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All Journal E-Jurnal Medika Udayana Indonesian Journal of Cardiology Jurnal Health Sains Jurnal Neuroanestesi Indonesia
Wiryawan, I Nyoman
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Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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GAMBARAN FAKTOR RISIKO HIPERTENSI PADA MASYARAKAT DI DESA UNGASAN, KECAMATAN KUTA SELATAN, KABUPATEN BADUNG Suryaningsih, Ni Putu Elsinthia; Wita, I Wayan; Wiryawan, I Nyoman; Yudha Dewangga, Made Satria
E-Jurnal Medika Udayana Vol 11 No 1 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.v11.i01.P14

Abstract

ABSTRAK Hipertensi sebagai penyakit degeneratif yang masih menjadi tantangan besar di dunia, begitu juga di Indonesia karena prevalensinya yang terus meningkat tiap tahunnya. Hipertensi bisa ditimbulkan akibat berbagai macam faktor. Komplikasi yang dapat ditimbulkan seperti stroke, gagal ginjal, kerusakan pada mata, ataupun coronary heart disease. Penelitian ini bertujuan untuk mengetahui gambaran faktor risiko pada penderita hipertensi di Desa Ungasan. Rancangan deskriptif sebagai metode yang digunakan dalam penelitian ini dengan studi potong lintang dan teknik consecutive sampling. Populasi dalam penelitian adalah masyarakat berusia ? 18 tahun dengan mengidap hipertensi yang berdomisili di Desa Ungasan, dan didapatkan jumlah sampel sebanyak 140 orang. Pengambilan data dilakukan dengan pemeriksaan tekanan darah dan wawancara menggunakan kuesioner terstruktur. Berdasarkan hasil penelitian berdasarkan derajat hipertensi didapatkan responden lebih banyak berada pada kelompok hipertensi derajat satu yaitu 104 responden (52%). Prevalensi hipertensi lebih banyak pada kelompok usia ? 40 tahun 112 responden (80%), berjenis kelamin perempuan 81 responden (57.9%), memiliki riwayat keluarga dengan hipertensi 104 responden (74.3%), sering mengkonsumsi garam 114 responden (81.4%), sering mengkonsumsi lemak 121 responden (86.4%), bukan perokok 102 responden (72.9%), dan sering beraktivitas fisik 95 responden (67.9%). Dapat dilakukan penelitian lanjutan dengan menggunakan hasil penelitian ini sebagai data acuan. Kata Kunci: Hipertensi, Faktor Risiko, Desa Ungasan
Evaluation of Cardiometabolic Factors Affecting Chronotropic Incompetence: A Cross-Sectional Retrospective Study in Sanglah General Hospital, Bali Prana Jagannatha, Gusti Ngurah; Yasmin, AA Ayu Dwi Adelia; Surya Pradnyana, I Wayan Agus; Kamardi, Stanly; Wiryawan, I Nyoman; Wita, I Wayan
Jurnal Kardiologi Indonesia Vol 43 No 1 (2022): Indonesian Journal of Cardiology: January - March 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1189

Abstract

Background: Recent studies have identified that chronotropic incompetence is correlated with poor cardiometabolic health and systemic inflammation that results in exercise intolerance, impaired quality of life and death due to cardiovascular disease (CVD). Unfortunately, there’s still paucity of data regarding cardiometabolic factors associated with chronotropic incompetence. The purpose of this study was to identify the cardiometabolic factors associated with chronotropic incompetence. Methods: This study was a cross-sectional retrospective study using cardiac treadmill stress test data at Sanglah General Hospital from May 2018 - May 2020 and 136 patients were enrolled. Data analysis used SPSS version 21. Pearson chi-square test was used to compare categorical variables based on cardiometabolic risk factors in chronotropic incompetence. Results: Patients were divided based on the characteristics of age, gender, smoking status, body mass index, coronary artery disease, heart failure, hypertension, dyslipidemia, type 2 diabetes mellitus (T2DM), the levels of HbA1C, total cholesterol, LDL, HDL, and triglyceride. In this study, it was found that T2DM (PR 2.29; 95%CI 1.16–3.37), HbA1C (PR 3.13; 95%CI 2.31-4.22), dyslipidemia (PR 1.773; 95%CI 1.170–2.687), high total cholesterol (PR 2.396; 95%CI 1.650-3;481), and high LDL level (PR 1.853, 95%CI 1.229-2.794) were significantly associated with chronotropic incompetence (all p-value <0.05), while other factors were not significantly related. Conclusion: Chronotropic incompetence can impair quality of life and contribute to cardiovascular mortality. However, T2DM, high HbA1C, dyslipidemia, high total cholesterol and LDL levels were found to be associated with chronotropic incompetence. This may contribute to higher cardiovascular risk attributed to those factors.
Anesthetic Management of Mechanical Thrombectomy for Acute Ischemic Stroke with Severe Mitral Stenosis: A Case Report MD, Burhan; Suarjaya, I Putu Pramana; Ratu, Tiffani; Wiryawan, I Nyoman; MD, Patricia; Tini, Kumara
Jurnal Neuroanestesi Indonesia Vol 14, No 3 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i3.719

Abstract

Acute ischemic stroke from large vessel occlusion requires prompt reperfusion to preserve brain function. Mechanical thrombectomy is the treatment of choice in selected cases, especially cardioembolic strokes. Anesthetic management plays a critical role, particularly in patients with cardiac comorbidities. We report a 62-year-old woman presenting with left-sided weakness and reduced consciousness, six hours prior to admission. She had a history of rheumatic mitral stenosis and atrial fibrillation. CT angiography showed infarction in the right MCA territory with distal ICA occlusion. Intravenous thrombolysis was initiated but failed to show improvement. Mechanical thrombectomy was then performed under general anesthesia. Due to the patient’s decreased consciousness and aspiration risk, general anesthesia was preferred to secure the airway and allow precise hemodynamic control. The anesthetic strategy focused on maintaining systemic vascular resistance while avoiding increased pulmonary vascular resistance to prevent right heart overload in mitral stenosis, also oxygenation and ventilation were carefully managed to avoid hypoxia and hypercapnia. Full vessel recanalization (mTICI 3) was achieved without complication. This case highlights the importance of tailoring anesthesia to individual risk profiles, particularly in stroke patients with valvular heart disease, where general anesthesia may provide optimal safety and procedural success.
Cryptogenic Stroke: A Challenge in Diagnosis and Management Purwowiyoto, Sidhi Laksono; Setianto, Budhi; Panindhita, Gea; Halomoan, Reynaldo; Wiryawan, I Nyoman
Jurnal Kardiologi Indonesia Vol 42 No 3 (2021): Indonesian Journal of Cardiology: July - September 2021
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1149

Abstract

Ischemic stroke is responsible for 85% of all stroke globally. However, the etiology of around a quarter of ischemic stroke are undetermined, this is called cryptogenic stroke. This kind of stroke affects younger population. Several mechanism are associated with the incidence of cryptogenic stroke such as paroxysmal atrial fibrillation, patent foramen ovale, atherosclerosis, and atrial cardiopathy. Despite many advanced knowledge on stroke generally, cryptogenic stroke is still a challenge in clinical settings. To understand more about cryptogenic stroke, a new term of embolic strokes of undetermined source (ESUS) is proposed and may need a specific workup. Specific workup aims to detect any silent risk factors and also to evaluate the cardiac structure. The term of ESUS also leads to the understanding that cryptogenic stroke is highly related to embolic mechanism and anticoagulation administration might benefit the patients. However, the result of several recent studies showed that anticoagulant was not superior to antiplatelet, and antiplatelet is still the preferred treatment. Studies on PFO closure also shows different result, but the majority of the trials showed benefit of PFO closure in reducing the risk of stroke recurrence.
Improving The Diagnostic Accuracy of Exercise Stress Testing in Detecting Coronary Heart Disease using St/Hr Hysteresis Suryaguna, I Made Sakta; Wiryawan, I Nyoman
Jurnal Health Sains Vol. 7 No. 1 (2026): Journal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v7i1.2796

Abstract

Coronary heart disease (CHD) is still the leading cause of cardiovascular morbidity and mortality in the world, including in Indonesia. Cardiac test with electrocardiography (ECG) is a widely used non-invasive test because it is relatively low cost and easy to perform, but the standard parameter of ST segment depression has limitations in diagnostic accuracy. ST/HR hysteresis is an alternative parameter that considers changes in the ST segment to heart rate during the exercise and recovery phases, which are reported to have better diagnostic capabilities. This study aims to assess the improvement of the diagnostic accuracy of cardiac training tests in detecting CHD using ST/HR hysteresis. This study is a diagnostic study conducted at Sanglah Hospital Denpasar in the period of December 2018 to April 2019. The subjects of the study were patients with suspected CHD who had undergone cardiac training tests and coronary angiography as the gold standard. The analysis was carried out on the ST/HR value of hysteresis obtained from secondary data, then the optimal cut-off point was determined using Receiver Operating Characteristic (ROC) analysis. A total of 134 patients were analyzed, with 59 patients (44%) proven to have significant CHD based on coronary angiography. The results of ROC analysis showed the cut-off point of ST/HR hysteresis ≥0.026 mV with an AUC value of 84.8%, sensitivity of 79.7%, and specificity of 85.3%. This value is higher than the variable parameters of the conventional ST segment. The net reclassification improvement (NRI) analysis showed a value of 0.28, which indicates an increase in diagnostic accuracy. It is concluded that ST/HR hysteresis improves the diagnostic accuracy of cardiac training tests and can be used as an effective and efficient additional parameter in detecting coronary heart disease.
Co-Authors Anak Agung Ayu Dwi Adelia Yasmin Budhi Setianto Halomoan, Reynaldo I Made Sakta Suryaguna I Wayan Wita Kamardi, Stanly MD, Burhan MD, Patricia Panindhita, Gea Prana Jagannatha, Gusti Ngurah Purwowiyoto, Sidhi Laksono Putu Pramana Suarjaya Ratu, Tiffani Surya Pradnyana, I Wayan Agus Suryaningsih, Ni Putu Elsinthia Tini, Kumara Yudha Dewangga, Made Satria