Articles
<![CDATA[Electrocardiographic pattern changed in hospitalized leptospirosis and its association with disease severity ]]>
<![CDATA[Bambang Irawan, Anggoro Budi Hartopo]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 04 (2009) ]]>
Publisher : <![CDATA[Journal of the Medical Sciences (Berkala Ilmu Kedokteran) ]]>
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<![CDATA[Background: Electrocardiographic (ECG)changes have been observed in leptospirosis. The prevalence of ECG alterations may reach 80%. Despite of this finding,few studies have been conducted to assess ECGpatterns in only hospitalized leptospirosis patients in Indonesia. Objective: To reveal the prevalence and type of ECGalterations in hospitalizedleptospirosisand its association with disease severity. Methods: This was a cross-sectional study using medical record data. Patients hospitalized in Dr. Sardjito Hospital (January 2003 - December 2007) with leptospirosis (lCDXA27.9) were enrolled. Electrocardiogramstaken in 24 hours of admission were evaluated. Disease severity was determined based on clinical and laboratory findings. Association between disease severity with ECGrecordings were performed using Kruskal-Wallisand Chi square test. P value < 0.05 was significant. Results: Sixtysamples were analyzed.The prevalence of alterationof ECGrecordingswas 66.7%. Sinustachycardia was the most frequent (36.7 %). The most common arrhythmia was atrial fibrillation(10 %). Other abnormalities were alterationof ventricularrepolarization(8.3%1.extrasystoles (6.6%) and disorderof conduction (4.9%). Although not significant, those with atrial fibrillationtended to have the worst clinicaland laboratory findings. Conclusions: The prevalenceof alterationof ECGrecordingsin hospitalizedleptospirosiswas 66.7 %. Atrialfibrillation was the most frequent arrhythmia, and patients with this arrhythmia were likelyto have the most severe disease.]]>
<![CDATA[Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital ]]>
<![CDATA[Setianto, Budi Yuli]]>;
<![CDATA[Sari, Julia]]>;
<![CDATA[Hartopo, Anggoro Budi]]>;
<![CDATA[Gharini, Putrika Prastuti Ra]]>
<![CDATA[ Acta Interna The JOurnal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine ]]>
Publisher : <![CDATA[Acta Interna The JOurnal of Internal Medicine ]]>
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<![CDATA[ABSTRACTBackground: The incidence of acute coronary syndrome in the young patients is increased recently.Several studies reported that young patients have distinct clinical characteristics as compare with olderpatients.Objective: To assess the prevalence, risk factors and clinical presentation of acute coronarysyndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.Methods: We conducted a cross sectional study between September 2008-May 2009 at intensivecardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admittedwith acute coronary syndrome. We divided the patients as young ACS (age ⤠45 years) and older ACS(age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrumsfrom both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was consideredsignifi cantly different.Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Mostyoung ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not differentfrom that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50%vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did notdiffer from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. Theyoung ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15%vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65).Thirty percent of young ACS patients presented with Killip class II or higher, however there were nosignifi cant differences between groups (p=0.40).Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinicalpresentation and spectrums between young ACS and older ACS patients. The need for preventionprogram in both groups should not be difference.Keywords: ACSâ youngâ olderâ clinical presentation.]]>
<![CDATA[Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital ]]>
<![CDATA[Setianto, Budi Yuli]]>;
<![CDATA[Sari, Julia]]>;
<![CDATA[Hartopo, Anggoro Budi]]>;
<![CDATA[Ra Gharini, Putrika Prastuti]]>
<![CDATA[ Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine ]]>
Publisher : <![CDATA[Acta Interna The Journal of Internal Medicine ]]>
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<![CDATA[ABSTRACTBackground: The incidence of acute coronary syndrome in the young patients is increased recently. Several studies reported that young patients have distinct clinical characteristics as compare with older patients.Objective: To assess the prevalence, risk factors and clinical presentation of acute coronary syndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.Methods: We conducted a cross sectional study between September 2008-May 2009 at intensive cardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admitted with acute coronary syndrome. We divided the patients as young ACS (age ⤠45 years) and older ACS (age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrums from both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was considered significantly different.Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Most young ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not different from that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50% vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did not differ from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. The young ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15% vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65). Thirty percent of young ACS patients presented with Killip class II or higher, however there were no significant differences between groups (p=0.40).Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinical presentation and spectrums between young ACS and older ACS patients. The need for prevention program in both groups should not be difference.Keywords: ACSâ youngâ olderâ clinical presentation.]]>
<![CDATA[Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital ]]>
<![CDATA[Budi Yuli Setianto]]>;
<![CDATA[Julia Sari]]>;
<![CDATA[Anggoro Budi Hartopo]]>;
<![CDATA[Putrika Prastuti Ra Gharini]]>
<![CDATA[ Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine ]]>
Publisher : <![CDATA[Faculty of Medicine Universitas Gadjah Mada ]]>
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DOI: 10.22146/acta interna.5728
<![CDATA[ABSTRACTBackground: The incidence of acute coronary syndrome in the young patients is increased recently. Several studies reported that young patients have distinct clinical characteristics as compare with older patients.Objective: To assess the prevalence, risk factors and clinical presentation of acute coronary syndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.Methods: We conducted a cross sectional study between September 2008-May 2009 at intensive cardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admitted with acute coronary syndrome. We divided the patients as young ACS (age ≤ 45 years) and older ACS (age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrums from both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was considered significantly different.Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Most young ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not different from that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50% vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did not differ from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. The young ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15% vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65). Thirty percent of young ACS patients presented with Killip class II or higher, however there were no significant differences between groups (p=0.40).Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinical presentation and spectrums between young ACS and older ACS patients. The need for prevention program in both groups should not be difference.Keywords: ACS– young– older– clinical presentation.]]>
<![CDATA[Electrocardiographic pattern changed in hospitalized leptospirosis and its association with disease severity ]]>
<![CDATA[Anggoro Budi Hartopo Bambang Irawan]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 04 (2009) ]]>
Publisher : <![CDATA[Journal of the Medical Sciences (Berkala Ilmu Kedokteran) ]]>
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<![CDATA[Background: Electrocardiographic (ECG)changes have been observed in leptospirosis. The prevalence of ECG alterations may reach 80%. Despite of this finding,few studies have been conducted to assess ECGpatterns in only hospitalized leptospirosis patients in Indonesia. Objective: To reveal the prevalence and type of ECGalterations in hospitalizedleptospirosisand its association with disease severity. Methods: This was a cross-sectional study using medical record data. Patients hospitalized in Dr. Sardjito Hospital (January 2003 - December 2007) with leptospirosis (lCDXA27.9) were enrolled. Electrocardiogramstaken in 24 hours of admission were evaluated. Disease severity was determined based on clinical and laboratory findings. Association between disease severity with ECGrecordings were performed using Kruskal-Wallisand Chi square test. P value < 0.05 was significant. Results: Sixtysamples were analyzed.The prevalence of alterationof ECGrecordingswas 66.7%. Sinustachycardia was the most frequent (36.7 %). The most common arrhythmia was atrial fibrillation(10 %). Other abnormalities were alterationof ventricularrepolarization(8.3%1.extrasystoles (6.6%) and disorderof conduction (4.9%). Although not significant, those with atrial fibrillationtended to have the worst clinicaland laboratory findings. Conclusions: The prevalenceof alterationof ECGrecordingsin hospitalizedleptospirosiswas 66.7 %. Atrialfibrillation was the most frequent arrhythmia, and patients with this arrhythmia were likelyto have the most severe disease.]]>
<![CDATA[Clinical Characteristics of Adult Uncorrected Secundum Atrial Septal Defect, A Pilot Study ]]>
<![CDATA[Lucia Krisdinarti]]>;
<![CDATA[Anggoro Budi Hartopo]]>;
<![CDATA[Dyah Wulan Anggrahini]]>;
<![CDATA[Ahmad Hamim Sadewa]]>;
<![CDATA[Abdus Samik Wahab]]>;
<![CDATA[Budi Yuli Setianto]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 2 (2016) ]]>
Publisher : <![CDATA[Journal of the Medical Sciences (Berkala Ilmu Kedokteran) ]]>
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DOI: 10.19106/JMedSci004802201603
<![CDATA[ABSTRACTAtrial septal defect (ASD) is the most frequent congenital heart disease in adulthood. Pulmonary hypertension (PH) complicating ASD compels patients seeking medical assistance because of its disabling symptom. Most adult ASD develop PH which render significant morbidity and mortality. The aim of the study is to characterize the clinical profiles of adult patients with ASD. The study design was cross sectional. The subjects were enrolled consecutively from outpatient clinics and inpatient wards. The demography, medical and imaging data were collected and recorded in case report form. Descriptive statistics was applied to characterize the subjects. Seventy-six subjects were enrolled. The majority were women (77.6 %) in the productive and child-bearing ages (63.2%). The most common symptoms were dyspneu on effort, fatigue, and palpitation. Most subjects had functional capacity of WHO class functional II (70.2 %). The mean oxygen saturation was 96.4 %. Based on the echocardiography examination, 77.6% of subjects had suffered from PH. The mean longest diameter of defects were 2.7 cm. The direction of blood flow was mostly left to right (77.6 %). Left and right ventricle function were within normal limit. Right heart catheterization showed mean left atrial pressure 11.5 mmHg, which confirmed the precapillary or arterial PH. Mean pulmonary artery pressure was 42.0 mmHg. The pulmonary artery resistance index mostly less than 4 Wood Unit/ m2 (63.7 %), indicating the feasibility to close the defect. Whereas 24.6 % of subjects were contraindicated for closing. Pulmonary artery hypertension (PAH) was diagnosed in 77.6 % subjects, meanwhile 13.2 % had borderline PAH. In conclusion, most adult ASD patients had developed PAH, mostly young women in productive ages, mainly visited hospital due to symptom of PH, the direction of flow predominantly left to right side and mostly had reduced functional capacity.]]>
<![CDATA[Association between serum soluble ST2 level and right ventricle systolic function on pulmonary hypertension due to atrial septal defect ]]>
<![CDATA[Firandi Saputra]]>;
<![CDATA[Anggoro Budi Hartopo]]>;
<![CDATA[Hariadi Hariawan]]>;
<![CDATA[Dyah Wulan Anggrahini]]>;
<![CDATA[Lucia Kris Dinarti]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020) ]]>
Publisher : <![CDATA[Journal of the Medical Sciences (Berkala Ilmu Kedokteran) ]]>
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DOI: 10.19106/JMedSci005203202005
<![CDATA[Pulmonary hypertension (PH) due to atrial septal defect (ASD) may cause a decline in right ventricle (RV) function. Soluble ST2 isa prognostic biomarker for left ventricle dysfunction. However, its role in RV function has not been investigated. This study aimed to investigate the association between serumsoluble ST2 with RV systolic function in patients withASD–associatedPH. This was a cross sectional study. Subjects were patients participated in the COHARD-PH registry performed in Dr. Sardjito General Hospital, Yogyakarta Indonesia. The patients with ASD and PH confirmed by right heart catheterization (RHC) were enrolled in this study. The soluble ST2 level was measured in the serum collected from pulmonary artery during RHC. Right ventricle systolic function was determined by transthoracic echocardiography using peak systolic velocity of tricuspid annulus (S’) parameter. This study was performed in 32 adults with uncorrected ASD. They predominantly females [n=29 (90.6%)] with median age of 31(22.5-44.0) years old. Mean ASD diameter was 2.69±0.53 cm. Median mean pulmonary artery pressure (mPAP) 45.0 (36.25-70.0) mmHg. Median soluble ST2 level was 23.28 ng/mL. There were no significant correlations between soluble ST2 level with S’value (r=0.071; p=0.35), with mPAP (r=0.043; p=0.815), with pulmonary vasculer resistance (PVR) (r=0.025; p=0.893) and with right ventricle (RV) diameter (r=0.200; p=0.273). Soluble ST2 level was found higher in subject with RV dysfunctionbut not statistically significant. In conclusion, serum soluble ST2 level did not associate withRV systolic function, measured by S’, in adult ASD-associated PH.]]>
<![CDATA[Pulmonary artery hypertension patients and the coronavirus disease of 2019 (COVID-19): are they protected from severe disease? ]]>
<![CDATA[Anggoro Budi Hartopo]]>;
<![CDATA[Dyah Wulan Anggrahini]]>;
<![CDATA[Bambang Budi Siswanto]]>;
<![CDATA[Lucia Kris Dinarti]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020): Special Issue: COVID-19 ]]>
Publisher : <![CDATA[Journal of the Medical Sciences (Berkala Ilmu Kedokteran) ]]>
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DOI: 10.19106/JMedSciSI005203202008
<![CDATA[The coronavirus disease of 2019 (COVID-19) is a current pandemic of viral infection which mainly involves respiratory system and may progress into severe multiple organ dysfunction and mortality. Pulmonary artery hypertension (PAH) is a disease marked by increased mean pulmonary artery pressure and pulmonary vascular resistance due to pulmonary panvascular remodeling. Although rare, the prevalence of PAH is currently escalating in Indonesia due to increased diagnostic capacity and referral, treatment availability and improved survival. Despite chronic cardiac and pulmonary diseases are at increased risk to develop severe COVID-19, patients with PAH are considered to be not in higher risk to develop severe COVID-19. However, whether this population is protected from severe COVID-19 is unclear. There are protective and offensive factors need to be considered in PAH patients in respect to COVID-19.]]>
<![CDATA[The significance of glycated haemoglobin, randomized admission blood glucose, and fasting blood glucose on in-hospital adverse cardiac events in patients with ST-elevation acute myocardial infarction ]]>
<![CDATA[Anggoro Budi Hartopo]]>;
<![CDATA[Vina Yanti Susanti]]>;
<![CDATA[Vita Yanti Anggraeni]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 1 (2022) ]]>
Publisher : <![CDATA[Universitas Gadjah Mada ]]>
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DOI: 10.19106/JMedSci005401202204
<![CDATA[In an ST-segment elevation acute myocardial infarction (STEMI), glucose metabolism undergoes disturbance secondary to acute myocardial injury, which affects the clinical outcome during the acute phase. Glucose metabolic disturbance indices are glycated haemoglobin, admission random glucose, and fasting glucose in blood circulation during STEMI. This is a retrospective cohort study, aimed to investigate whether glycated haemoglobin, admission random blood glucose, and fasting blood glucose levels are the risk factors for developing in-hospital adverse cardiac events in STEMI. The result showed that among the three glucose metabolic disturbance indices, fasting glucose was an independent predictor (adjusted OR: 1.010 (95% CI: 1.001-1.018) and the most accurate factor (AUC 64.9 %) for adverse cardiac events. Other glucose metabolic indices, namely random blood glucose and glycated haemoglobin, were associated with increased odds to develop adverse cardiac events but they did not independently predict adverse cardiac events. Therefore, fasting blood glucose was an independent predictor and the most accurate factor for adverse cardiac events in the acute event of STEMI.]]>
<![CDATA[Pulmonary arterial hypertension after atrial septal defect closure: a case report ]]>
<![CDATA[Lucia Kris Dinarti]]>;
<![CDATA[Dyah Wulan Anggrahini]]>;
<![CDATA[Muhammad Reyhan Hadwiono]]>;
<![CDATA[Abdul Majid Halim Wiradhika]]>;
<![CDATA[Vera Dewanto]]>;
<![CDATA[Anggoro Budi Hartopo]]>
<![CDATA[ Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 4 (2021) ]]>
Publisher : <![CDATA[Journal of the Medical Sciences (Berkala Ilmu Kedokteran) ]]>
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DOI: 10.19106/JMedSci005304202111
<![CDATA[Most patients with congenital heart disease (CHD) who underwent successful shunts defect repair can be remained asymptomatic for years. It leads to a high number of losses to follow-up after patients discharge. After closure, pulmonary hypertension (PH) prevalence seems to be high and associated with increased morbidity and mortality. We reported a 55 y.o. female diagnosed with pulmonary arterial hypertension (PAH) and atrial fibrillation (AF) 31 years after atrial septal defect (ASD) closure by surgery, who never had routine follow-up evaluation because she remained asymptomatic for years. Physical examination revealed heart enlargement with irregular rhythm and pan systolic murmur in the fourth left sternal border. Electrocardiogram showed AF normal ventricular response, right axis deviation and suggestive for right ventricular hypertrophy. Laboratory testing found the NT pro-BNP level was 2,476 pg/mL. The chest X-ray showed enlargement of the heart and was representative of PH. From echocardiography study, transthoracic and transoesophageal echocardiography, we found no sign of residual shunt. There were right atrial and right ventricular dilatation, severe tricuspid regurgitation (TR) and a high probability of PH with TR velocity of 4.46 m/s. Right heart catheterization concluded mean pulmonary arterial pressure 46 mmHg, flow ratio 1.1, and pulmonary artery resistance index 15.5 Woods unit.m-2. We highlight this case because of the high incidence of PH long after defect closure. The high number of lost to follow-up patients can lead to morbidity and mortality.]]>
