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
The propaganda discourse is the most widely circulated in the media and communication studies, where the interest of scholars and researchers in this field has become clear in the analysis and interpretation of the content of this discourse, to identify the intentions, purposes and objectives of the communicator activity, which exceeded the borders of states in the heated atmosphere of rivalries and political conflicts that characterize The countries of the world as a whole and for many years.
In particular, the economically and militarily developed countries (the Nordic capitalist countries) have exerted special efforts in the production of information and ideas, using advanced methods and means in all details of communication w
... Show MoreThis study is at the heart of the pragmatic theory, as this research seeks to highlight the concept of necessity, and what the researchers have tended to do is that the development that has acquired integrated pragmatics is only for the development of the subject of necessity, as it is one of the contents of the saying, and this is what made Decroux define it as the semantic element that Concerning the saying, as for Grace; He paid great attention to the conversational imperative, and understood the requirement by clues or suggestions, as it is an element known for its absence and presence in the linguistic structures included in the text when reading or when understanding. This study has paved the way for clarifying the concept of necessi
... Show MoreThis research deals with the perceived and the imagined in the texts of Yusef Al-Sayegh, considering language as the most important source in literature and theatrical criticism, and given the importance of the subject, the researcher monitored many philosophical and psychological opinions and theories related to (the perceived and the imagined), and they were discussed and their compatibility with the Iraqi theatrical t As for the second chapter, where (the theoretical framework), it included two topics, and the first topic was about the concept of the perceived and the imagined, and the second topic was about Youssef Al-Sayegh and the structure of the theatrical text.
In the third chapter, where (research procedures), the research
Praise be to God, Lord of the worlds, and prayers and peace be upon our master Muhammad and upon his family and companions.
And after:
Muslim scholars have fought in the extent of regard to these interests, each according to his opinion and according to his evaluation, and his consideration of this interest, but it remains important that the legislation in them needs more precaution and caution against the predominance of passions, because the passions often decorate spoilers so they see an interest, so practical application must To realize the spirit of Islamic Sharia in its entirety of its rulings, and the preponderance between the interests and evils that prevail in our societies, which c
... Show MoreModern critical theories revealed polemical views about the reality of the existence of communication - as a necessity for building a deliberative discourse - in the theater or not. To the theory of communication with all the conditions it imposes on thinking, interaction, and emancipation of selves in different contexts.
Therefore, the current research included four chapters, the first chapter dealt with the research problem, which was represented in (the philosophy of sensory and physical communication in theatrical performance), and the first chapter included the importance of the research, its goal and its limits, and ended with defining the terminology, and the second chapter included (theoretical framework) the first topic (ph
The achievement of world peace is a humanitarian demand that humanity has sought since its existence. Despite the international and regional efforts to achieve this demand, it is still reaching its desired ambitions if conflicts, contradictions, and internal and external wars continue to justify us clearly in terms of ethnic, religious and sectarian conflict. The revolution of informatics and the impact of globalization opened a new era of communication and openness and the negative and positive impact of others, which re-published and distributed values, ideas and new cultures Some of them carries extremist ideas urging violence and destruction and other abolition, it became necessary to follow policies and reward The culture of peace,
... Show MoreThe traditional city suffers from the decline of the urban image due to urban development and homogeneity with the urban context of the city, and because of the lack of determinants governing the urban image, it is that the center of the city of traditional Kadhimiya suffers from a break in the urban image, Therefore, the research included how to build a distinctive urban image of the center of the traditional city of Kadhimiya and achieve the visual pleasure and comfort of the recipient and the urban image here means is an image not picture which are related to several aspects, including physical, social and psychological as well as the collective memory of individuals and their rela
Abstract
Experimental work from Magnetic Abrasive Finishing (MAF) tests was carried out design parameters (amplitude, and number of cycle which are formed the shape of electromagnetic pole), and technological parameters (current, cutting speed, working gap, and finishing time) all have an influence on the mechanical properties of the surface layer in MAF process. This research has made to study the effect of design and technological parameters on the surface roughness (Ra), micro hardness (Hv) and material removal (MR) in working zone. A set of experimental tests has been planned using response surface methodology according to Taguchi matrix (36) with three levels and six factors
... Show MoreThe research aims to determine the effectiveness of auditing in light of the relationship between the governance of investment policy and the cost of debt in companies listed on the Iraqi Stock Exchange. The problem of the research is to raise the question about the effect of the governance of investment policy and the cost of debt on the effectiveness of auditing and auditors. During the research, the most important of them were: the existence of an impact relationship on the effectiveness of auditing through the relationship between the governance of investment policy and the cost of debt. The companies listed in the Iraqi Stock Exchange lack an effective proposed guide or framework dealing with the governance of investment policy desp
... Show More