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
This study deals with the absence of state control over the whole of the Syrian geography in creating an environment conducive to the emergence of a new force represented by armed groups and organizations that point to fundamental changes in the conflict and to transform competition for control over the land into a struggle for influence. Which in itself represents the prospects of change in the Syrian scene, and that understanding their interests requires shedding light on the extent of the continuation of this competition and the conflict on land and expansion at the expense of the other, and thus contribute to complicate the Syrian scene, especially after attempts to bite Of land and annexation to each party's areas of influence, espe
... Show MoreBecause of Cadmium selenide quantum dots (CdSe quantum dots) has a tuning energy gap in the visible light range, therefore; it is provided a simple theoretical model for the absorption coefficient of CdSe quantum dots, where the absorption coefficient determines the extent to which the light of a material can penetrate a specific wavelength before it is absorbed. CdSe quantum dots have an energy gap can be controlled through two effects: the temperature and the dot size of them. It is found that; there is an absorption threshold for each directed wavelength, where CdSe quantum dots begin to absorb the visible spectrum at a size of 1.4 nm at room temperature for a directed wavelength 3
The Behavioral Disorders of Primary School pupils the son of Alcohol and Non Alcoholic
The study addressed the water ecosystems of the marshes of Maysan Governorate as one of the important areas in Iraq in terms of the environmental, economic and tourism aspects. This area was exposed to great environmental changes due to natural and human factors which greatly affected the water ecosystem and made the area susceptible to many problems that affected the biological life of living organisms. The marshes of Maysan Governorate was affected by vital factors and non-vital factors. The marshes of Maysan Governorate was characterized by the UN Organization as one of the most important centers of biodiversity in the world because of the abundance of different and rare living organisms such as birds, fish, and reptiles as well as the e
... Show MoreThe article characterizes metaphors and comparisons as a means of rethinking the phenomena of the surrounding world; two directions are named within which metaphors and comparisons are studied: 1) the linguo-classification direction combines several classifications of metaphors and comparisons, which are basically focused on comparing two denotations through the meanings of word forms that are part of the trope; 2) the theoretical and conceptual direction is associated with the concept of conceptual displacement and is the basis of the theoretical and methodological study of metaphor and comparison, i.e. the modern theory of metaphor is being formed; The main attention is focused on the comparative concept of Aristotle, which postul
... Show MoreFailure in asphalt mixture and distress in pavement are major issues to roads infrastructure. Selecting an appropriate chemical composition of asphalt cement is a key component in avoiding these issues. This work aimed to investigate the effect of the chemical composition of different polar fractions on the rheological and physical properties of asphalt cement. Four types of asphalt cement with penetration grades of 20/30, 40/50, 60/70 and 85/100 were divided into four fractions. Complex shear modules, rutting resistance and rotational viscosity of the asphalt cement were determined by using a Dynamic Shear Rheometer and a Rotation Viscometer, respectively. The results show that an increase in the asphaltene content and Gastel index resulte
... Show MoreIn this study, the effect of ceramic coating on the performance and gases emission on diesel engine was investigated. A four-stroke, direct injected, single cylinder, diesel engine was tested at constant speed and at different load conditions without coating. Then, the inlet and exhaust valves faces were coated by about 500µm with ceramic materials. Ceramic layers were made of YttriaStabilized Zirconia (YSZ), and NiCrAl as a bond coat. The coating technique adapted in this work is the flame spray method. The engine with valves ceramiccoated research was tested for the same operation conditions of the engine (without coating). The results indicate a reduction in both fuel consumption by about 7.6% and particulate emissions by about (13
... Show MoreThe Research deals with the negative phenomena which appeared in the urban scenes of the Iraqi cities after 2003, particularly trespassing the architectural design of the urban Individual houses. Many academic researchers , critics, and cultural circles, drawn attention to the impact of political and cultural variable change on such phenomena without detailed analysis . The research problem is set according to central questions : If the phenomena is the trespass , what
are the sides which are being trespassed in the division of the individual house? , If the diagnosis of the phenomena denotes perceived repetition of the cases , So what's size of this transposes on the architectural design of t
Estimation of the names and verbs of some letters to consider the grammatical industry