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Improvement in left ventricle geometry and function after kidney transplantation Baiq Gerisa Rahmi Faharani; Hasanah Mumpuni; Yulia Wardhani; Metalia Puspitasari; Raden Heru Prasanto; Iri Kuswadi; Anggoro Budi Hartopo
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 01 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i01.11774

Abstract

Chronic kidney disease (CKD) is associated with remodeling of the left ventricle (LV), affecting both its geometry and function. Kidney transplantation in patients with stage 5 CKD may lead to improvements in LV remodeling and result in better cardiac function. The aim of the study was to determine changes and improvements in LV geometry and function after kidney transplantation in patients with stage 5 CKD. This was an observational study conducted by collecting secondary data from the Hospital's Kidney Transplantation Registry, Dr. Sardjito General Hospital spanning the years 2017 to 2020. The study employed a comparative design, contrasting the results before and after treatment (kidney transplantation). We compared transthoracic echocardiographic parameters for LV geometry and function before and after kidney transplantation. The evaluation timeframe after kidney transplantation was divided into <12 and ³12 mo. A total of 27 patients qualified for inclusion in this study. In the <12 mon (n=20) evaluation group, there was a reduction in proportion of LV hypertrophy from 70% to 45%. There was an increase in global LV systolic function (ejection fraction) from 60.1±10.95% to 67.85±6.48% (p=0.014), and a decrease in LV diastolic dysfunction from 45% to 15% (p=0.07). In the ³12 mon (n=11) evaluation group, there was a decrease in the proportion of LV hypertrophy from 81.8 to 54.5%, an increase in global LV systolic function (ejection fraction) from 57.73±13.07% to 69.36±6.12% (p=0.011), and a decreased LV diastolic dysfunction from 63.6% to 0% (p=0.016). In conclusion, significant changes in LV geometry and function are observed following kidney transplantation, indicating improvements in these parameters. There are improvements in LV systolic function started at <12 mo and in LV diastolic function at ³12 mo after kidney transplantation.
Association between chemotherapy-related cardiac dysfunction (CTRCD) and 6-minute walking distance (6MWD) in breast cancer patient receiving anthracycline-based chemotherapy Putri Ayudhia Trisnasari; Irsad Andi Arso; Hasanah Mumpuni; Vita Yanti Anggraeni; Susanna Hilda Hutajulu; Mardiah Suci Hardianti; Hartopo, Anggoro Budi
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 4 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i4.12240

Abstract

Anthracycline chemotherapy is one of the most commonly given therapies to breast cancer patients. Anthracycline has a cardiotoxicity effect causing cardiac myocyte death. This chemotherapy-related cardiac dysfunction (CTRCD) will decrease oxygen delivery to tissues characterized by reduced cardiorespiratory fitness. The 6-min walking distance (6MWD) could be a predictor of cardiorespiratory fitness. This study aimed to investigate the association between CTRCD and the reduction in 6MWD after receiving anthracycline-based chemotherapy. It was an analytical observational study with a retrospective cohort design that conducted on breast cancer patients underwent anthracycline-based chemotherapy. Subjects were patients from the Cardio-oncocare registry who met the inclusion and exclusion criteria. The CTRCD was assessed using left ventricle ejection fraction (LVEF) and global longitudinal strain (LVGLS) by transthoracic echocardiography examination based on criteria from the European Society of Cardiology guidelines. The 6MWD was assessed by performing 6-min walking tests. The LVEF, LVGLS and 6MWD data were retrieved from the Cardio-oncocare registry database, which were performed before and after chemotherapy. The changes and association of LVEF, LVGLS and 6MWD from before to end of chemotherapy were analyzed. Of 250 Cardio-oncocare registered patients, 58 patients met the criteria. Among them, 17 patients (29%) had CTRCD, and 41 patients (71%) had no CTRCD after chemotherapy. A significant decrease in LVEF and LVGLS in patients with CTRCD was observed. The 6MWD before chemotherapy did not statistically differ between CTRCD and no CTRCD patients. After chemotherapy, the proportion of patients experienced reduction of 6MWD was not significantly different between CTRCD patients and no CTRCD patients [7 patients (41%) vs. 21 patients (51%); p=0.342]. In conclusion, there is no significant association between CTRCD and reduction of 6MWD in breast cancer patients receiving antracycline-based chemotherapy.
Tekanan darah sistolik, indeks kardiak dan sindrome Eisenmenger merupakan prediktor kematian pada pasien hipertensi arteri pulmonal terkait penyakit jantung bawaan: analisis dari register COHARD-PH Rochmat, Muflihatul Baroroh; Setianto, Budi Yuli; Anggrahini, Dyah Wulan; Dinarti, Lucia Kris; Hartopo, Anggoro Budi
Jurnal Kardiologi Indonesia Vol 45 No 3 (2024): July - September, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1623

Abstract

Background: Pulmonary arterial hypertension (PAH) is a complication of left-to-right intracardiac shunt congenital heart disease (LtR-shunt CHD). There are several known predictors of mortality in PAH patients, however predictors of mortality in LtR-shunt CHD-associated PAH need to be validated. Objectives: We aimed to investigate the predictors of mortality among adult LtR-shunt CHD-associated PAH patients. Methods: This research was a retrospective cohort study that included adult patients with LtR-shunt CHD-associated PAH retrieved from the COHARD-PH registry. Several baseline variables were selected as potential predictors of mortality, namely (1) clinical data: WHO-functional class, SaO2, 6-min walking distance, systolic blood pressure, and Eisenmenger syndrome; (2) laboratory data: hemoglobin and NT-pro BNP levels; (3) echocardiography data: pericardial effusion, defect size, and TAPSE; and (4) hemodynamic data: right atrial pressure, cardiac output and index, SvO2, and flow ratio. The mortality outcome was assessed from the cohort registry. Results: A total of 124 subjects with LtR-shunt CHD-associated PAH were included. Sixteen subjects (12.9%) died during the follow-up period. The baseline variables which showed significant association with mortality were lower systolic blood pressure, Eisenmenger syndrome, higher NT-pro BNP level, and lower cardiac output. The multivariable analysis showed that systolic blood pressure <100 mmHg (OR 10.99; 95% CI 2.54-47.51, p=0.001), cardiac index <2.5 L/min/m2 (OR 8.13; 95% CI: 1.59-42.28, p=0.011) and Eisenmenger syndrome (OR 3.87; 95%CI: 1.06-14.07) were the independent predictors for mortality. Conclusions: The systolic blood pressure <100 mmHg, cardiac index <2.5 L/min/m2, and Eisenmenger syndrome were independent predictors of mortality among adults with LtR-shunt CHD-associated PAH.
Safety monitoring of chloroquine and hydroxychloroquine in COVID-19 patients in Indonesia on QT prolongation: hospital based monitoring study Jarir At Thobari; Togi Junice Hutadjulu; Tri Asti Isnariani; Umi Sa'adatun Nikmah; Lukman Ade Chandra; Pompini Agustina Sitompul; Anggoro Budi Hartopo; Rizki Amalia Gumilang; Luhur Pribadi; Deva Bachtiar; Anwar Santoso
Indonesian Journal of Pharmacology and Therapy Vol 4 No 1 (2023)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.7148

Abstract

Chloroquine (CQ) and Hydroxychloroquine (HCQ) are the challenging drugs used for COVID-19. Several studies show its beneficial, however, both medications can prolong the QTc interval and increase the risk of patients for torsades de pointes and death. The Tisdale score is identified to have successfully predicted the at-risk population of side effects of these drugs. This study aim to evaluate the QT prolongation caused by the administration of chloroquine and hydroxychloroquine in COVID-19 patients and the association with the treatment outcomes based on their Tisdale score. We conducted an observational study on 213 hospitalized patients with confirmed or suspect COVID-19 in 6 referral hospitals in Indonesia. All baseline demographic such as age and gender, RT-PCR test result, severity of disease, history of cardiovascular disease (myocardial infarction, heart failure, hypertension), serum kalium level at baseline, and the use of medication associated with risk QTc interval prolongation were collected. The Tisdale risk score was used for predicting high-risk patients for QT corrected (QTc) interval prolongation. Out of 213 patients who were treated with CQ/HCQ, there were 60 (28.2%) patients had QTc interval prolongation, included 43 patients (20.2%) who had normal QTc interval at baseline and at the end of treatment had prolong interval; or 17 patients (8.0%) who had QTc interval more than 470 msec at baseline and QTc interval prolongation was worsen at the end of treatment. Several factors, including age more than 50 years, COVID-19 confirm PCR, and had comorbidity heart failure, were statistically significant associated with QTc interval prolongation. The high-risk score of Tisdale score have increased risk significantly on QTc interval prolongation (RR: 2.15, 95%CI 1.07-4.32) and associated with risk of death (RR: 3.50, 95%CI 1.34-9.13) compared to low-risk score. Our findings showed that the treatment of CQ/HCQ in COVID-19 patients is associated with QTc prolongation. The Tisdale score can be used as a valuable tool to predict the COVID-19 patients’ outcome after treatment of these QTc-prolonging drugs.
Familial atrial septal defect: a case report in Indonesia Muhammad Gahan Satwiko; Lucia Kris Dinarti; Armalya Pritazahra; Abdul Majid Halim Wiradhika; Muhammad Reyhan Hadwiono; Dyah Wulan Anggrahini; Anggoro Budi Hartopo
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 1 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i1.20213

Abstract

Familial atrial septal defect (ASD) is defined as the occurrence of ASD in the first-degree family of the ASD patient. Recently, familial ASD has been increasingly studied. Familial ASD could manifest as an isolated ASD or with other abnormalities. Furthermore, because ASD is usually asymptomatic, it is very difficult to recognize ASD in a first-degree family based only on symptoms. However, if the family was screened using electrocardiography or echocardiography, the occurrence of familial ASD could be found. Therefore, screening plays an important role in detecting familial ASD. We reported an ASD patient with several occurrences of familial ASD. ABSTRAK Atrial septal defect (ASD) familial didefinisikan sebagai terjadinya ASD di keluarga tingkat pertama pada pasien ASD. Studi mengenai ASD familial saat ini telah semakin banyak dilakukan. ASD familial dapat bermanifestasi sebagai ASD yang terisolasi ataupun ASD yang disertai dengan abnormalitas yang lain. Selain itu, karena ASD biasanya asimptomatik, sangat sulit mengenali ASD pada keluarga tingkat pertama hanya berdasarkan gejalanya. Meski demikian, jika keluarga tersebut diperiksa menggunakan elektrokardiografi atau ekokardiografi maka dapat ditemukan terjadinya ASD familial. Oleh karena itu, skrining memegang peranan penting dalam deteksi ASD familial. Kami melaporkan pasien ASD dengan beberapa kejadian ASD familial.
Impact of Cardiac Rehabilitation on Functional Aerobic Capacity in Coronary Artery Disease Patients Sjughiarto, M.Afies; Arso, Irsad Andi; Hartopo, Anggoro Budi
Advances In Social Humanities Research Vol. 3 No. 5 (2025): Advances In Social Humanities Research
Publisher : Sahabat Publikasi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/adv.v3i5.437

Abstract

Cardiac rehabilitation (CR) is a vital component of secondary prevention in patients with coronary artery disease (CAD), known to improve cardiorespiratory fitness (CRF), enhance quality of life, and reduce cardiovascular morbidity and mortality. This study aimed to examine the impact of physical activity status on functional aerobic capacity (FAC) and CRF classification, as well as to identify significant predictors of FAC among CAD patients. A cross-sectional study was conducted involving 104 CAD patients who underwent exercise stress testing. Participants were divided into three groups: (1) those who completed phase II CR within 30 days, (2) those who engaged in regular exercise without formal CR, and (3) physically inactive individuals. FAC was calculated as the ratio of achieved to predicted metabolic equivalents (METs) and used to classify CRF into four categories (A: <69%, B: 70–99%, C: 100–129%, D: ?130%). The Kruskal-Wallis test revealed a significant association between rehabilitation status and FAC scores (p=0.047). Patients who completed phase II CR had significantly higher FAC than physically inactive individuals (p=0.011). The inactive group showed the lowest FAC (mean 0.58), with most classified in the lowest CRF category. Quantile regression demonstrated that phase II CR positively influenced FAC at the 50th and 75th quantiles (p=0.048 and p=0.011, respectively), while residual ischemia had a negative effect (p=0.005 and p=0.025). In conclusion, phase II CR significantly improves FAC in CAD patients, particularly those with moderate to high baseline capacity. Tailored CR programs may be especially beneficial for patients with residual ischemia, supporting individualized approaches in clinical rehabilitation practice.
Indonesia-INTERASPIRE study: an Indonesian cross-sectional multicenter survey on cardiovascular secondary prevention in coronary heart disease Ambari, Ade Meidian; Hasan, Harris; Dwiputra, Bambang; Desandri, Dwita Rian; Hamdani, Rita; Krevani, Citra Kiki; Syaoqi, Muhammad; Ridwan, Muhammad; Anandini, Hesti; Fitra, Maha; Arso, Irsad Andi; Anggraeni, Vita Yanti; Hartopo, Anggoro Budi; Siregar, Yasmine Fitrina; Tjahjono, Cholid Tri; Tiksnadi, Badai Bhatara; Febrianora, Mega; Tarsidin, Najmi Fauzan; Arityanti, Dean; Qhabibi, Faqrizal Ria; Makes, Indira Kalyana; Susilowati, Eliana; Erwan, Nabila Erina; Hergaf, Indah Widyasari; Raynaldo, Abdul Halim
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257833

Abstract

BACKGROUND Cardiovascular disease (CVD) is projected to affect more than 23.3 million people by 2030. Therefore, CVD prevention strategies were established to decrease morbidity and mortality while enhancing overall well-being. The Joint European Societies (JES) guidelines on CVD prevention were developed to enhance preventive cardiology practices. This study aimed to evaluate the adherence to JES guidelines for cardiovascular prevention in routine clinical practice for secondary prevention. METHODS This multicenter cross-sectional study was conducted in 7 centers between August 2020 and June 2021. Patients under 80 years old who had undergone percutaneous transluminal coronary angioplasty, coronary artery bypass graft, percutaneous coronary intervention, or experienced acute coronary syndrome were identified from medical records and interviewed a year later. Descriptive statistics were used to calculate the occurrence of risk variables, medication use, and index events associated with low-density lipoprotein cholesterol (LDL-C), hemoglobin A1c, and blood pressure (BP). RESULTS A total of 402 participants (13.9% female) were interviewed, and their medical records were reviewed. Among the study population, 74.4% had a smoking history, 35.4% had dyslipidemia, 33.1% did not meet the BP target, and only 28.4% achieved the LDL-C target. Additionally, less than half (43.8%) participated in physical activity for >150 min/week. Only 15.6% of the patients among the centers who had scored >8 for the guideline-based target score. CONCLUSIONS Most patients did not meet the guidelines for secondary prevention, primarily due to the high prevalence of dyslipidemia and physical inactivity, although some achieved the LDL-C target.
Congenital heart disease screening program in elementary schools: a research-based policy Dinarti, Lucia Kris; Hartopo, Anggoro Budi; Hadwiono, Muhammad Reyhan; Wiradhika, Abdul Majid Halim; Meliala, Andreasta; Putri, Likke Prawidya; Fajarwati, Prahesti; Anggrahini, Dyah Wulan
BKM Public Health and Community Medicine Vol 39 No 01 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.v39i01.5783

Abstract

Purpose: CHD is a condition where heart abnormalities develop before birth and can lead to severe complications such as heart failure and premature death, especially among younger adults. Delayed diagnosis and treatment worsen the situation for CHD patients. Early screening can prevent CHD and ensure timely interventions. This study discusses the latest advancements in CHD screening for primary school children and the valuable insights gained from the program. Method: The CHD screening program in Yogyakarta province involved three stages: consolidation, implementation, and incorporation. During the consolidation stage, key decision-makers in the province and local health offices were involved. Primary healthcare workers and primary school teachers were trained to deliver the screening during the implementation stage. Stakeholders, health workers, and teachers were invited to discuss the results, and the Provincial Governor's office was engaged during the incorporation stage. Results: In 2018–2019, 18 CHDs were identified from 6,116 school-age children in 4 districts in Indonesia. The screening program was led by academics in the Universitas Gadjah Mada through 3 stages: consolidation, implementation, and incorporation. Strong collaboration with local stakeholders has contributed to the program's success in engaging 130 schools, 60 community health centers, and 190 health workers. Several opportunities for improvement are: strengthening the capacity and number of health providers at health centers to screen CHDs using 12-lead electrocardiography, addressing patients' reluctance to visit the health facility due to the COVID-19 pandemic, and motivating parents to have their children checked. Conclusion: CHD screening using 12-lead electrocardiography and auscultation should be part of primary school health screenings. Academics can train health workers, and local governments can provide funding and prepare health facilities for follow-up treatment.
Association between serum endothelin-1 level and major adverse cardiovascular events following percutaneous coronary intervention in stable coronary artery disease Rahayu, Dian Herlusiatri; Anggrahini, Dyah Wulan; Hartopo, Anggoro Budi
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.20513

Abstract

Coronary artery disease (CAD) affects greatly the global population, exhibits high mortality and morbidity rates. Major adverse cardiovascular events (MACE), such as stroke, myocardial infarction, heart failure, and death, are the focus of research due to their significant contribution to morbidity and mortality in patients with CAD. Endothelin-1 is identified as a CAD prognostic indicator, especially for heart failure outcome. This study aimed to investigate the association between serum endothelin-1 level and MACE within 1 yr observation in patients with CAD underwent percutaneous coronary intervention (PCI). It was a retrospective cohort study where conducted at Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Subjects were patients with stable CAD who underwent elective PCI. Baseline serum endothelin-1 level was measured by ELISA at the time of elective PCI procedure. The outcome was MACE, which consisted of heart failure, acute coronary syndrome, stroke, and cardiac death, occurred within 1 yr after elective PCI. The ROC curve was designed to determine serum endothelin-1 cut-off value to predict MACE. Sixty-three subjects were enrolled and the endothelin-1 level in serum samples was analyzed. Out of these, 11 (17.5%) experienced MACE within 1 yr post elective PCI. Serum endothelin-1 cut-off value was 1.932 pg/mL, which determined based on ROC curve. There was no significant association between serum endothelin-1 and MACE. There was a trend of higher incidence of MACE, in subjects with above-cut-off endothelin-1 level (≥1.932 pg/mL) (MACE incidence: 23.1% vs. 8.3%; p=0.181). Above-cut-off endothelin-1 level significantly associated with incidence of heart failure (100% vs. 0%; p=0.039) for 1 yr follow-up after elective PCI. Higher serum endothelin-1 level had a trend of higher incidence of 1-yr MACE in patients with stable CAD undergone elective PCI. Among 1-yr MACE, higher serum endothelin-1 associated with increased incidence of heart failure.
Co-Authors Abdul Majid Halim Wiradhika Abdul S Wahab, Abdul S Ageng Brahmadhi Ambari, Ade Meidian Anandini, Hesti Andreasta Meliala Anggraeni, Vita Yanti Anggrahini, Dyah Wulan Anwar Santoso Anwar Santoso Arityanti, Dean Armalya Pritazahra Badai Bhatara Tiksnadi Baiq Gerisa Rahmi Faharani Budi Yuli Setianto Cholid Tri Tjahjono Desandri, Dwita Rian Deva Bachtiar Deva Bachtiar Dwiputra, Bambang Dyah Wulan Anggrahini Erwan, Nabila Erina Fajarwati, Prahesti Febrianora, Mega Fitra, Maha Gumilang, Rizki Amalia Hariadi Hariawan Hasan, Harris Hasanah Mumpuni Hendry Purnasidha Bagaswoto Hergaf, Indah Widyasari I Dewa Putu Pramantara Iri Kuswadi Irsad Andi Arso Irsad Andi Arso, Irsad Andi Iswandi Darwis Jarir At Thobari Jarir At Thobari Jati, Lintang Daru Julia Sari Kathrine, Anita Septiana Maria Krevani, Citra Kiki Likke Prawidya Putri Lucia Kris Dinarti Lucia Kris Dinarti Lucida Kris Dinarti, Lucida Kris Luhur Pribadi Luhur Pribadi Lukman Ade Chandra Lukman Ade Chandra Makes, Indira Kalyana Mardiah Suci Hardianti Metalia Puspitasari Muhammad Gahan Sarwiko Muhammad Gahan Satwiko Muhammad Reyhan Hadwiono Muhammad Reyhan Hadwiono Muhammad Ridwan Nahar Taufiq Nahar Taufiq, Nahar Pompini Agustina Sitompul Pompini Agustina Sitompul Prasetia, Arif Eka Putri Ayudhia Trisnasari Putrika Prastuti Ra Gharini Putrika Prastuti Ra Gharini Qhabibi, Faqrizal Ria Raden Heru Prasanto Rahadiyani, IDA Swasty Rahayu, Dian Herlusiatri Raynaldo, Abdul Halim Rita Hamdani Rizki Amalia Gumilang Rochmat, Muflihatul Baroroh setiaji, dimas Shiddiq, Achmad Sjughiarto, M.Afies Susilowati, Eliana Syaoqi, Muhammad Tarsidin, Najmi Fauzan Togi Junice Hutadjulu Togi Junice Hutadjulu Tri Asti Isnariani Tri Asti Isnariani Umi Sa'adatun Nikmah Umi Sa'adatun Nikmah Vina Yanti Susanti Vita Yanti Anggraeni Wiradhika, Abdul Majid Halim Yasmine Fitrina Siregar Yulia Wardhani