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All Journal Acta Interna : The Journal of Internal Medicine Indonesian Journal of Cardiology ACI (Acta Cardiologia Indonesiana) Heart Science Journal Cardiovascular and Cardiometabolic Journal (CCJ) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Berita Kedokteran Masyarakat Indonesian Journal of Biomedicine and Clinical Sciences
Hasanah Mumpuni
Department Of Cardiology And Vascular Medicine, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada – Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Correlation of thirst with ejection fraction and plasma sodium level in elderly with chronic heart failure Sri Lestari; I Dewa Putu Pramantara; Hasanah Mumpuni
Acta Interna The Journal of Internal Medicine Vol 4, No 2 (2014): The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/acta interna.16572

Abstract

ABSTRAKLatar Belakang: Haus merupakan simptom yang umum dan mengganggu bagi pasien gagal jantung.Banyak pasien gagal jantung usia lanjut mengeluh rasa haus berlebihan. Perjalanan alamiah gagal jantung,terapi farmakologi dan non farmakologi dapat meningkatkan rasa haus. Cardiac output yang rendah danpeningkatan aktivasi sistem neurohormonal seperti sistem renin-angiotensin aldosteron akan merangsangpusat haus di hipotalamus. Hubungan antara rasa haus dengan fraksi ejeksi dan kadar natrium plasma padapasien gagal jantung kronis usia lanjut belum diketahui.Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara derajat rasa haus denganfraksi ejeksi dan kadar natrium plasma pada gagal jantung kronis usia lanjut.Metode: Penelitian menggunakan metode potong lintang, dilakukan di Bagian Penyakit Dalam dan BagianKardiologi RSUP Dr. Sardjito Yogyakarta. Subyek penelitian adalah pasien usia lanjut penderita gagal jantungkelas fungsional III-IV sesuai dengan kriteria NYHA, usia ≥60 tahun. Pengukuran rasa haus dilakukandengan menggunakan skor VAS. Pemeriksaan fraksi ejeksi dilakukan dengan ekokardiografi . Karakteristiksubyek penelitian disajikan dalam bentuk rerata dan simpangan baku. Hubungan antara derajat rasa hausdengan fraksi ejeksi dan kadar natrim plasma dianalisis dengan menggunakan uji korelasi Pearson. Nilai p<0.05 dianggap signifi kan.Hasil: Didapatkan 30 subyek sebanyak 63.3% laki-laki dengan median usia 69.5 tahun. Diperoleh rerata rasahaus 63.67±17.5 mm dan rerata fraksi ejeksi sebesar 41.93±15.5%. Rerata hasil pemeriksaan kadar natriumadalah 139.7±4.1 mmol/l sedangkan rerata osmolalitas plasma 296.4±10.1 mOsm/kg.Kesimpulan: Pada uji korelasi Pearson didapatkan korelasi antara rasa haus dengan fraksi ejeksi adalahkorelasi negatif lemah namun tidak signifi kan secara statistic (r=-0.314, p=0.091). Tidak didapatkan korelasiantara rasa haus dengan kadar natrium plasma (r=-0.04 p=0.833).Kata kunci: usia lanjut, rasa haus, gagal jantung kronis, fraksi ejeksi, natrium plasmaABSTRACTBackground: Thirst is a common symptom that disturbs patient with heart failure. Many elderly patients withheart failure get severe thirst. Natural history of heart failure, pharmacological and non-pharmacological therapiescould increase the thirst level. Low cardiac output and activation of neuro-hormonal system e.g. renin angiotensinaldosteronesystem, would stimulate the thirst center in hypothalamus. Correlations of thirst with ejection fractionand plasma sodium level in elderly with chronic heart failure have not been known yet.Aims: The aims of this study are to investigate the correlations of thirst with ejection fraction and plasmasodium level in elderly with chronic heart failure. Cross sectional design has been conducted on elderly patients(age of ≥60 years) with heart failure of functional class of III-IV (based on NYHA criteria) in Departmentof Internal Medicine and Department of Cardiology, Dr. Sardjito General Hospital, Yogyakarta.Method: Measurement of thirst was done using VAS score, while the investigation of ejection fraction wasperformed using echocardiography. Characteristics of subjects were presented in the average and standarddeviation values. Correlations between thirst with ejection fraction and plasma sodium level were analyzedby using Pearson correlation test with p < 0.05 considered to be signifi cant.Result: There were 30 subjects, 63.3% male, median of age of 69.5 years. The average of thirst value was63.67} 17.5 mm and the ejection fraction was 41.93} 15.5%. The averages of plasma sodium level andplasma osmolality were respectively 139.7} 4.1 mmole/l and 296.4} 10.1 mOsm/kg.Conclusion: Pearson correlation test has revealed a weak negative correlation of thirst and ejection fraction(r= -0.314, p=0.091). On the other hand, there was no correlation between thirst and plasma sodium level(r=-0.04 p=0.833).Keywords: thirst, elderly, chronic heart failure, ejection fraction, plasma sodium level
Correlation Between Tp-Te Interval With the Degree of Disfunction in Liver Cirrhosis Based on Child Pugh Turcotte Score in Dr. Sardjito General Hospital RA Aditya Adhi Puruhita; Hasanah Mumpuni; Neneng Ratnasari
Acta Interna The Journal of Internal Medicine Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.62843

Abstract

Background. Hyperdynamic syndrome due to portal hypertension in cirrhosis of the liver leads to failure ofcontractions and cardiac structures that result in complications of cardiomyopathy cirrhosis. The incidenceof arrhythmias was reported in various non- cardiac diseases including liver cirrhosis. We aim to evaluatethe T peak wave - T end (Tp-Te) as a parameter for suspected arrhythmias that occur in liver cirrhosis.Aims. To  determine the  correlation between the  Tp-Te  interval  with dysfunction in the degree of livercirrhosis, which was assessed using the Child Pugh Turcotte score.Methods. This research is a cross-sectional study. Data taken from liver cirrhosis patients who has been metthe inclusion and exclusion criteria were admitted to the Inpatient and Outpatient Hospital Dr. Sardjito untilMay 2020, an assessment of the degree of dysfunction of liver cirrhosis with Child Pugh score Turcotte, andelectrocardiographic examination to assess Tp-Te wave. The independent variable was the Child Pugh Turcottescore, the dependent variable was the Tp-Te wavelength. Analysis of correlation data using the Spearman test.Results. Subjects included 51 patients with liver cirrhosis, correlation analysis found a strong correlation,the higher the Child Pugh Turcotte score was linearly correlated with the Tp-Te wavelength (r = 0.692; p<0.05). Wavelength Tp-Te at Child Pugh to any group showed a significant (p <0.001) , the wavelengthof Tp-Te Child Pugh A  group   67.94 ± 7.80 ms, the Child Pugh  B group   77.26 ± 8.38 ms, whereas inthe Child Pugh C group 92.31 ± 11.36 ms.Conclusion.  There was a strong positive correlation between the Tp-Te interval with the degree of livercirrhosis dysfunction which was assessed using the Child Pugh Turcotte score.
Ekokardiografi Transtorakal pada Deteksi Awal Gangguan Fungsi Katup Mitral Prostetik Hasanah Mumpuni; Amiliana M Soesanto
Jurnal Kardiologi Indonesia Vol. 34, No. 4 Oktober - Desember 2013
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v34i4.388

Abstract

Pemeriksaan ekokardiografi transtorakal (TTE)merupakan cara yang masih diandalkandalam skrening gangguan fungsi katup mitralprostetik (prosthetic mitral valve – PMV),karena ekokardiografi transesopagus (TEE) tidakdapat dikerjaan secara rutin. Tetapi adanya gambaranacoustic shadow sangat mengganggu pada deteksidisfungsi PMV dengan pemeriksaan TTE terutamaadanya regurgitasi.
The Incidence of Mitral Valve Prolapse and Mitral Valve Regurgitation in Patient with Secundum Atrial Septal Defect Ni Made Elva Mayasari; Dyah Wulan Anggrahini; Hasanah Mumpuni; Lucia Krisdinarti
ACI (Acta Cardiologia Indonesiana) Vol 1, No 1 (2015)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.17790

Abstract

Background: Association between secundum atrial septal defect (ASD) and mitral valve disease has been recognized for many years. Noninvasive studies indicate a high incidence of mitral valve prolapse (37-70 percent) in these patients. Change of left ventricular geometry in atrial septal defect had been showed were associated with degree of mitral valve prolapse. This study delineates the incidence of mitral valve prolaps and mitral regurgitation in adult patients with secundum atrial septal defect and association with age at onset and size defect. Method: This study was a substudy from ASD registry in Dr. Sardjito General Hospital. The records of 103 adult patients ranged in age from 17 to 76 years old, with an average of 36 years old, and consisted of 16 men and 87 women who had secundum atrial septal defects demonstrated by crosssectional echocardiography between july 2012 until july 2013. Echocardiographic examinations were performed with the patient in the supine position. The echocardiograph was a Vivid 7. The mitral valve apparatus and mitral regurgitation was examined with long axis images, short axis image and apical four chamber view. Result: Mitral valve prolapse was observed in 76% patients with secundum atrial septal defect. Prolaps of anterior mitral leafl et (AML) in age group younger than 35 years and older than 36 years are 38,6% and 61,4% respectively. The incidence of mitral regurgitation was 43%. Severity varianceof mitral regurgitation were 31,7% mild, 7,7% moderate and 2,9% severe. Mitral regurgitation in patient with prolapse AML was 56.4%. None of the patients without mitral valve prolapse had mitral regurgitation.In patient with size defect more than 2 cm, the proportion of prolapse of AML and mitral regurgitation was higher as compared with patient with size defect less than 2 cm. Conclusion: Incidence of mitral valve prolaps and mitral regurgitation are high in patient with atrial septal defect and increase with onset of age. Patients with larger size defect had a greater likelihood of mitral prolapse and mitral regurgitation. Onset of age and size defect might be associated with magnitude of the shunt and abnormal ventricular geometry.Keywords: secundum atrial septal defect, mitral valve prolaps, mitral regurgitation
The Role of Anticoagulant and Thrombolysis in The Management of Deep Vein Thrombosis Anggia Endah Satuti; Hariadi Hariawan; Hasanah Mumpuni
ACI (Acta Cardiologia Indonesiana) Vol 1, No 1 (2015)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.17792

Abstract

Deep vein thrombosis (DVT) is a clinical challenge encountered by clinicians of all specialties. The major complication to date is thrombus embolization into the lung which can be fatal. The mainstay of DVT therapy is an anticoagulant to prevent the thrombus development and recurrence. However, anticoagulant has no direct thrombolysis effect and recanalization of DVT largely depends on the effectiveness of the endogenous fi brinolytic system. Many agents are developed to improve the outcome and prevent a post thrombotic syndrome (PTS). The aim of this review is to give explanation on the use of anticoagulant, especially vitamin K antagonist, warfarin and thrombolytic therapy in DVT.
Efficacy of Lumbrokinase and Warfarin Compared to Single Warfarin on Thrombus Resolution in Deep Vein Thrombosis Anggia Endah Satuti; Hariadi Hariawan; Hasanah Mumpuni
ACI (Acta Cardiologia Indonesiana) Vol 1, No 2 (2015)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.17798

Abstract

Background: Deep vein thrombosis (DVT) is a challenging condition for clinician in all specialities. Prognosis after vein thromboembolism is worse and much worse after pulmonary embolism. Anticoagulant is the mainstay therapy for deep vein thrombosis, but there is still slow thrombus resolution even with the use of optimal anticoagulant. The use of intravenous thrombolytic agentsis one of the methods to signifi cantly lyse thrombus. Since there is increasing risk of bleeding with the use of the agents, indication is limited. Lumbrokinase is oral thrombolytic that may give significant thrombus lyses without increasing the risk of bleeding for deep vein thrombosis. This study was conducted to compare single warfarin therapy with combination of lumbrokinase andwarfarin for thrombus resolution in deep vein thrombosis patients. Methods: This study was a randomized open labeled trial comparing deep vein thrombosis patients using single warfarin therapy group to group using combination lumbrokinase and warfarin. 22 patients meet the inclusion and exclusion criteria. Patients were followed for 30 days and in the end of the trial, evaluation using vascular Doppler ultrasonography was done. Chi-square analysis was used to compare the outcome between two therapy groups. Results: In this trial, group therapy with added lumbrokinase to warfarin yielded a tendency toward better thrombus resolution compared to group with single warfarin therapy (58.3% vs.30%, p=0.231). Conclusion : Added therapy with lumbrokinase to warfarin may give better thrombus resolution as compared to single warfarin therapy, although there is no signifi cant difference between groups.Keywords: deep vein thrombosis, lumbrokinase, warfarin
Correlation Between Right Ventricular Function Using Myocardial Performance Index (Tei Index) with Pulmonary Arterial Hypertension Severity in Patient with Atrial Septal Defect Hendry Purnasidha Bagaswoto; Dyah Wulan Anggrahini; Hasanah Mumpuni; Lucia Krisdinarti
ACI (Acta Cardiologia Indonesiana) Vol 2, No 1 (2016)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (137.52 KB) | DOI: 10.22146/aci.17818

Abstract

Background: Right ventricular (RV) volume overload that occurs in patients with atrial septal defect (ASD) could lead to the development of pulmonary arterial hypertension (PAH). RV function has been found depressed in some patients with PAH. Myocardial performance index (MPI) is one of methods to assess RV function. The aim of this study was to assess correlation between RVfunction using RV-MPI with PAH severity in patients with ASD. Methods: We conducted a cross sectional study between July 2012-July 2013. We enrolled 67patients with secundum type ASD. RV-MPI, defi ned as the sum of isovolumic relaxation time and isovolumic contraction time derived by ejection time, was measured from tricuspid infl ow and RV outflow. The normal range is 0.28-0.32. Pulmonary artery systolic pressure (PASP) was measured from echocardiography. Results: There were 67 patients (54 women) with mean age was 38.01±14.29 years (11.9% with no PAH, 11.9% mild PAH, 26.9% moderate PAH and 49.3% severe PAH). The mean PASP was 67.16±32.33 mmHg and mean MPI was 0.44±0.25. We found signifi cant correlation between PASP and MPI (r=0.73; p=0.000). In addition, we classifi ed the PAH severity based on PASP and there was signifi cant differences of MPI between groups (no PAH, MPI 0.25±0.07; mild PAH 0.24±0.05; moderate PAH 0.24±0.12; severe PAH 0.63±0.21; p=0.000). Furthermore, in severe PAH group, the correlation between PASP and MPI remain signifi cant (r=0.42; p<0.05). Conclusion: These result demonstrate a correlation between PAH severity and MPI in patientswith ASD. Specifi cally, RV function found decreased in ASD patients with severe PAH.Keyword: myocardial performance index (Tei index), pulmonary arterial hypertension, right ventricular function, atrial septal defect
Association Between Mean Platelet Volume (MPV) with Major Adverse Cardiovascular Events in Acute Coronary Syndrome during Hospitalization Hasanah Mumpuni; Hariadi Hariawan; Lucia Kris Dinarti
ACI (Acta Cardiologia Indonesiana) Vol 2, No 2 (2016)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.22602

Abstract

Background: Platelets play a central role in the pathogenesis of acute coronary syndrome with various clinical manifestations of unstable angina pectoris, myocardial infarction with ST segment elevation, and myocardial infarction without ST segment elevation. Mean platelet volume (MPV), the average size of platelets in blood obtained from routine blood tests, reflects the activation of platelets. Previous study revealed that higher MPV showed a higher thrombotic potential, by increasing the platelet activation, secretion of tromboxan A2 and the expression of glycoprotein Ib and IIb/IIIa receptors. This study aims to determine whether the MPV may predict the major cardiovascular events in patients with acute coronary syndrome.Metode: We perform a retrospective cohort study involving 372 patients with acute coroanry syndrome who admitted to Intensive Cardiac Care Unit Dr. Sardjito Hospital Yogyakarta. The research is conducted between January 2009 to January 2011, comprising 180 (48.3%) STEMI patients, 87 (23.3%)NSTEMI patients and 105 (28.4%) unastable angina patients. Subjects are further grouped as those with high MPV and low MPV. MPV measurement is obtained on routine blood tests of those patients.The major adverse cardiovascular events are cardiovascular death, non fatal reinfarction, stroke, acute heart failure and cardiogenic shock.Result: Cut-off value of MPV in this study is 8.85 fL determined with ROC curve analysis. The major adverse cardiovascular events is significantly higher in those with MPV >8.85 fL compared with those with the MPV ≤8.85 fL (incidence: 28.4% vs. 18.9%, p = 0.034), with the relative risk (RR) 1.65, 95% CI 1.037-2.783. The mean MPV in patients with major adverse cardiovascular events was significantly higher as compared to those without major adverse cardiovascular events (9.506 ± 1.76 fl vs.8.96 ± 1.45 fl, p = 0.001).Conclusion: Mean platelet volume (MPV) are associated with major adverse cardiovascular events in acute coronary syndrome. The high MPV may be considered as a predictor of major cardiovascular events in patients with acute coronary syndrome.Keywords: acute coronary syndrome, mean platelet volume, major adverse cardiovascular events.
Current Diagnosis and Management of Myocarditis Windhi Dwijanarko; Hasanah Mumpuni; Bambang Irawan
ACI (Acta Cardiologia Indonesiana) Vol 2, No 2 (2016)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.22605

Abstract

Myocarditis is an inflammation of the myocardium. The clinical presentations of myocarditis range from nonspecific systemic symptom such as fever, myalgias, palpitations, or exertional dyspnea, to severe hemodynamic derangement and sudden death. The wide variation of clinical manifestations has made the exact incidence of myocarditis difficult to determine. The prevalence of myocarditis based on autopsy data is ranging from 2 to 42%. Myocarditis has heterogeneous clinical presentation, ranging from mild chest pain or palpitations to cardiogenic shock and life-threatening ventricular arrhythmias. The diagnosis of myocarditis requires a high initial suspicion. Non-invasive techniques, such as cardiac magnetic resonance imaging, can be useful to diagnose and monitor of disease. The endomyocardial biopsy is the gold standard for definitive diagnosis of myocarditis and can identify the etiology of myocarditis. By endomyocardial biopsy, it can direct patients who can be managed by conventional therapy or who require specific treatment based on underlying etiology, such as antiviral or intravenous immunoglobulin infusion.Keywords: myocarditis; diagnosis; management
Brain Abscess in Young Adult with Double Outlet Right Ventricle (DORV): A Case Report Hendry Purnasidha Bagaswoto; Rendi Asmara; Hasanah Mumpuni
ACI (Acta Cardiologia Indonesiana) Vol 2, No 2 (2016)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.22606

Abstract

Intracranial lesions frequently occur in association with congenital malformation of the heart. Intracranial abscess and cerebral thrombosisare the two most serious complications of the brain due to congenital cyanotic heart disease. We reported a case of brain abscess occurring in patients with double outlet right ventricle (DORV). The identification of focal infection and appropriate treatment with parenteral antibiotics,steroid, antiplatelet and anticonvulsant improved patients clinically.Keywords: brain abscess; congenital; double outlet right ventricle
Co-Authors Abdus Samik Wahab Ageng Brahmadhi Amiliana M. Soesanto Anggia Endah Satuti Anggoro Budi Hartopo Anggoro Budi Hartopo Azhafid Nashar Baiq Gerisa Rahmi Faharani Bambang Irawan Baskoro Adi Prabowo Braghmandaru Adhi Bhaskara Citra Dewi Wahyu Fitria Dyah Adhi Kusumastuti Dyah Wulan Anggrahini Erika Maharani Fera Hidayati Ford Ance E. Aritonang Gharini, Putrika Prastuti Ratna Hariadi Hariawan Hashina Zulfa Hendry Purnasidha Bagaswoto I Dewa Putu Pramantara Iqbal Maulana Iri Kuswadi Irsad Andi Arso Irsad Andi Arso Kartika Apshanti Krisdinarti, Lucia Laeli Ardiani Putri Lucia Kris Dinarti Lucia Kris Dinarti Lucia Kris Dinarti Lucia Krisdinarti Maemonah, Maemonah Mardiah Suci Hardianti Marsam, Real Kusumanjaya Metalia Puspitasari Nahar Taufiq Nahar Taufiq Neneng Ratnasari Neni Trilusiana Ni Made Elva Mayasari Personaldi Personaldi, Personaldi Probokusumo, Jagaddhito Putri Ayudhia Trisnasari RA Aditya Adhi Puruhita Raden Heru Prasanto Rano Irmawan Real Kusumanjaya Marsam Rendi Asmara Sanggula, Pratiwi Noor Purnama Putri Sanggula SRI LESTARI Vita Yanti Anggraeni Windhi Dwijanarko Yulia Wardhani