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 value of culture in its interaction is composed and formulated according to compatible and incompatible roles which view the identity that adopts that formation although it is in most cases perceived and declared. The attraction and difference characteristic might be implied within subjective and procedural meaning through which it seeks to make the identity mobile subject to identity- shaping cultural causes implying the conflicts that take the shape and culture of real time. As for the end of the twentieth century and afterward where the concepts of hegemony, globalization, cultural invasion, colonial and imperial culture, all these causes made the cultural identity concept appear on the surface of the critical studies as a
... Show MoreThe Transformation of environments surrounding human which called (place), formed an intermediate compresser in forming awareness pictures, human knowledge, culture and thought features, and changing the systems and contexts of human societies, which led to a change the rhythm of life as a whole. So according to that the place will be encodes according to these data for psychological connotations, lead to human sense of harmony with the place in different manner format, here the search problem lies when trying to detect how Iraqi artist deliberating with the place concept, wondering how to investing place in the contemporary Iraqi drawing within its reference dimension, and showing mechanisms from comparative study for the works of two a
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Although the subject of biofuels industry is linked directly to the energy sector, but has links and numerous indirect effects, in particular effects on the environment and agriculture, this study (opportunities and challenges of biofuels industry and impact on the development of the agricultural sector in developing countries) a modest step to identify the industry in detail and identify the types of products and raw materials entering, then define or limit the positive and negative impacts of this industry in General and for specific products In particular, detailed, and then flip all those effects on the agricultural sector in developing countries can benef
... Show MoreThe rivers are the main source of fresh water for many countries and the great development which is considered as one of the sustainable development elements in its various agricultural, industrial, domestic and environmental fields .The countries of the world seek food security and water security in order to ensure the basic needs of citizens .Because their distribution is uneven in many regions of the world with different human needs, which leads to conflicts over water sources, especially those located in one international river basin .This has led to the emergence of internationallegal rules governing the management of The problem revolves around the dialectic between limited water resources and increased need for water use b
... Show MoreThe article attempts to provide the theoretical fundamentals for the semiotic component of lacunae in a language. The definitions of the following notions have been represented: 1) lacunarity as a complex phenomenon that works in the modes of language, speech and speech behaviour; 2) lacuna as a gap, an empty space, which lacks something, which may be characteristic of a written work. The author of the article considers the main classes of lacunae, among which are: 1) generic lacunae, which reflect the absence of a common name for a class of objects; 2) species lacunae are the absence of specific names, names of individual types of objects or phenomena; 3) intralingual lacunae are found within the paradigms of one language; 4) interlanguage
... Show MoreThe study aims to identify the uses and the impact of social networking applications and websites on stock markets and their role in defining the details of dealing with stock movement and trading. The study also aims to highlight the role of these networks by increasing confidence in stock markets and companies as well as encouraging and inciting young people to invest in these markets, the study belongs to the descriptive analytical approach, the study population consisted of all current and potential investors in the stock and financial markets in the United Arab Emirates. The study used a questionnaire that was distributed to a number of followers of social networking pages and websites that deal with trading
... Show MoreAbstract: Despite the distinct features of the continuous wave (CW) Terahertz (THz) emitter using photomixing technique, it suffers from the relatively low radiation output power. Therefore, one of effective ways to improve the photomixer emitter performance was using nanodimensions electrodes inside the optical active region of the device. Due to the nanodimension sizes and good electrical conductivity of silver nanowires (Ag-NWs), they have been exploited as THz emitter electrodes. The excited surface plasmon polariton waves (SPPs) on the surface of nanowire enhances the incident excitation signal. Therefore, the photomixer based Ag-NW compared to conventional one significantly exhibits higher THz output signal. In thi
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A modified Leslie-Gower predator-prey model with a Beddington-DeAngelis functional response is proposed and studied. The purpose is to examine the effects of fear and quadratic fixed effort harvesting on the system's dynamic behavior. The model's qualitative properties, such as local equilibria stability, permanence, and global stability, are examined. The analysis of local bifurcation has been studied. It is discovered that the system experiences a saddle-node bifurcation at the survival equilibrium point whereas a transcritical bifurcation occurs at the boundary equilibrium point. Additionally established are the prerequisites for Hopf bifurcation existence. Finally, using MATLAB, a numerical investigation is conducted to verify the va
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