to bring renewable energy sources and non-renewable (shale oil, oil sands, solar energy, wind energy .... etc) replace traditional fossil energy sources (oil, gas, coal) and despite the recent availability dramatically and spread throughout the the world, but they are going to dry up in the foreseeable future. So many countries, especially the developed sought to find
... Show MoreThe research aims to measure the economic efficiency and technological change and the total productivity of resources using the parameter and non-parameter methods, for agricultural companies registered in the Iraqi stock exchange, the number of 6 companies for the period from 2005 to 2017 based on the hypothesis that the agricultural companies do not achieve economic efficiency and does not control the management of its operations, and It may be technically efficient but the size of its operations is not optimal. From non-parametric methods, the data envelope analysis method was used. Using the DEAP program, the Middle East Company achieved the highest average technical and cost efficiency of 0.62 and 0.58, respectively. The Iraq
... Show MoreThis research aims to identify the impact of Daniel's model on the development of critical thinking. In order to achieve this objective, the following hypotheses are formulated: 1. There is no statistically significant difference at the significance level (0.05) between the average differences in the posttest scores of the experimental group taught according to Daniel's model and the control group taught according to the traditional method in the measure of critical thinking. 2. There is no statistically significant difference at the significance level (0.05) between the average differences in the preand post-tests scores of the experimental group taught according to Daniel's model in the measure of critical thinking. The current research i
... Show MoreThe amino acids in the liver of chick embryo was analysed for ages (7, 11, 14 and 19) days incubation and small chicken aged (14) days after hatching and adult. The study recorded (18) amino acid, the highest concentration of amino acids in the liver of embryo age (7) days incubation was Cysteine (Cys) and in small chicken aged (14) day after hatching, the following amino acids were found: Asparagine (Asn), Alanine (Ala), Histidine (His), Threonine (Thr), Valine (Val), Lysine (Lys), as well as in adult the following amino acids were recorded the highest concentration: Aspartic (Asp), Glutamic (Glu), Serine (Ser), Arginine (Arg), Proline (Pro), Glycine (Gly), Tyrosine (Tyr), Methionine (Met), Isoleucine (Ile), Leucine (Leu) and phenyl alanin
... Show MoreThe current study aims to find a new plan to manage the water quality of the western part of the Hammar Marsh to reduce the salts that cause problems for the marshes and preserve their environmental life by isolating the southwestern part of the Hammar Marsh by closing the outlet under the railway embankment. The outlet is discharging saline water to the east-western part of Al Hammar Marsh. After isolating the southwestern part of the marsh, a new outlet is proposed. The impact of the flow hydrodynamics on improving the water quality was simulated using the SMS model. The hydrodynamics and water quality simulation models for the marsh are : a hydrodynamic model and average depth (SMS RMA2) and a two-dimensional water quality model (SMS
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The study aims to clarify the impact of the adoption of the International Financial Reporting Standard (IFRS16) on lease contracts in the General Iraqi Insurance Company on the financial statements, and thus the impact on financial ratios and indicators, Since the financial reporting standard considers lease contracts as an asset called the right to use the asset and is offset by a liability, this changes the way the financial statements are presented, with an addition to both the asset and liability sides. In order to show the extent to which the adoption of the standard reflects on the financial performance
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