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
Abstract
This research aims to define the roles of auditors by clarifying the concept and risks of cyber security in protecting information and financial data in economic units. Najaf, Babylon and Karbala, then the results were analyzed and the results were presented and analyzed to show that adopting cyber security improves the quality of reports Finance through what it achieves in displaying information with credibility and transparency, in a way that suits the needs of users, and cyber security has a role in managing economic resources more effectively to obtain benefits that would have been lost in the event of an
... Show MoreAttention increased to the topic of academic accreditation by the university as a modern philosophy by which to improve its performance and provide high-quality education. Universities and colleges in general and Iraqi universities and colleges in particular have begun interest in accreditation and desire to get it. So starting from the pursuit of the Administration and Economics College / Baghdad University in obtaining accreditation of Association to Advance Collegiate Schools of Business (AACSB) The research is present which aims to determine the level of application (AACSB) International standards at the College of Administration and Economics / Baghdad University in preparation to get its accreditation in the future. Researc
... Show MoreThe article reflects the results of the analysis of the use of metaphors when creating the image of the main character of the story by D. Rubina "You and me under the peach clouds" - a pet, a dog named Kondraty. Through metaphorization, the image of the dog is filled by the author with purely human qualities, thus passing into the category of a full member of the family. The article is a continuation of the study of the work of D. I. Rubina.
consideration
In the purposes of faith and destiny
Eat this research study features Technical Ceramics Islamic and Chinese The study of four chapters , such as the first chapter the general framework for research and containing the problem that put the following question: Mamdy effect features art on porcelain Islamic and Chinese ) , and whether there are dimensions of the aesthetic , intellectual and ideological in porcelain Islamic and Chinese with lies the importance of research in the promise of a qualitative study and add a scientific theme features art in porcelain Islamic and China , and the objectives of this study One was in the detection of features technical Ceramics Islamic and Chinese study examined the length of time the ninth century AD , and the tenth century AD , and in
... Show MoreThe reason for studying (The secret of Repentance and Confession in Christianity) goes back to the deep roots of repentance in all religions, specially the three revealed religions, and those who adhere to them. The human psych by nature is incessantly demanding sins and the wrong deeds. It is in need of repentance which God has opened for them. Almighty God is happy when his creatures repent and refrain from sinning. This is the reason for success in life and the hereafter and the principle of the happiness. It is also a condition for the good course. Therefore, man should refrain from sinning and feel regret for committing sins forever.
The neighbourhood unit is a small local community in a city dwelled by certain number of dwellers who are characterized by common features, mostly economic. They daily deal with each other & unified with the feeling of neighbourhood. The daily primary services are available in this small community (like education, shopping & entertainment). This community is separated from other communities by physical boundaries like streets, gardens… etc. The neighbourhood is not an exotic notion on human community but it is as ancient as history itself since it was there in ancient communities that dwelled on earth. Complications of urban life needs, caused by cities’ expansion, and the weakness of social relationships, imposed phy
... Show MoreWar was and remains one of the main instruments for the practice of international relations, and has always been a major focus of the study of international relations. War, such as diplomacy, propaganda, etc., is an instrument of national politics. States have used wars to achieve their goals and aspirations and achieve their national interests. War and peace issues are essential to understanding international relations. They are questions that involve the problem of survival.
Today the term "war" is used in many different ways. We talk about Cold War, Hot War, Limited War, Total War, Conventional War, Unconventional War, Civil War, Gang War, Preventive War etc. However, the war continued to exist, and took various forms.
... Show MorePerhaps masculinity and femininity in our Arabic language are among the linguistic issues that have occupied the attention of researchers, ancient and modern. Many books, works, and research have been written on this subject, but there is still something in it that must be revealed, clarified, and established, as the ancients did not classify the feminine and masculine into real, metaphorical, auditory, analogical,