Background: Gestational hypertension represents a transient period of elevated blood pressure wit... more Background: Gestational hypertension represents a transient period of elevated blood pressure with special effects on the maternal left ventricle that is different from the effects observed in chronic essential hypertension; it affects a previously normal heart and lasts for a maximum of nine months associated with volume and pressure overload on the maternal heart. Tei index (also called myocardial performance index) was found to be a dependent combined index evaluating the systolic and diastolic function of the left ventricle and represents a sensitive indicator for many types of heart diseases. Objective: to evaluate the effects of gestational hypertension on the maternal myocardial function during the third trimester by measuring the Tie index using transthoracic echocardiography. Method: This study was performed in Baghdad teaching hospital in the time period from November 2015 to August 2016. The study included a total of 150 women; 100 women had gestational hypertension, in the third trimester of a singleton pregnancy and with a mean age (29.83 ± 5.33 year), gestational hypertension was identified as elevated systolic or diastolic blood pressure over 140/90 mmHg that emerges after the 20th week of gestation with proteinuria level lower than 300 mg/dl. Another 50 normotensive pregnant women with singleton pregnancy and mean age (28 ± 3.18 year) were used as controls. Left ventricular mass index (LVMI) and relative wall thickness (RWT) were measured to find the type of hypertrophy in gestational hypertension. Ejection fraction (EF) was measured with 2D directed M mode echocardiography, and isovolumic relaxation time (IVRT), isovolumic contraction rime (ICT) and ejection time (ET) were measured for both groups using pulse wave Doppler echocardiography in order to calculate the myocardial performance index which is also called "Tei index" and equals the sum of IVRT and IVCT divided by the ET (Tei index = IVRT+IVCT/ET). Results: Left ventricular mass index and relative wall thickness were significantly higher in gestational hypertensive women, 41% of gestational hypertensive women had normal geometry and 59% had abnormal geometry (34% eccentric hypertrophy, 19% concentric hypertrophy and 6% concentric remodeling). IVRT and IVCT were significantly higher in gestational hypertensive women with p value of 0.0001 and P = 0.003. ET showed a non-significant lower values (p= 0.34) in gestational hypertensive women. Tei index was significantly higher in Gestational hypertension (P=0.011). Conclusion: Women with gestational hypertension had altered myocardial function characterized by the higher Tei index values associated with eccentric hypertrophy which can be explained by the fact that gestational hypertension poses higher afterload on the left ventricle instead the state of low peripheral resistance that is ysually expected during normotensive pregnancy.
Background: Atrial septal defect (ASD) is one of the most widely recognized cardiac congenital ab... more Background: Atrial septal defect (ASD) is one of the most widely recognized cardiac congenital abnormalities in adulthood. Atrial septal defect is characterized by an inter-atrial septum defect that allows the pulmonary venous return from the left atrium to pass directly to the right atrium. Paradoxical septal motion is mainly detected by two-dimensional and M-mode echocardiography. The recently introduced Doppler tissue imaging (TDI) echocardiographic modality has been used in many clinical situations, including ventricle wall movement determination. Objective: To investigate the validity of Tissue Doppler imagery (TDI) coded in color as one of the parameters in ASD assessment. Patients and methods: A cross-sectional retrospective study was performed from June 2018 to June 2019 in multi-teaching centers in Iraq. This study involved adult patients with ASD (confirmed with transthoracic TTE and transesophageal echocardiography TEE), patients with other congenital or pathological cardiac defects were removed from the research. TEE was conducted in just 6 patients (Diagnostic only), whereas TTE obtained all the measurements. The echocardiographic analysis included two-dimensional imagery from the long and short parastern axis view, apical and subcostal view with Doppler color demonstration of interatrial shunt, Doppler color coded tissue to determine interventricularseptal motion Results: There are 40 patients and 40 controls in this sample. The mean case patient age was 30.4 (SD ± 8.42) and the controls age was 33.5 (SD± 9.74). Among the case and control groups there were 33 females (83%) and 7 males (17%), the mean BSA (body surface area) of the case population was 1.88 m2 (SD ± 0.14) and that of the control was 1.81 m2 (SD ± 0.12).), these were not statistically significant differences. There was 36 (90 percent) ASD secondum, and 4 (10 percent) of sinus venosus type. Parameters (Qp / Qs, RA. Area, and RV., basal diameter) were significantly different between case and control groups. There were no significant differences in the SL between case and control groups in colour-coded tissue Doppler image parameter Standardized septal length as follows (68.2± 2.162), (36.7± 2.944) and (66.6± 1.700), respectively (36.8± 2.122); There were significant differences in color change point distance (CCP), standardized color change point distance, and the ratio of CCP to SL between case and control groups as follows (28.12± 3.114), (15.24± 2.359), (40.9± 3.532) and (16.975± 1.765), (9.29± 0.99), (25.54± 2.513) respectively. Conclusions: TDI has been found to be a reliable tool to assess wall movement anomalies in adult ASD patients and can be used as additional criteria to support ASD diagnosis.
Background:-Atherosclerosis is a systemic disease that often affects multiple vascular distributi... more Background:-Atherosclerosis is a systemic disease that often affects multiple vascular distributions in a single patient. The increased prevalence of renal artery stenosis in association with coronary artery disease has been well documented. Objectives:-To examine in detail the prevalence of renal artery stenosis in patients undergoing cardiac catheterization for suspected coronary artery disease. Patients &methods:-Between April 2010 and February 2011, two hundred patients underwent coronary and renal angiography at the same session in Ibn Al-bitar Hospital for Cardiac Surgery. Clinical and procedural data for patients undergoing renal angiography were prospectively collected and entered into database specially designed for the present study. Results:-Two hundred patients were included in this study, 133 (66.5%) were males and a mean age of 53±12 years, age range (42-73 year). Significant renal artery stenosis (≥ 50% luminal narrowing) was identified in 18 patients (9%) made up the renal artery stenosis group. Age, hypertension, diabetes mellitus and renal impairment were significantly associated risk factors for renal artery stenosis. Gender, smoking and hyperlipidemia were not significantly associated with either group. The frequency of renal artery stenosis is significantly increased with the number of stenotic coronary segments; patient with two and three vessel disease had more frequent renal artery stenosis than the others. Conclusion:-Renal artery stenosis is prevalent in a significant proportion of patients undergoing cardiac catheterization for suspected coronary artery disease & the number of coronary arteries with stenotic lesions is a remarkable predictor of significant renal artery stenosis.
Background: dyslipidemia plays a crucial rule in the development of cardiovascular disease, which... more Background: dyslipidemia plays a crucial rule in the development of cardiovascular disease, which has become the leading cause of death in most developed countries as well as in developing countries (1). The effects of reducing low density lipoprotein – C (LDL-C) concentrations on the prevention of cardiovascular events and stroke have been well reported in many clinical trials.Objectives: Evidence supports the use of statins for lipid modifications in the primary prevention of coronary artery disease, morbidity and mortality. This study aims to determine the effectiveness of atorvastatin in treating dyslipidemia in Iraqi obese patients.Methods: 200 overweight and obese patients with hypercholesterolemia, according to NCEP ATP III criteria, were included. They were randomized into 3 groups according to atorvastatin dose, 10, 20, 40 mg/ day, and treated for 8 weeks. Blood lipid profile, liver enzymes ALT and AST, urea, creatinine, uric acid, calcium and glucose were measured before and after therapy.Results: There was a significant reduction of total cholesterol (TC), Triglycerides (TG), low density lipoprotein (LDL), very low density lipoprotein (VLDL), but a non-significant reduction of high density lipoprotein (HDL) with all atorvastatin doses. The high doses of the drug caused a significant elevation of serum levels of ALT and AST and a significant decrease of blood calcium; but there was no significant change in blood levels ofurea, creatinine, uric acid or glucose with any dose.Conclusion: Short-term atorvastatin therapy in dyslipidemic obese patients caused a reduction of TC, TG, LDL, and VLDL, but had no significant effect on HDL, non-significant changes in blood urea, serum creatinine, serum uric acid or blood glucose, while there was a dose dependent elevation of ALT and AST.
Annals of Tropical Medicine and Public Health, 2021
Background:In 2012 the consensus issued by both the American College of Cardiology & Foundation H... more Background:In 2012 the consensus issued by both the American College of Cardiology & Foundation Heart Rhythm Society Recommend the use of Dual Chamber Pace maker instead of Single chamber pace maker for patients with Sinus Node dysfunction. Restoration of atrioventricular synchrony in patient with sinus node dysfunction or Atrioventricular block representing a new era in electrical therapy. the focus on normal physiology led to the nearly universal application of dual-chamber pacing to restore atrioventricular (AV) synchrony in patients with sinus rhythm. Objective: To evaluate Speckle Tracking Echocardiography in detection of early ventricular changes toward Heart failure after implantation of dual chamber pacemaker. Patients & Methods: Speckle tracking was used to evaluate the percent of v entricular deformation before and 3months follow upafter dual chamber implantation, this study included 28 patients with Sinus node dysfunction or Heart Failure-LBBB. This prospective observational study was carried out on patients of medical city, Baghdad Teaching Hospital, cardiology & Echocardiography Higher Education (Diploma) center from November 2016 to July 2017. Results: No statistical difference was noted between both gender groups in regard to main risk factors.Four methods were used to evaluate ventricular function synchrony (Ejection Fraction %, Global longitudinal stain, intraventricular synchrony using septal to posterior wall motion delay, interventricular Mechanical delay by Pulse wave), Global EF evaluated by Simpson biplane method remained the same in all patients after 3-month follow-up (P = NS). Global longitudinal strain (GLS) significantly decreased in all patients. Inter-ventricular dyssynchrony evaluation revealed no significant change after 3 months. Conclusion: Global longitudinal strain and Left Ventricular dessynchrony assessment enables us to detect early signs of LV dysfunction in Subjects with dual chamber pacemaker.
License, which permits unrestricted use, distribution, and reproduction in any medium, provided t... more License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To assess differences in age of onset, hypertension duration, type of drug, treatment compliance, and salt-free diet compliance between patients with stroke and myocardial infarction. Patients and Methods. The study was conducted in 3 hospitals in Baghdad between June 2010 and June 2011. First group includes 81 stroke patients (36 females and 45 males), age ranges between (33–82 years). Second group includes 110 myocardial infarction patients (46 females and 64 males), ages ranges from (23– 76 years). Results. Salt-free diet noncompliance was seen in 69 % and 62 % of Myocardial infarction and stroke groups, respectively. Silent hypertension was seen in 6.3 % and 19.7 % of myocardial infarction and stroke groups, respectively. Noncompliant on antihypertensive therapy was seen in 61%, 71%, and 48 % of the total, myocardial infarction, and stro...
Jordan Journal of Agricultural Sciences, Dec 4, 2012
This experiment was conducted at the Agricultural Research Center of Ainkawa / Erbil / Iraq, duri... more This experiment was conducted at the Agricultural Research Center of Ainkawa / Erbil / Iraq, during the growing season 2005-2006. The aim of this experiment was to investigate the effect of planting dates and plant density on vegetative growth of two varieties of strawberry Fragaria × ananassa Duch. Three planting dates 20 thsep., 10 thoct. and 30 thoct. in 2005 and three plant densities (46000, 23000 and 15332 plants/Hec) with two varieties of strawberry “ Kaiser’s Smaling and Hapil” had been investigated. The annual hill system was used with fixed spacing (1m) between rows. The experimental design was split-split plot within RCBD, with 4 replicates and the experimental unit area was 7.2m2. All results were tested using Duncan’s multiple range test at probability of 5%. Results obtained could be summarized as following: 1. The average of leaf area, dry mater of foliage, number of runners per plant significantly increased in Hapil variety, while the content of total chlorophyll only increased significantly in Kaiser’s Smaling variety. 2. The low plant density (by increasing the distance between plants) caused a significant increasing for all vegetative growth characteristics in both varieties. 3. The early planting dates on 20 thsep. caused a significant increase in all vegetative growth characteristics in both varieties.
Zenodo (CERN European Organization for Nuclear Research), Aug 20, 2021
assessment of global left ventricular perfusion before and after percutaneous coronary interventi... more assessment of global left ventricular perfusion before and after percutaneous coronary intervention in patients with chronic stable angina Evaluación ecocardiográfica transtorácica de la perfusión ventricular izquierda global antes y después de la intervención coronaria percutánea en pacientes con angina crónica estable
Background: Gestational hypertension represents a transient period of elevated blood pressure wit... more Background: Gestational hypertension represents a transient period of elevated blood pressure with special effects on the maternal left ventricle that is different from the effects observed in chronic essential hypertension; it affects a previously normal heart and lasts for a maximum of nine months associated with volume and pressure overload on the maternal heart. Tei index (also called myocardial performance index) was found to be a dependent combined index evaluating the systolic and diastolic function of the left ventricle and represents a sensitive indicator for many types of heart diseases. Objective: to evaluate the effects of gestational hypertension on the maternal myocardial function during the third trimester by measuring the Tie index using transthoracic echocardiography. Method: This study was performed in Baghdad teaching hospital in the time period from November 2015 to August 2016. The study included a total of 150 women; 100 women had gestational hypertension, in the third trimester of a singleton pregnancy and with a mean age (29.83 ± 5.33 year), gestational hypertension was identified as elevated systolic or diastolic blood pressure over 140/90 mmHg that emerges after the 20th week of gestation with proteinuria level lower than 300 mg/dl. Another 50 normotensive pregnant women with singleton pregnancy and mean age (28 ± 3.18 year) were used as controls. Left ventricular mass index (LVMI) and relative wall thickness (RWT) were measured to find the type of hypertrophy in gestational hypertension. Ejection fraction (EF) was measured with 2D directed M mode echocardiography, and isovolumic relaxation time (IVRT), isovolumic contraction rime (ICT) and ejection time (ET) were measured for both groups using pulse wave Doppler echocardiography in order to calculate the myocardial performance index which is also called "Tei index" and equals the sum of IVRT and IVCT divided by the ET (Tei index = IVRT+IVCT/ET). Results: Left ventricular mass index and relative wall thickness were significantly higher in gestational hypertensive women, 41% of gestational hypertensive women had normal geometry and 59% had abnormal geometry (34% eccentric hypertrophy, 19% concentric hypertrophy and 6% concentric remodeling). IVRT and IVCT were significantly higher in gestational hypertensive women with p value of 0.0001 and P = 0.003. ET showed a non-significant lower values (p= 0.34) in gestational hypertensive women. Tei index was significantly higher in Gestational hypertension (P=0.011). Conclusion: Women with gestational hypertension had altered myocardial function characterized by the higher Tei index values associated with eccentric hypertrophy which can be explained by the fact that gestational hypertension poses higher afterload on the left ventricle instead the state of low peripheral resistance that is ysually expected during normotensive pregnancy.
Background: Atrial septal defect (ASD) is one of the most widely recognized cardiac congenital ab... more Background: Atrial septal defect (ASD) is one of the most widely recognized cardiac congenital abnormalities in adulthood. Atrial septal defect is characterized by an inter-atrial septum defect that allows the pulmonary venous return from the left atrium to pass directly to the right atrium. Paradoxical septal motion is mainly detected by two-dimensional and M-mode echocardiography. The recently introduced Doppler tissue imaging (TDI) echocardiographic modality has been used in many clinical situations, including ventricle wall movement determination. Objective: To investigate the validity of Tissue Doppler imagery (TDI) coded in color as one of the parameters in ASD assessment. Patients and methods: A cross-sectional retrospective study was performed from June 2018 to June 2019 in multi-teaching centers in Iraq. This study involved adult patients with ASD (confirmed with transthoracic TTE and transesophageal echocardiography TEE), patients with other congenital or pathological cardiac defects were removed from the research. TEE was conducted in just 6 patients (Diagnostic only), whereas TTE obtained all the measurements. The echocardiographic analysis included two-dimensional imagery from the long and short parastern axis view, apical and subcostal view with Doppler color demonstration of interatrial shunt, Doppler color coded tissue to determine interventricularseptal motion Results: There are 40 patients and 40 controls in this sample. The mean case patient age was 30.4 (SD ± 8.42) and the controls age was 33.5 (SD± 9.74). Among the case and control groups there were 33 females (83%) and 7 males (17%), the mean BSA (body surface area) of the case population was 1.88 m2 (SD ± 0.14) and that of the control was 1.81 m2 (SD ± 0.12).), these were not statistically significant differences. There was 36 (90 percent) ASD secondum, and 4 (10 percent) of sinus venosus type. Parameters (Qp / Qs, RA. Area, and RV., basal diameter) were significantly different between case and control groups. There were no significant differences in the SL between case and control groups in colour-coded tissue Doppler image parameter Standardized septal length as follows (68.2± 2.162), (36.7± 2.944) and (66.6± 1.700), respectively (36.8± 2.122); There were significant differences in color change point distance (CCP), standardized color change point distance, and the ratio of CCP to SL between case and control groups as follows (28.12± 3.114), (15.24± 2.359), (40.9± 3.532) and (16.975± 1.765), (9.29± 0.99), (25.54± 2.513) respectively. Conclusions: TDI has been found to be a reliable tool to assess wall movement anomalies in adult ASD patients and can be used as additional criteria to support ASD diagnosis.
Background:-Atherosclerosis is a systemic disease that often affects multiple vascular distributi... more Background:-Atherosclerosis is a systemic disease that often affects multiple vascular distributions in a single patient. The increased prevalence of renal artery stenosis in association with coronary artery disease has been well documented. Objectives:-To examine in detail the prevalence of renal artery stenosis in patients undergoing cardiac catheterization for suspected coronary artery disease. Patients &methods:-Between April 2010 and February 2011, two hundred patients underwent coronary and renal angiography at the same session in Ibn Al-bitar Hospital for Cardiac Surgery. Clinical and procedural data for patients undergoing renal angiography were prospectively collected and entered into database specially designed for the present study. Results:-Two hundred patients were included in this study, 133 (66.5%) were males and a mean age of 53±12 years, age range (42-73 year). Significant renal artery stenosis (≥ 50% luminal narrowing) was identified in 18 patients (9%) made up the renal artery stenosis group. Age, hypertension, diabetes mellitus and renal impairment were significantly associated risk factors for renal artery stenosis. Gender, smoking and hyperlipidemia were not significantly associated with either group. The frequency of renal artery stenosis is significantly increased with the number of stenotic coronary segments; patient with two and three vessel disease had more frequent renal artery stenosis than the others. Conclusion:-Renal artery stenosis is prevalent in a significant proportion of patients undergoing cardiac catheterization for suspected coronary artery disease & the number of coronary arteries with stenotic lesions is a remarkable predictor of significant renal artery stenosis.
Background: dyslipidemia plays a crucial rule in the development of cardiovascular disease, which... more Background: dyslipidemia plays a crucial rule in the development of cardiovascular disease, which has become the leading cause of death in most developed countries as well as in developing countries (1). The effects of reducing low density lipoprotein – C (LDL-C) concentrations on the prevention of cardiovascular events and stroke have been well reported in many clinical trials.Objectives: Evidence supports the use of statins for lipid modifications in the primary prevention of coronary artery disease, morbidity and mortality. This study aims to determine the effectiveness of atorvastatin in treating dyslipidemia in Iraqi obese patients.Methods: 200 overweight and obese patients with hypercholesterolemia, according to NCEP ATP III criteria, were included. They were randomized into 3 groups according to atorvastatin dose, 10, 20, 40 mg/ day, and treated for 8 weeks. Blood lipid profile, liver enzymes ALT and AST, urea, creatinine, uric acid, calcium and glucose were measured before and after therapy.Results: There was a significant reduction of total cholesterol (TC), Triglycerides (TG), low density lipoprotein (LDL), very low density lipoprotein (VLDL), but a non-significant reduction of high density lipoprotein (HDL) with all atorvastatin doses. The high doses of the drug caused a significant elevation of serum levels of ALT and AST and a significant decrease of blood calcium; but there was no significant change in blood levels ofurea, creatinine, uric acid or glucose with any dose.Conclusion: Short-term atorvastatin therapy in dyslipidemic obese patients caused a reduction of TC, TG, LDL, and VLDL, but had no significant effect on HDL, non-significant changes in blood urea, serum creatinine, serum uric acid or blood glucose, while there was a dose dependent elevation of ALT and AST.
Annals of Tropical Medicine and Public Health, 2021
Background:In 2012 the consensus issued by both the American College of Cardiology & Foundation H... more Background:In 2012 the consensus issued by both the American College of Cardiology & Foundation Heart Rhythm Society Recommend the use of Dual Chamber Pace maker instead of Single chamber pace maker for patients with Sinus Node dysfunction. Restoration of atrioventricular synchrony in patient with sinus node dysfunction or Atrioventricular block representing a new era in electrical therapy. the focus on normal physiology led to the nearly universal application of dual-chamber pacing to restore atrioventricular (AV) synchrony in patients with sinus rhythm. Objective: To evaluate Speckle Tracking Echocardiography in detection of early ventricular changes toward Heart failure after implantation of dual chamber pacemaker. Patients & Methods: Speckle tracking was used to evaluate the percent of v entricular deformation before and 3months follow upafter dual chamber implantation, this study included 28 patients with Sinus node dysfunction or Heart Failure-LBBB. This prospective observational study was carried out on patients of medical city, Baghdad Teaching Hospital, cardiology & Echocardiography Higher Education (Diploma) center from November 2016 to July 2017. Results: No statistical difference was noted between both gender groups in regard to main risk factors.Four methods were used to evaluate ventricular function synchrony (Ejection Fraction %, Global longitudinal stain, intraventricular synchrony using septal to posterior wall motion delay, interventricular Mechanical delay by Pulse wave), Global EF evaluated by Simpson biplane method remained the same in all patients after 3-month follow-up (P = NS). Global longitudinal strain (GLS) significantly decreased in all patients. Inter-ventricular dyssynchrony evaluation revealed no significant change after 3 months. Conclusion: Global longitudinal strain and Left Ventricular dessynchrony assessment enables us to detect early signs of LV dysfunction in Subjects with dual chamber pacemaker.
License, which permits unrestricted use, distribution, and reproduction in any medium, provided t... more License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To assess differences in age of onset, hypertension duration, type of drug, treatment compliance, and salt-free diet compliance between patients with stroke and myocardial infarction. Patients and Methods. The study was conducted in 3 hospitals in Baghdad between June 2010 and June 2011. First group includes 81 stroke patients (36 females and 45 males), age ranges between (33–82 years). Second group includes 110 myocardial infarction patients (46 females and 64 males), ages ranges from (23– 76 years). Results. Salt-free diet noncompliance was seen in 69 % and 62 % of Myocardial infarction and stroke groups, respectively. Silent hypertension was seen in 6.3 % and 19.7 % of myocardial infarction and stroke groups, respectively. Noncompliant on antihypertensive therapy was seen in 61%, 71%, and 48 % of the total, myocardial infarction, and stro...
Jordan Journal of Agricultural Sciences, Dec 4, 2012
This experiment was conducted at the Agricultural Research Center of Ainkawa / Erbil / Iraq, duri... more This experiment was conducted at the Agricultural Research Center of Ainkawa / Erbil / Iraq, during the growing season 2005-2006. The aim of this experiment was to investigate the effect of planting dates and plant density on vegetative growth of two varieties of strawberry Fragaria × ananassa Duch. Three planting dates 20 thsep., 10 thoct. and 30 thoct. in 2005 and three plant densities (46000, 23000 and 15332 plants/Hec) with two varieties of strawberry “ Kaiser’s Smaling and Hapil” had been investigated. The annual hill system was used with fixed spacing (1m) between rows. The experimental design was split-split plot within RCBD, with 4 replicates and the experimental unit area was 7.2m2. All results were tested using Duncan’s multiple range test at probability of 5%. Results obtained could be summarized as following: 1. The average of leaf area, dry mater of foliage, number of runners per plant significantly increased in Hapil variety, while the content of total chlorophyll only increased significantly in Kaiser’s Smaling variety. 2. The low plant density (by increasing the distance between plants) caused a significant increasing for all vegetative growth characteristics in both varieties. 3. The early planting dates on 20 thsep. caused a significant increase in all vegetative growth characteristics in both varieties.
Zenodo (CERN European Organization for Nuclear Research), Aug 20, 2021
assessment of global left ventricular perfusion before and after percutaneous coronary interventi... more assessment of global left ventricular perfusion before and after percutaneous coronary intervention in patients with chronic stable angina Evaluación ecocardiográfica transtorácica de la perfusión ventricular izquierda global antes y después de la intervención coronaria percutánea en pacientes con angina crónica estable
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