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 parallel with the shell model using the harmonic oscillator's single-particle wave functions, the Hartree-Fock approximation was also used to calculate the neutron skin thickness, the mirror charge radii, and the differences in proton radii for 13O-13B and 13N-13C mirror nuclei. The calculations were done for both mirror nuclei in the psdpn model space. Depending on the type of potential used, the calculated values of skin thickness are affected. The symmetry energy and the symmetry energy's slope at nuclear saturation density were also determined, and the ratio of the density to the saturation density of nuclear matter and the symmetry energy has a nearly linear correlation. The mirror ener
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The global vision for the future of mankind and societies to achieve supremacy, empowerment and victory is limited to the sincerity of the sincere Islamic vision and its evidence, and this true vision is presented through the texts of the Noble Qur’an, the Sunnah of the Prophet and the concrete reality to achieve victory and empowerment of Islam, and does not respond by tracking the movement of history and its interventions.
The Islamic nation is a nation of survival and continuity with God’s promise and it needs to wake up and alert, and leadership that takes its hand into the path of victory and empowerment, and that this promise fulfills conditions of the most important of these is a promis
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The purpose of the present paper is to light on the relationship between jobs design, analysis and its reflections on reinforcing workers' vocational adjustment. The present paper aims to accomplish cognitive and applied goals, top of which, test of functional analysis ability to have effect upon workers' vocational adjustment via job design directly and indirectly owning to the virtual factor practiced by these practices on the sought organization. The problem of the present paper comes with many, the most important is the of how to bolster and back up worker's technical adjustment through good and accurate design for the job.
Based on this problem and goals as to expla
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تتناول هذه الورقة مخططات وسياسات الاستيطان في الضفة الغربية والقدس الشرقية منذ العام 1967، عبر سياسات قادها حزب العمل وأكملها حزب الليكود وكاديما وبقية الأحزاب الإسرائيلية، تلك السياسات التي استهدفت فرض السيطرة السياسية الكاملة على الأرض، وما نتج عن ذلك من سيطرة حصرية على الأرضوتقييد استخداماتها، ومحاصرة الوجود الفلسطيني والتضييق عليه، وتحويل مراكز ال
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