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Background The association between epicardial fat thickness and coronary artery disease (CAD) has been evaluated previously using echocardiography. Recently, multidetector computed tomography (MDCT), as a valuable tool in cardiovascular CT imaging, can improve characterization of CAD and give a more accurate volumetric quantitation of EF. The purpose of our study was to evaluate the relationship between the epicardial fat volume and CAD using multi-detector row CT. Results Out of the studied 120 patients, 22 patients were negative for CAD, while 98 patients had positive CAD. There was significant difference between both groups as regard epicardial fat volume (p < 0.001), and good relation was found between the amount of epicardial fat volume and coronary calcium score, number of affected vessel, plaque burden and degree of stenosis (p =  < 0.001). Conclusion EAT volume was larger in the presence of obstructive CAD and atheromatous plaques. These data suggest that EAT is associated with the development of coronary atherosclerosis and potentially the most dangerous types of plaques.

Background: Water pipe (WP) tobacco smoking is gaining wide popularity among young and middle aged males and females. Aim of the work: The aim of this study was to evaluate the immediate effect of 1st pipe water smoking on brachial Flow mediated dilatation% (FMD%) and Nitrate mediated dilatation% (NMD %) as markers of systemic endothelial function. Methods: The present study comprised of 40 young healthy volunteers with no cardiovascular risk factors (the mean age 28 AE 5 years, males) randomized to either smoking (cigarette or pipe water) or not smoking in a crossover fashion. All the participants underwent a physical examination, laboratory analysis, Standard echocardiography, brachial artery FMD% Z [(DmaxeDbase)/ Dbase] multiplied by 100 (%). and endothelium independent dilation (NMD%) Z [(DNTG-Dbase)/Dbase] multiplied by 100 (%) were assessed with a high-resolution ultrasound probe and the arterial diameters before smoking, just after smoking, 1 h and 2 h after obtained. Results: FMD% after 1 h of both water pipe and cigarette were significantly lower (p < 0.001) than FMD% of the base e line and normalized after 2 h. No differences in median NMD % values (p > 0.05). Conclusion: Our findings confirm that even one time pipe water smoking is associated with systemic endothelial dysfunction comparable to cigarette smoking in young non-smoker volunteers with no cardiovascular disorders or risk factors.

Background: Limb Ischemia is an obstruction of the arteries which reduces blood flow to the extremities (hands, feet and legs) and has progressed to the point of severe pain and even skin ulcers, sores, or gangrene. The pain caused by ischaemia can -wake up an individual at night. This pain is often in the leg and can be relieved temporarily by hanging the leg over the bed or getting up to walk. The complications of diabetic vasculopathy commonly include two categories: microvascular and macro-vascular complications. Macro vascular disease is the most common reason of mortality and morbidity in diabetes and is responsible for high incidence of vascular diseases such as stroke, myocardial infarction, and peripheral vascular diseases (PAD). Epidemiological evidence has confirmed an association between diabetes and increased prevalence of PAD. The duration and severity of diabetes correlate with incidence and extent of PAD. Diabetes changes the nature of PAD. Aim of the Work: The aim of this present study is to evaluate the role of colour Doppler Ultrasound (US) in the diagnosis of lower limb ischaemia. Patients and Methods: In this study, 40 diabetic patients with ischemic limb underwent arterial reconstruction or intervention bypass surgery at Department of Diagnostic Radiology, Tanta University Hospitals. The age of our selected patients ranged from 40-80 years showing that about 2/3 patients in this study were above the age of 60 years and this was found in 24 patients (60%) this is due to high incidence of ischemia and prevalence of atherosclerosis in old age. Results: There are variable risk factors were present. DM was present in 100% of patients followed by hypertension was found in 30 patients (75%) coronary heart disease was found in 9 patients (22.5%) and at least cigarettes smoking was found in 12 patients (30%). Regarding the clinical presentation, intermittent claudication pain was the most frequent symptoms and was present in 26 patients (65%), followed by persistent pain and delayed healing foot ulcer was present in 9 patients (22.5%), followed by rest pain was present in 4 patients (10%) at least amputated leg was present in one patient (2.5%). Colour Doppler US has some limitation eg. In ability to see particular vessels wall due to wall calcification, gases and vessels tortuously. Colour Doppler US sometimes failed to differentiate between tight stenosis and total occlusion. CTA still had an important role especially in the infra-popliteal region and peri-vascular masses. Conclusion: Our study suggested that computed tomography angiography can be used to assess the entirety of lower extremity arterial inflow and runoff, with volumetric data that demonstrate robust arterial enhancement and minimal venous opacification. Nevertheless, computed tomography angiography cannot be considered a viable clinical alternative to colour Doppler US until its diagnostic accuracy and effectiveness are determined.