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
China is moving towards building the largest economic power in the world, so what does this mean economically and politically for Europe, America, the Middle East and the Arab world? This project is called the expansionist Chinese Marshall Plan which is a revival of the old Silk Road in a new way. It represents the aspirations of the Chinese people and their president, Xi Jinping, to build a transport route from Asia to Europe and a railway plan to transport goods. The purpose of this is to develop the economic growth model, expand into new markets, promote the Chinese currency, and expand economic and political influence in the areas covered by the Chinese initiative. Equal opportunities in distributing investments to these countries, a
... Show MoreThe design of the interior spaces process the product of intellectual civilization expresses the prevailing thought, discoverers of principles and beliefs through the sheen reflects the present, and generating languages graphical variety caused a different revolution in design mounting structure, and because of the complex nature of the interior spaces were and we have to be a reflection of cultural reality of being a form of cultural expression and true embodiment of scientific developments prevailing for each stage where she was born, the changes occurring in human thought and then extremism and the discrepancy tastes among individuals all communities factors have caused a change in the design structure involving modernization an
... Show MoreDomesticated translation has been for a long time the norm in cultural communication between nations all over the world. The texts are translated mainly into English (being the dominant language) in terms dictated principally by the requirements of the target language (English). The claim has been that fluency, readability, and immediate intelligibility can be guaranteed as far as the reader of the target language is concerned (English). The foreignness of the text (of the culture which produced it) would be not preserved. Not only this. Being the language of predominant cultures, English has become number one among languages into which texts are translated. The imbalance has been noticeable between the volumes of works translated from a
... Show MoreThe study tagged: (The aesthetics of balance and its relationship to the design of the body of the industrial product) discussed the role of balance in the design of industrial products of different shapes, colors and sizes, as well as their function. Based on the research problem that was determined by the following question: What is the relationship between balance and the design of the body of the industrial product? The aim of the research is to: reveal the statement of the effectiveness of the balance in the design of the industrial product body.
The study was defined in four chapters: in the first chapter, a problem, the importance, and the aim of the research were presented. The second chapter contained the theoretical framewor
عانت الغابات في العراق قصوراً واضحاً في مجال إشباع حاجة السكان لمنتجاتها الرئيسية المتمثلة بالأخشاب ومنتجاتها الثانوية المتمثلة بالأغصان والأوراق والنباتات الطبيعية والحيوانات البرية ونواتجها الأخرى، مما يتطلب التفكير بمحاولة إيجاد سبل جديدة لحل هذه المشكلة الاقتصادية المرتبطة بعنصريها الحاجة للأخشاب والأموال المخصصة لتطويرها عموماً.
لقد دمرت مساحات كبيرة من الغابات وحرقت وقطعت من
... Show More(( The Basic word and Terms of sports, games and motions in the Holy Quran : semantic
study )).
The research consists of apreface followed by an Introduction , and three sections and
aconclusion, finally the research concluded with a list of the sources . and also alist of terms
and word in English language for a wider use .
As for reach sections, they are section one it covers a group of words sports games that
are forty two words .
Section two : it covers five fields :-
a- A group of words ( sports ruless) that an seventeen words.
b- A group of ( sports montions ) that are ten .
c- A group of ( sports tools ) that are seven words.
d- A group of ( sports sciences ) that are seven words only .
e- A gro
The aim of this research is to show the level of banking leadership trends in the importance of organizational confidence and its reflection in the dimensions of the strategic position the research was applied in a bank (Al- Mansour Investment, Business Bay), and the Questionnaire Was adopted as a tool to collect data and information from the number of the sample (15) who are in allocation (Department Manager, Department Manager Department Manager, Division Officer, Unit Officer) and he used the statistical program (spss) to calculate (standard deviation, arithmetic mean, percentages, regression, analysis,F-test coefficient of determination R2, Coefficieent, square Kay and the research reached a number of conclusions, the mos
... Show MoreThe research aimed to prepare a psychological counseling program for the coaches of the Sports Care Center in the gymnasium, and to learn about the impact of the psychological counseling program in reducing irrational ideas and causal attribution of the coaches of the Sports Talent Care Center in the gymnasium, to assume that there are statistically significant differences between the results of the tribal and posttests of the research group Experimental in the scale of irrational ideas, and there are statistically significant differences between the results of the tribal and posttests of the experimental research group in the scale of the causal attribution scale, The experimental approach was adopted by designing one experimental
... Show MoreIn the city of Hebron, small business industrial organizations face a major challenge related to its ability to reach, attract and sustain a sufficient number of customers in order to ensure its continuity and sustainability. The research problem is summarized in an attempt to reveal how the e-marketing could improve and support the marketing effectiveness of small business industrial organizations in the city of Hebron/Palestine. The importance of this research stems from the fact that it addresses a new knowledge branch of the field of marketing, which is electronic marketing for small business organizations, and the fact that the research highlights appropriate marketing solutions for these organizations in light of the Intern
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