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All Journal Global Medical and Health Communication Health Notions Biomolecular and Health Science Journal Jurnal Ilmiah Kesehatan Majalah Biomorfologi (Biomorphology Journal) Cardiovascular and Cardiometabolic Journal (CCJ) Narra J
Lefi, Achmad
Department Of Cardiology And Vascular Medicine, Faculty Of Medicine Universitas Airlangga, Surabaya, Indonesia - Dr. Soetomo General Hospital Surabaya
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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 1 
Relationship Between Risk Factors of Coronary Heart Disease on The Amount of Lesioned Coronary Artery Monitrya Nababan; Achmad Lefi; Djohar Nuswantoro
Health Notions Vol 3, No 12 (2019): December
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn31208

Abstract

Objective: To determine the relationship of coronary heart disease traditional risk factors to the number of lesioned coronary arteries and calculate the relative risk. Methods: This study used an analytical research design with a retrospective cohort study design using patient catheterization report data. Data analysis was performed using the chi square test and relative risk in 449 individuals. Results: Based on the analysis results obtained p value 0.05 indicating no relationship between risk factors for coronary heart disease with the number of coronary arteries the lesions based on sex, history of hypertension and history of smoking. Conclusion: There is a relationship between age, history of diabetes mellitus, history of dyslipidemia and the number of coronary arteries that are lesions in patients with coronary heart disease and there is no relationship between sex, history of hypertension and smoking history with the number of coronary arteries that are lesions in patients with coronary heart disease. Keywords: single vessel disease; multivessel disease; coronary artery disease; risk factors CAD
Clinical Characteristics and Number of Valve Lesion in Rheumatic Heart Disease Severity Saskia Ratna Desita; Achmad Lefi; Mahrus Rahman; Yudi Her Oktaviono
Global Medical & Health Communication (GMHC) Vol 9, No 1 (2021)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (547.148 KB) | DOI: 10.29313/gmhc.v9i1.6609

Abstract

Rheumatic heart disease (RHD) occurs due to sequelae in the form of damage to the heart valves from the failure of acute rheumatic fever (ARF) therapy. Heart valve damage can cause various complications such as congestive heart failure, arrhythmias, pulmonary hypertension, atrial fibrillation, endocarditis, which can cause death. The study aimed to assess the association between clinical characteristics and valve lesion and rheumatic heart disease severity. The study was an analytic observational with a cross-sectional design of 73 patients with definite RHD from September 2019 to March 2020 in Dr. Soetomo Regional General Hospital. The majority of patients were female (80%, p=0.235) 30–39 years old (34%, p=0.157). The mean age was 42.08±12.16 years. The majority of patients have low socioeconomic status (78%, p=0.025) and rural dwelling location (70%, p=0.138) over three-quarters of patients living with more than four people in the same house (75%). Multivalvular lesions (90%, p=0.003) and severe RHD (77%) were present predominantly. In conclusion, low socioeconomic status and multivalvular lesions are associated with rheumatic heart disease severity. KARAKTERISTIK KLINIS DAN JUMLAH LESI KATUP PADA DERAJAT KEPARAHAN PENYAKIT JANTUNG REUMATIKPenyakit jantung reumatik (PJR) adalah penyakit yang terjadi akibat gejala sisa berupa kerusakan katup jantung dari kegagalan terapi demam reumatik akut (DRA). Kerusakan katup jantung pada PJR dapat menimbulkan berbagai komplikasi seperti gagal jantung kongesti, aritmia, hipertensi pulmonal, atrial fibrilasi, dan endokarditis yang dapat menyebabkan kematian. Penelitian ini bertujuan mencari hubungan karakteristik klinis dan jumlah lesi katup dengan derajat keparahan PJR. Penelitian ini merupakan analitik observasional menggunakan pendekatan cross-sectional. Sampel penelitian ini adalah pasien yang terdiagnosis definitif PJR berdasar atas ekokardiografi pada bulan Sepetember 2019–Maret 2020 di RSUD Dr. Soetomo Surabaya. Didapatkan 73 pasien sesuai dengan kriteria inklusi. Mayoritas pasien berjenis kelamin perempuan (80%; p=0,235), dengan kelompok usia 30–39  (34%; p=0,157). Usia rerata 42,08±12,16 tahun. Sebagian besar pasien berstatus sosial ekonomi rendah (78%, p=0,025) dan lokasi tinggal pedesaan (70%; p=0,138). Lebih dari tiga perempat pasien tinggal dengan ≤4 orang di satu atap (75%). Lesi multivalvular (90%; p=0,003) dan PJR berat (77%) ditemukan secara dominan. Simpulan, status sosial ekonomi rendah dan lesi katup multivalvular berhubungan dengan derajat keparahan penyakit jantung reumatik.
THE SIMILAR CHANGES OF GLUCOSE LEVELS BEFORE AND AFTER MODERATE INTENSITY EXERCISE ACUTELY IN THE MORNING AND EVENING Ronik Harsono Kamal; Kristanti Wanito Wigati; Achmad Lefi
Majalah Biomorfologi Vol. 30 No. 2 (2020): MAJALAH BIOMORFOLOGI
Publisher : Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mbiom.v30i2.2020.39-44

Abstract

Background: There is a lot of research on the importance of exercise but studies on the effective time of exercise regarding regulation of blood glucose levels are not clearly known. Objective: This study aimed to determine the comparison of changes in blood glucose levels before and after moderate intensity physical exercise in the morning and evening. Materials and Methods: Healthy men (n=34), age between 17-22 years, Body Mass Index (BMI) between 18.5-22.9 kg/m2 (normal Asia Pacific), participating in the morning (8.00 am) or evening group (20.00 pm) are asked to do moderate intensity physical exercise (55-70% of maximum heart rate) using ergocycle for a total of 40 minutes. Blood glucose levels 2 hours post prandial capillaries were taken before exercise and blood glucose levels after exercise were taken acutely. Results: The mean decrease in blood glucose levels in the morning group was ± 8.353 ± 9.16 mg/dL and in the evening group was ± 6.294 ± 10.10 mg/dL. Blood glucose levels decreased significantly for the morning group (p=0.002) and the evening group (p=0.021). The comparison of changes in blood glucose levels between the morning and evening groups was not significant (p=0.538). Conclusion: There was no difference between morning or evening exercise related to changes in blood glucose levels.
Correlation of Neutrophyl-Lymphocyte Ratio, Vessel Score based on Sullivan Scoring System, and Troponin in Acute Coronary Syndrome Patients Chelssi Gloria Tessari; Achmad Lefi; Yetti Hernaningsih
Cardiovascular and Cardiometabolic Journal Vol. 3 No. 2 (2022): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v3i2.2022.75-86

Abstract

Acute Coronary Syndrome (ACS) is one of the highest causes of death globally, with the number of deaths reaching more than 9 million people in 2016. Therefore, a fast and accurate ACS diagnosis is needed. This study aimed to determine the relationship between the neutrophil-lymphocyte ratio, the number of coronary artery lesions evaluated by angiography, and troponin I in ACS patients Material and Methods: This research is an analytic observational with a retrospective cross-sectional design. Sampling was carried out using a total sampling technique and obtained 87 samples that met the inclusion and exclusion criteria for the 2019-2020 period at Dr. Soetomo Regional General Hospital Surabaya. The correlation between the number of coronary artery lesions and the neutrophil-lymphocyte ratio to troponin I levels were respectively analyzed using chi-square and spearman-rho with SPSS ver. 25. Results: The results showed a moderately significant correlation between the neutrophil-lymphocyte ratio and troponin I levels (p =0.003, rs = 0.319). While the correlation analysis between the number of coronary artery lesions and the vessel score on troponin I showed insignificant results (p = 0.525), which means that the number of coronary artery lesions was not correlated with troponin I. Conclusion: This study concludes a significant correlation with moderate correlation between the neutrophil-lymphocyte ratio and troponin I. However, there is no significant correlation between the number of coronary artery lesions assessed by the Sullivan and troponin I levels.
High-Dose Nitroglycerin Bolus and Non-Invasive Ventilation Prevent Intubation or ICU Admission on Hypertensive Emergency and Acute Pulmonary Edema: Sympathetic Crashing Acute Pulmonary Edema (SCAPE) Treatment on STEMI Patient: A Case Report Mahendra Eko Saputra; Achmad Lefi; Makhyan Jibril Al Farabi; Pandit Bagus Tri Saputra; Ariikah Dyah Lamara
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 4 No. 2 (2023): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v4i2.2023.99-104

Abstract

Highlight: 1. SCAPE could lead to respiratory failure when not treated promptly. 2. High-dose NTG and NIV support can be used as an alternative treatment to overcome hypertensive emergency and pulmonary edema, thus preventing the need for endotracheal intubation and ICU admission. - Background: A marked elevation in blood pressure that causes acute heart failure and fluid accumulation in the lungs is known as sympathetic crashing acute pulmonary edema (SCAPE). Here, we present a SCAPE patient with severe respiratory failure who was successfully treated with high-dose nitroglycerin (NTG) bolus and non-invasive ventilation (NIV). Case summary: A 48-year-old male was referred to our center with typical chest pain and dyspnea. Physical and additional examination found hypertensive emergency (196/66 mmHg), acute pulmonary edema, and acute heart failure, accompanied by anterior STEMI and severe respiratory failure (P/F ratio of 72) in need of intubation. He was given 2 mg intravenous NTG bolus twice supported with NIV, diuretics followed by the primary percutaneous coronary intervention (PCI) stenting in mid left anterior descending (LAD). The patient recovered from acute pulmonary edema, and the P/F ratio improved from 72 to 321 without intubation. Discussion: SCAPE could lead to respiratory failure requiring intubation and intensive care unit (ICU) admission when not treated promptly. The administration of large doses of NTG and NIV was safe and resulted in a speedy improvement in symptoms. Conclusion: SCAPE can be resolved without invasive procedures, using high-dose NTG and NIV support to overcome hypertensive emergency and pulmonary edema.
Correlation between interleukin-6 expression in post-mortem core liver biopsy and degree of liver injury in patients with fatal COVID-19 Maimunah, Ummi; Maharani, Andi RK.; Soegiarto, Gatot; Rahniayu, Alphania; Gunawan, Vania A.; Wiratama, Priangga A.; Djuanda, Stephanie N.; Supriadi, Supriadi; Marhana, Isnin A.; Semedi, Bambang P.; Lefi, Achmad; Kusumastuti, Etty H.; Suyanto, Edi; Lilihata, Jilientasia G.; Anggoro, Adhitri; Rinjani, Lalu GP.; Rosyid, Alfian N.; Wahyu, Dwi; Fauziah, Dyah; Rahaju, Anny S.; Kurniasari, Nila; Ariani, Grace; Nugroho, Gilang MS.; Yandi, I KR.; Nugraha, Ricardo A.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.463

Abstract

Excessive release of interleukin-6 (IL-6) during the progression of coronavirus disease 2019 (COVID-19) induces cytokine storms, resulting in multi-organ damages including liver injury, similar in nature with mechanism of viral hepatitis. Systemic IL-6 has been associated with the incidence of liver injury among COVID-19 patients; however, studies on IL-6 expression in the liver tissue are completely lacking. The aim of this study was to measure the IL-6 expression in the liver tissues and to determine its correlation with the degree of liver injury in fatal COVID-19 patients. Through this first cross-sectional study, IL-6 expression was measured through immunohistochemical staining and the degree of liver injury was identified based on level of serum alanine aminotransferase (ALT). The Spearman correlation test was used to identify the correlation between IL-6 expression and the degree of liver injury. A total of 47 deceased COVID-19 patients were included and IL-6 expression was observed in all post-mortem liver specimens, ranging from mild to strong expression. Liver injury at various degrees (mild to severe) was found in more than half (59.5%) of the cases. The Spearman correlation analysis suggested a statistically insignificant correlation between liver IL-6 expression and the degree of liver injury (r=0.152; p=0.309). In conclusion, even IL-6 expression was observed in all post-mortem liver specimens, there was an insignificant correlation between IL-6 expression in the liver tissue with the degree of liver injury among fatal COVID-19 patients, suggesting that IL-6 was not the only main factor contributing to liver damage in COVID-19 patients.
Association between Serum Magnesium Level with Acute Coronary Syndrome (ACS) in Diabetes Mellitus (DM) Patients Wulansari, Ratih; Soelistijo, Soebagijo Adi; Lefi, Achmad
Biomolecular and Health Science Journal Vol. 2 No. 2 (2019): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (260.672 KB) | DOI: 10.20473/bhsj.v2i2.15354

Abstract

Introduction: Until now, cardiovascular complications are still the highest cause of death and disability in DM patients. Hypomagnesemia in DM accelerate atherosclerosis and can cause instability and plaque rupture which can lead to acute coronary syndrome.Methods: Design of this study was observational analytic using a "case control" study involved 76 samples of DM patients, consisting of 38 samples with SKA (+) and 38 samples with SKA (-). Subjects of this study were all DM patients in the period July-December 2018 in the Emergency Room (ER) and Outpatient Installation of Endocrine at the RSUD Dr. Soetomo Surabaya, which fulfills the criteria for inclusion and exclusion. Demographic data and clinical characteristics are presented descriptively. If data is normally distributed then an unpaired t test is carried out and if the data is not normally, distributed with Mann Whitney test is performed. The statistical test was stated to be significant if p <0.05. The association between hypomagnesemia and the incidence of ACS a multivariate logistic regression test was performed, the risk number was in the form of odds ratios (OR). Results: This study involved 76 subjects with diabetes mellitus with SKA and non SKA 38 subjects. The mean serum magnesium level in the ACS group was lower than non ACS (1.9 mg / dL vs. 2.1 mg / dL), hypomagnesemia cut-off of <2.08 mg / dL. In this study hypomagnesemia as a risk factor for the incidence of ACS in DM patients with OR 2.8 (CI 1.1-7.6; p = 0.039).Conclusion: Magnesium levels in the ACS group were lower than the non ACS group. Hypomagnesemia Increase The Incidence of Acute Coronary Syndrome in Diabetes Mellitus Patients.
Evaluation of Right and Left Ventricular Function in Ebstein Anomaly Using RVGLS and LVGLS: A Narrative Literature Review Sembiring, Matthew Risdian Pratama; Lefi, Achmad; Kartikasari, Dian Paramita
Jurnal Ilmiah Kesehatan Vol 17 No 2 (2025): Jurnal Ilmiah Kesehatan
Publisher : Universitas Mohammad Husni Thamrin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37012/jik.v17i2.3133

Abstract

Ebstein anomaly is a rare congenital heart defect characterized by tricuspid valve malformation, atrialization of the RV, and hemodynamic disturbances that may affect both ventricles. Assessing ventricular function in this condition is essential because it is closely related to disease progression, clinical symptoms, and long term prognosis. Conventional parameters such as TAPSE, RVFAC, and LVEF are commonly used but have limitations. Speckle Tracking Echocardiography (STE), through Right Ventricular Global Longitudinal Strain (RVGLS) and Left Ventricular Global Longitudinal Strain (LVGLS), provides higher sensitivity for detecting ventricular dysfunction. This narrative literature review evaluates the role of RVGLS and LVGLS in patients with Ebstein anomaly. Evidence shows that RVGLS is more accurate in identifying RV dysfunction compared with TAPSE and RVFAC, and possesses strong prognostic value for mortality. LVGLS can detect LV dysfunction at a subclinical stage even when LVEF remains preserved, reflecting involvement of longitudinal myocardial fibers due to ventricular interdependence and secondary remodeling. After tricuspid valve surgery, both RVGLS and LVGLS remain sensitive indicators of changes in ventricular performance. Overall, RVGLS and LVGLS demonstrate superiority over conventional systolic parameters and are recommended as primary tools for evaluating biventricular function in patients with Ebstein anomaly
Co-Authors Alphania Rahniayu Anggoro, Adhitri Ariani, Grace Ariikah Dyah Lamara Chelssi Gloria Tessari Dian Paramita Kartikasari Djuanda, Stephanie N. DYAH FAUZIAH, DYAH Edi Suyanto Gatot Soegiarto Gunawan, Vania A. Kusumastuti, Etty H. Lilihata, Jilientasia G. Maharani, Andi RK. Mahendra Eko Saputra Mahrus A Rahman, Mahrus A Makhyan Jibril Al Farabi Marhana, Isnin A. Monitrya Nababan Nila Kurniasari Nugraha, Ricardo A. Nugroho, Gilang MS. Nuswantoro, Djohar Pandit Bagus Tri Saputra Rahaju, Anny S. Rinjani, Lalu GP. Ronik Harsono Kamal Rosyid, Alfian N. Saskia Ratna Desita Sembiring, Matthew Risdian Pratama Semedi, Bambang P. Soelistijo, Soebagijo Adi Sony Wibisono Supriadi Supriadi Thomas Jatiman Ummi Maimunah Wahyu, Dwi Wigati, Kristanti Wanito Wiratama, Priangga A. Wulansari, Ratih Yandi, I KR. Yetti Hernaningsih Yudi Her Oktaviono, Yudi Her