Raynaldo, Abdul Halim
Departemen Kardiologi Dan Kedokteran Vaskuler, Fakultas Kedokteran, Universitas Sumatera Utara

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The Relationship between Pre Discharge Left Ventricle Diastolic Dysfunction and 30 days And 6 Months Rehospitalization in Patients with Heart Failure with Reduced Ejection Fraction (HFrEF) at Haji Adam Malik General Hospital Medan Khaidirman, Sophia Khairina; Mukhtar, Zulfikri; Sarastri, Yuke; Ketaren, Andre Pasha; Raynaldo, Abdul Halim; Andra, Cut Aryfa
Journal of Society Medicine Vol. 2 No. 5 (2023): May
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i5.33

Abstract

Introduction: Heart failure (HF) is a complex clinal manifestation that cause abnormality of structural and/or functional of the heart. HF is due to diastolic dysfunction and systolic dysfunction of the left ventricle (LV). The aim of this study is to assess the relationship between grading of pre-discharge LV diastolic dysfunction and readmission at 30 days post discharge and 6 months post discharge. Method: This is a cohort retrospective study in HFrEF patients which are treated at Pusat Jantung Terpadu RSUP H. Adam Malik Medan on January 2021 until December 2021. Pre discharge echocardiography has been done to assess LV diastolic dysfunction and the we do the follow up of readmission at 30 days and 6 months by phone. Results: From 93 patients, there are 40 patients (43%) with grade I LV diastolic dysfunction, 22 patients (23,7%) with grade II LV diastolic dysfunction and 31 patients (33,3%) with grade III LV diastolic dysfunction. There are 34 patients (26,6%) with readmission at 30 days and 21 patients (26,6%) readmission at 6 months. There is a significant relationship between grading of pre-discharge LV diastolic dysfunction and readmission at 30 days post discharge (p value 0,000), but not at 6 months post discharge (p value 1,000). Conclusion: Grading of pre-discharge LV diastolic dysfunction on HFrEF patient is correlated with readmission at 30 days post discharge.
Consensus Statements on the Use of High-Sensitivity Troponin I as the Assessment of Cardiac Risk in Apparently Healthy Population in Indonesia Ambari, Ade Meidian; Ng, Sunanto; Rejeki, Vidya Gilang; Rina Artha, I Made Junior; Raynaldo, Abdul Halim; Alsagaff, Mochamad Yusuf; Wicaksono, Sony Hilal; Dwiputra, Bambang; Desandri, Dwita Rian
Jurnal Kardiologi Indonesia Vol 44 No 3 (2023): Indonesian Journal of Cardiology: July - September 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1544

Abstract

Cardiovascular disease (CVD) is a growing burden in Indonesia, making primary prevention of utmost importance. High sensitivity cardiac troponin I (hsTnI) has been known as one of the biomarkers of choice for diagnosing acute myocardial infarction. Nonetheless, recent studies indicate that hsTnI assay has potential as a predictor of cardiac risk in asymptomatic individuals. An advisory board consisting of renowned cardiologists from the Indonesian Heart Association was convened in Jakarta in March 2023. The meeting aimed to explore the appropriate use of hsTnI for cardiovascular (CV) risk stratification in apparently healthy adults in Indonesia. The board reviewed relevant literature and developed key consensus statements, including hsTnI cut-off for identifying high-risk asymptomatic patients, the proposed algorithm, and monitoring after aggressive risk factor control. This article presents the resulting consensus statements to provide clinicians with a practical tool for planning primary prevention strategies. Furthermore, it is expected to raise awareness and advocacy among stakeholders in the healthcare infrastructure regarding the use of hsTnI as a guide for assessing CV risk in Indonesia.
The Level of Knowledge of the Community About Heart Health in The Covid-19 Pandemic Era Harris Hasan; Raynaldo, Abdul Halim
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 4 No. 2 (2022): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v4i2.9126

Abstract

Background: Cardiovascular disease is still a global health problem. Data obtained from the World Health Organization (WHO) states that the death rate from cardiovascular disease (CVD) is 17.7 million people every year and 31% is the cause of all global deaths. The purpose of this study was to determine the level of public knowledge about heart health in the covid-19 pandemic era.  Method: The sampling technique used consecutive sampling, namely subjects who came and met the inclusion criteria were included in the study until the number of samples was met. This study is expected to provide information to the public about heart health and its relationship to the era of the covid-19 pandemic in the community/employees in the USU Medical Faculty Results: In this study, the number of samples was 100 people, the age group > 30 years (62%), while the age group ≤ 30 years (38%). The majority of the sample works as official governments 40 people (40%), had good score predicate, good level of knowledge is Government Employees 20 peoples (20%), health workers (20%), while the level of education is Strata 1.  Conclusion: The level of knowledge of the community about heart health in the Covid-19 pandemic era is good with education level Strata 1 and most of them are Government Employees
Cardiometabolic Profile Screening as an Early Detection of Cardiometabolic Risk Sarastri, Yuke; Raynaldo, Abdul Halim; Ilyas, Kamal Kharrazi; lubis, Dian Anindita
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 4 No. 2 (2022): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v4i2.9156

Abstract

Background: Cardiometabolic risk profile is a set of interconnected risk factors, namely abdominal obesity, hypertension, dyslipidemia, hyperglycemia, and hyperinsulinemia, and causes global death. This study was conducted to obtain data on cardiometabolic profiles of people who participated in the Commemoration of World Hypertension Day 2021 at RSUP H Adam Malik Medan Method: This research is a descriptive study with a cross-sectional research design peoples namely by looking at the description of the cardiometabolic profile. The sample is an affordable population that meets the inclusion criteria, people with age >18 years old. Variables of blood pressure, waist circumference, blood sugar levels, and total cholesterol levels are numerical variables. Blood pressure examination is measured using a sphygmomanometer and expressed in mmHg units. The measurement of the abdominal circumference is carried out by examining the size of the abdominal circumference obtained using a tape measure in cm. Blood sugar levels are obtained from the results of measuring blood sugar levels during laboratory examination of blood in mg/dl units. Cholesterol levels are obtained from the results of measuring total cholesterol levels from blood laboratory examinations in mg/dl.  Results: All subjects in this study (n= 100) are 42 men and 58 women with normal waist circumference, and education level strata -1, only 9% of the subjects had high blood sugar levels, and 41% of subjects were classified as central obesity 9% of subjects. Most patients (91%) with normal postprandial glucose and high total cholesterol 66%. Conclusion: In this study, most of the cardiometabolic risks of patients are overweight/obesity and dyslipidemia
Inflammatory Mediators as Predictors of Improved Functional Capacity after Phase 2 Cardiac Rehabilitation in Coronary Artery Bypass Surgery Patients Raynaldo, Abdul Halim; Sarastri, Yuke; Ilyas, Kamal Kharrazi; Tarigan, Stefanie
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 5 No. 1 (2023): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v5i1.12145

Abstract

Background: Inflammatory parameters correlate with the atherosclerotic acute coronary syndrome (ACS) process and can predict future cardiovascular events in healthy populations. Coronary heart disease (CHD) subjects who had undergone coronary artery bypass grafting (CABG) procedures and underwent cardiac rehabilitation must be prevented from increased cardiovascular events. The study aims to evaluate the effect of cardiac rehabilitation programs on marker inflammation of cardiovascular risk factors. Method: This study was conducted at Departement Cardiology and Vascular Diseases Integrated Heart Center H. Adam Malik Hospital Medan who had undergone CABG procedures and underwent phase I and II cardiac rehabilitation. All subjects were carried out to collect basic patient data based on anamnesis, physical examination, results of laboratory tests, and functional capacity of the heart. Result: The subjects of this study were male 26 (89.7%) subjects and female 3 (10.2%) subjects. The average BMI in this study was 26.4207±0.675 kg/m2, the most common CHD risk factor was smoking in 21 (72.4%) subjects, dyslipidemia in 20 (69%) subjects, hypertension in 18  (62.1%) subjects, obesity 14 (48.3%) subjects and T2DM 13 (44.8%) subjects. Based on echocardiography results, the average ejection fraction was 47.931±2.17 %, and 18 (62.1%) subjects had cardiomegaly. After undergoing phase I and II cardiac rehabilitation,  there was improved significantly of the 6-minute walk test to hsCRP, IL-6, neutrophil-lymphocyte ratio (NLR), and functional capacity (all, p <0.001). IL-6 value is correlated significantly with functional capacity improvement (p<0.05) in both phase I and II cardiac rehabilitation. Conclusion: Cardiac rehabilitation (CR) should be considered as a preventive plan in the treatment of CHD patients. Physical exercise is noteworthy and they reduce morbidity and mortality due to reduced inflammation.
A Correlational Study Elevated Risk of Cardiometabolic Illness and the Prevalence of Obstructive Sleep Apnea Among the Population of Tebing Tinggi, North Sumatra, Indonesia Raynaldo, Abdul Halim; Pase, Muhammad Aron; Ketaren, Andre Pasha
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 5 No. 3 (2023): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v5i3.14330

Abstract

Background: Obstructive Sleep Apnea (OSA) is a prevalent sleep-related breathing issue, marked by repeated full or partial blockages of the upper airways. It's a primary respiratory condition that heightens the chances of cardiometabolic diseases. In our research, we explored the link between the increased risk of cardiometabolic ailments and the potential for OSA. Method: We studied 75 participants during community service activities and investigated the association between the high risk of cardiometabolic disease and the risk of OSA in the Society of Tebing Tinggi. We measured variables such as gender, age, weight, height, Body Mass Index (BMI), blood pressure, heart rate, random blood glucose, waist and neck circumference, and total cholesterol. Subsequently, we categorized the data and performed chi-square tests to analyze the associations between various factors and the risk of OSA. Variables with p<0.05 are considered eligible for multivariate analysis using binary logistic regression. Results: We identified 42 patients had a high risk of OSA (59.2%), while 33 patients had a low risk (40.8%). The study identified significant links between OSA risk and gender, age, blood pressure, and neck circumference (p-values <0.001, <0.001, and 0.01 respectively). In contrast, BMI, heart rate, glucose levels, waist size, and cholesterol did not show a significant connection to OSA risk. This indicates that while certain factors like gender, certain age groups, hypertension, and neck size are important in assessing OSA risk. However, BMI, heart rate, random blood glucose, waist circumference, and total cholesterol are not significant factors in determining the risk of OSA (p=0.2, p=0.4, p=0.2, p=0.1, p=0.9). Conclusions: Higher risk of cardiometabolic diseases (older age, gender, hypertension, neck size) was positively associated with the risk of OSA.
Acute Kidney Injury as Predictor of Major Adverse Cardiac Event (MACE) in 3 Months after Admission of Acute Heart Failure Patients in Haji Adam Malik General Hospital Medan Chan, Muhammad Ikhsan; Andra, Cut Aryfa; Raynaldo, Abdul Halim; Hasan, Harris; Sarastri, Yuke; Sitepu, Andika
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 5 No. 2 (2024): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v5i02.2024.82-94

Abstract

Highlights: 1. This study provides novel evidence that acute kidney injury (AKI) is a strong predictor of major adverse cardiovascular events (MACE) in patients with acute heart failure, highlighting the critical need for early detection and intervention to improve outcomes. 2. This research underscores the importance of incorporating kidney function assessment into the comprehensive management of acute heart failure patients. - Background: Acute heart failure is a condition with high morbidity and mortality. Decreased renal function after hospitalization is a predictor of longer hospitalization and increased mortality. Patients with acute renal failure, especially injury or failure grade, have a worse long-term prognosis compared to patients without acute renal failure, which will lead to MACE. Major adverse cardiovascular events are a combination of non-fatal stroke, non-fatal myocardial infarction, or cardiovascular death. Material and Methods: This study was a retrospective cohort study of 159 patients with acute heart failure at HAM General Hospital from April 1, 2023 to December 31, 2023. Electrocardiographic, laboratory, and echocardiographic data were collected. Patients were categorized according to RIFLE classification and monitored to see MACE in the samples. Bivariate tests were performed to see the correlation between samples. Furthermore, Kaplan-Meier curves were analyzed to see the survival rate. Results: Total subjects were 159 patients consisting of 98 acute heart failure patients with AKI and 61 heart failure patients without AKI. There was a correlation between heart failure patients who developed acute renal failure and the number of days of hospitalization (p = 0.000), in hospital mortality (p = 0.002), rehospitalization in less than 3 months (p = 0.000), and mortality in less than 3 months (p = 0.001). Conclusion: Acute kidney injury has a correlation with MACE so that it can be a predictor of major cardiovascular events in patients with acute heart failure.
Early detection of subclinical rheumatic heart disease through echocardiographic screening: a study in North Sumatra, Indonesia Ardini, Tengku Winda; Ilyas, Kamal Kharazzi; Nasution, Ali Nafiah; Ketaren, Andre Pasha; Napitupulu, Bertha Gabriella; Batubara, Gio Justisia; Sarastri, Yuke; Raynaldo, Abdul Halim; Siregar, Abdullah Afif; Siregar, Yasmine Fitrina; Dewita, Auliya; Andra, Cut Aryfa; Lubis, Anggia Chairuddin
Heart Science Journal Vol. 5 No. 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.10

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BACKGROUND: Given the urgent need to address the significant morbidity and mortality associated with Rheumatic Heart Disease (RHD) in Indonesia, there is a growing interest in exploring cost-effective screening approaches, such as handheld echocardiography.OBJECTIVES: The purpose of this study was to ascertain the prevalence of RHD in North Sumatra, Indonesia.METHODS: This descriptive observational study was conducted within the population of North Sumatra from 2022 to 2023. Junior high school students aged 12 to 15 years were included from randomly selected schools in Langkat, Tebing Tinggi, and Labuhan Batu. Data collection encompassed various parameters, including social demographic information, parental characteristics, environmental factors, household details, anthropometric measurements, physical assessments, auscultation findings, and echocardiographic data. The data were analyzed descriptively.RESULTS: In our study, a total of 692 children were examined, with an average age of 12.9 years and a standard deviation of 1.1 years, among whom 42.5% were male. Utilizing echocardiographic evaluations, we identified RHD in four children, yielding a prevalence rate of 0.6%. Further examination of these cases revealed that the majority, accounting for three individuals (75%), exhibited borderline RHD, while one child (25%) presented with definite RHD.CONCLUSION: In our study population, the prevalence of RHD was 0.6%. A broader echocardiographic screening program is necessary to determine the overall prevalence of RHD, assess the disease burden, and identify individuals earlier to prevent adverse outcomes.
The TIMI Risk Index as a Predictor of Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention at Haji Adam Malik Hospital Medan Purba, Antonius Leonardo; Hasan, Refli; Raynaldo, Abdul Halim
Journal of Society Medicine Vol. 4 No. 3 (2025): March
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i3.204

Abstract

Introduction: ST-segment elevation myocardial infarction (STEMI) is a severe cardiovascular condition requiring urgent treatment through Primary Percutaneous Coronary Intervention (PPCI). However, PPCI increases the risk of Contrast-Induced Nephropathy (CIN), a condition characterized by a significant rise in serum creatinine levels. To minimize the risk of CIN, identifying patients at high risk is essential. This study evaluates the TIMI Risk Index (TRI) as a predictor of CIN in STEMI patients undergoing PPCI at Haji Adam Malik Hospital, Medan. Methods: This observational analytical study employed a cross-sectional design, focusing on STEMI patients with symptoms lasting less than 12 hours who underwent PPCI between January 2023 and December 2024. Participants were selected according to inclusion and exclusion criteria. Bivariate analysis was used, with the chi-square test for normally distributed data and the Fisher exact test for non-normally distributed data, with a significance level of p < 0.05. Results: The results indicated that TRI effectively predicted CIN occurrence, with a p-value of 0.0001, an area under the curve (AUC) of 0.834, and a 95% confidence interval (CI) of 0.752–0.916. A TRI cut-off score of 23.47 demonstrated a sensitivity of 77.3%, specificity of 77%, a positive predictive value (PPV) of 47.05%, and a negative predictive value (NPV) of 91.8%. Conclusion: In conclusion, the TRI with a cut-off score of 23.47 is a reliable tool for predicting CIN in STEMI patients undergoing PPCI, offering high sensitivity, specificity, and NPV, which can help improve clinical outcomes by identifying at-risk patients.
The Relationship Between Platelet and Lymphocyte Ratios and Left Atrial Thrombus Formation in Patients with Severe Mitral Stenosis due to Rheumatic Heart Disease at Haji Adam Malik Hospital Medan Ramzi, Defriyan; Hasan, Harris; Raynaldo, Abdul Halim
Journal of Society Medicine Vol. 4 No. 3 (2025): March
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i3.205

Abstract

Introduction: Rheumatic heart disease is an immune disease condition that often causes damage to the structure of the heart valves, such as mitral stenosis. One of the complications of severe mitral stenosis is thrombus in the left atrium. This condition is closely related to inflammation, so inflammatory cells such as lymphocytes and platelets are closely related to their severity and complications. Therefore, this study aims to see the ability of mitral platelet and lymphocyte ratios to the incidence of left atrial thrombus. Methods: This study is an analytical descriptive study with a cross-sectional research design, conducted at the Integrated Heart Center of Haji Adam Malik Hospital, from November 2024. The parameters of echocardiography, blood laboratory, as well as thrombus in the left atrium data were acquired. A statistical analysis test will be was done to assess the difference in the average ratio of platelets and lymphocytes based on the presence of thrombus in the left atrium, as well as the ability of the predictor of the ratio. Statistical analysis was carried out using SPSS software, a P value of < 0.05 was considered significant. Results: There are a total of 175 samples in this study. A total of 45 (25.7%) of the sample had thrombus in the left atrium. The median value and interquartile range of the Platelet/Lymphocyte Ratio (PLR) were higher in the thrombus group in the left atrium compared to the group without thrombus in the left atrium (P = 0.0001). The ROC curve analysis showed PLR parameters, with P = 0.0001, AUC 0.713, and 95% CI 0.620 – 0.806. The threshold value of PLR 132.5 has a sensitivity of 71.1% and a specificity of 61.0% has the ability to predict the presence of thrombus in the left atrium. Conclusion: The PLR ratio has a significant association with the occurrence of thrombus in the left atrium, in the condition of severe mitral stenosis due to rheumatic heart disease