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 examines the relationships between Kuwait and the Soviet Union from 1961 to 1991, chiefly by analyzing not only the factors that drove Kuwait to form diplomatic relationships with Moscow in 1963 but also how domestic, regional, and international variables affected the development of those relationships until 1991. The study presents the analytical and historical research methods used to reach its findings. Among the findings, Kuwait’s decision to forge diplomatic relationships with Moscow in 1963 indeed seems to have been driven by domestic, regional, and international factors, including Kuwait’s geographical situation, the historical background of the relationships between Kuwait and Moscow, and the structure of t
... Show MoreThe Umayyad era is characterized by the diversity of the subjects and their multiplicity in the literary phenomena. These phenomena are singing phenomena, although they were known in previous eras, they took a distinctive form in the era.
In this light, the researcher tried to prove that singing theory in the Umayyad period was characterized by development and renewal. The research was entitled (evolution and renewal in the theory of singing in the Umayyad era).
The products of the surrealist school since its inception to this day have greatly influenced art in the world, so we find many artists around the world invested in their visual texts the forms generated by surrealism, and here the researcher raises several questions: What are the formal vocabulary that directly or indirectly refers to Self-used by the surrealist painter? Was the surrealist form understood as intended by the movement? In these questions, the research problem is summarized. The importance of it lies in identifying the references to the form of the human self, which are related to the psychological field in the works of the surrealists, especially Salvador Dali. Then the researcher chose his research community from the wor
... Show MoreThe idea of the design of combination Between split – plot and split block means that an experiment conducted with a design
formed by combination Between split – plot and split block, and it presents a precise manner to analytic who aimed to make appropriate statistical analysis for the experiment because such design contains four random errors , it make a high precision rather than another designs. The plan and the theoretical analysis were presented with application to show its idia and the ability to use it in many fields especially in agricultural experiments field .
This research shed light on the relationship between the social orientation of the marketing (interests of the Organization ,the welfare of society, satisfaction the customer) strategies competitive dimensions of (cost leadership strategy, differentiation strategy, focus and strategy), As well as to to seek to achieve a number of knowledge and applied goals, and represented the field research problem extent of interesting researched the application of social orientation and interest in achieving competitive strategy and omission of this interest in the hotels the surveyed Organization, Based on this problem, and to clarify the relationshi
... Show More The integration of AI technologies is revolutionizing various aspects of the apparel and textile industry, from design and manufacturing to customer experience and sustainability. Through the use of artificial intelligence algorithms, workers in the apparel and textile industry can take advantage of a wealth of opportunities for innovation, efficiency and creativity.
The research aims to display the enormous potential of artificial intelligence in the clothing and textile industry through published articles related to the title of the research using the Google Scholar search engine. The research contributes to the development of the cultural thought of researchers, designers, merchants and the consumer with the importance of integ
Abstract This study seeks to deal academically with how the EU treats clandestine immigration, through adopting a purley security approach, based on the European understanding of security threats posed to the security of communities and States in EU at all levels. So they agreed upon criminalizing this threat within the bloc while using repressive tools and steps to limit illegal immigrants flow to European territories. Accordingly, the EU gave the phenomen a security character. So it takes it from low politics level , that of employment and economic field to that of high politics, as a new security problem lying within a new security language embraced by ruling European elites, in other words EU touched on this issue as a speech act emp
... Show MoreBreak in the bond and its impact on the difference of scholars
The research aims to measure the net nominal protection coefficients for the products table eggs and poultry meat and the extent of its impact on domestic production volume for the period of 1990- 2013 has been the use of mathematical formulas simplified in the calculation of the transaction process with a view to the extent of support and protection offered by the state pricing policy for products Resources Sector Animal in Iraq and reach search Highlights and most important, there are volatile price state policy with regard to eggs and poultry meat, as it ranged net nominal protection coefficients between the larger and less than the right one, which means that values are unstable to support local producers or consumers, and can be The
... Show MoreThe e-commerce is one of the best achievements of the twentieth century, since the conduct commercial transactions via the Internet may be the consumer easy selection process and purchase convenient manner different from traditional methods, and with the beginnings of the new millennium impose the emergence of e-commerce term significant challenges to the insurance industry as an important economic sectors Generally, and insurance companies in particular as a result of scientific development, which has led to a reduction in costs and innovation in the production, which led to intense competition on both levels local or global. The insurance industry is a vital part of the economy and it has a varied impact to the community and individual
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