الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Coronary artery disease (CAD) is the leading cause of death worldwide. Previously thought to affect primarily high-income countries, CAD now leads to more death and disability in low- and middle-income countries (Murray et al., 2012). Atherosclerosis is a systemic disease, and carotid and coronary arteries are the two most common sites of involvement of atherosclerosis (Robinson and Gidding, 2014). Heart failure with reduced ejection fraction (HF-rEF) and preserved ejection fraction each make up about half of the overall HF burden. The most common etiology of HF-REF in the developed world is ischemic heart disease, which is associated with more than 60% of diagnoses. Coronary artery disease (CAD) associated with left ventricular systolic dysfunction is a condition related to poor prognosis (Gheorghiade et al., 2006). Imaging of arteries to identify and quantify the presence of subclinical vascular disease has been suggested to further refine CAD risk assessment (Tierney et al., 2015). Whereas coronary angiography has stood the test of time to assess atherosclerotic burden in coronary arteries, the cost and skill needed to perform this test has left this test unaffordable and unreachable to many. Carotid intima-media thickness (CIMT) is a simple and inexpensive tool to assess the cumulative effect of atherosclerotic risk factors and has been proven to be an independent predictor of future cardiovascular risk in various studies (Touboul, 2022). Carotid artery disease is a manifestation of atherosclerosis and is very often present concurrently with coronary artery disease (CAD) and peripheral artery disease (Costanzo et al., 2014) Carotid artery intima-media thickness (CIMT) measurement is a non-invasive method to diagnose early atherosclerosis or predict the risk of myocardial infarction and stroke. Increased CIMT in the common carotid segment is accompanied by yearly risk of 0.7%– 2.2% in coronary heart disease, 0.4%–1.8% for stroke and from 1.8% to 3.2% for total cardiovascular disease (Alipour et al., 2013). The non¬invasive and reliable diagnostic tool for evaluating carotid artery atherosclerosis plaque or stenosis (CAS) is an ultra¬sound including measurement of intima-media thickness (IMT), which represents mainly medial layer hypertrophy (von Reutern et al., 2012). IMT is usually measured in the common carotid artery and the internal carotid artery (Touboul et al., 2012b) In recent years, automated and semi-automated measurements of IMT were developed (Molinari et al., 2010b). The Aim of this study : This study is conducted to assess the value of the carotid intima –media thickness and plaque as a predictor for ischemic etiology in patients with severe left ventricular systolic dysfunction. Materials and methods : This study was descriptive comparative prospective study and conducted on (70) consecutive patients who admitted with heart failure symptoms in Mansoura cardiovascular department from 01/06/2021 up to 01/06/2022 , all patients with LV systolic dysfunction with EF ≤ 35% undergoing coronary angiography. Results :The results of the current study revealed that the carotid intima media thickness and plaque could predict the presence of ischemia of coronary arteries before the failure of left ventricle.