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
Because of the diverse circumstances in Andalusia, the Jews lost much of the atmosphere of freedom and coexistence, which they enjoyed under Islamic rule there, to leave more Jews in the sixth century AH, under Spanish rule abolishing the existence of the other. And to impose his negativity with unjust domination. What motivated the people of Judaism; to turn their faces on the Islamic East; according to the coexistence climates that glorified various religions. It has emerged in this regard Benjamin Title (d. 685 e), who made a long journey to the east, recorded in the texts of the traveler, what will be shown research, God willing.
Abstract
Binary logistic regression model used in data classification and it is the strongest most flexible tool in study cases variable response binary when compared to linear regression. In this research, some classic methods were used to estimate parameters binary logistic regression model, included the maximum likelihood method, minimum chi-square method, weighted least squares, with bayes estimation , to choose the best method of estimation by default values to estimate parameters according two different models of general linear regression models ,and different s
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Traditional programs and the tedious and financially costly processes they require are no longer the best choice for content makers. The continuous development and development have led to the emergence of competitive software that offers capabilities that are more suitable for aesthetic needs, as it breaks down stereotypical frameworks from the familiar to the unfamiliar to be more suitable for graphic subjects in terms of dealing with the requirements of the digital content industry. Video for communication platforms, as it has more advantages than traditional software and the flexibility and high quality it offers at the level of the final product, All of this contributed to supplementing the image with aesthetic employments with data
... Show MoreConcert place high school in the community Keep pace with societal change and what is going through Iraqi society from the wars and occupation and the sectarian and ethnic conflict and authoritarian policies and Dictator ship .
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This 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 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 MoreIn 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