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
War 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,
This research for university students dialectic unemployment and work, focusing on
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Praise be to Allah, Lord of the Worlds, and peace and blessings be upon our master Muhammad and his good and pure family. At the end of this research, we summarize some of the most important findings of our research, namely:
Raising a child properly from childhood leads to integrity in the life of the individual society, and if the young raised bad education, this education will affect itself and society negatively, so on parents and government institutions in any country to take care of children, and Islamic countries Specifically to give the child great attention; he is raised on the Koran and watered from its fountains, and armed with a weapon of morality from a young age, and to understand the biography of Mustafa (peace be upon h
This paper is an attempt to demonstrate the syntactic behavior of -ly adverbs and -ly adjectives. It mainly deals with -ly as an inflectional suffix that forms adverbs and adjectives It is hypothesized that there are differences between adjective-forming –ly and adverb-forming –ly.The researcher first made general and specific observations about the morphological processes of -ly adverbs and -ly adjectives. Since the study focuses on a linguistic phenomenon, its data is a set of -ly adverbs and -ly adjectives used as examples to support the hypothesis. The importance of studying the syntactic behavior of -ly stems from the fact that thousands of English adjectives and adverbs are created by adding the suffix "-ly" to their roots
... Show Morethe structrual and mechanical properties of thin Ni films of different thicknesses deposited on coring glass substrate using lonbeam sputtering(IBS) technique under vacuum torr have been studied the TEM and electron
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The aim of this research is to demonstrate the nature of the interactive relationship between the dimensions of the requirements of economic intelligence Represented by(Administrative and regulatory requirements, human requirements, and technical requirements) The strategic success of banks is represented by (Customer satisfaction, customer confidence, quality of service, growth) In three of the Iraqi banks own bank(Middle East Iraqi Investment, Al Ahli Iraqi, Gulf Commercial), The questionnaire was adopted as a tool for collecting data and information Of the sample (85) Who are they(Director of the Commissioner, M. Director Plenipotentiary, Director of Department, Director of Section, M. Section Manager, Division Officer, Unit Officer),
... Show MoreThe aim of this paper is to know the persuasive methods and public relations strategies in building the reputation of the United Arab Emirates, since the UAE is progressing among the international indicators in good reputation. The researcher used the survey method, using the content analysis tool, to analyze the publications of the UAE Ministry of Foreign Affairs and International Cooperation for the period from 10/1/2021 to 12/31/2021.The researcher reached a set of results, the most important of which are: The UAE Foreign Ministry relied on public relations strategies in order to build a good reputation for the country, as it focused on the media strategy and gave little importance to the consensus-building strategy, as well as focuse
... Show MoreThe research synthesis variables of competitive advantage and the mechanism achieved by focusing on knowledge abilities and strategic of the administrative leadership, and governments and the developed countries took the racing frantically and my destiny to invest more money and resources to development of wealth and human knowledge is so choice investment winner always and who Aaikhyee never, because God Almighty give humans the abilities of all other creatures and that these abilities varying from person to person, there is the problem of search provoking questions about the essence of what it's about research and both sides theoretical and field, the objective of this research
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