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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Indonesian Journal of Cardiology ACI (Acta Cardiologia Indonesiana) Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Journal of Community Empowerment for Health Indonesian Journal of Biomedicine and Clinical Sciences

Dyah Wulan Anggrahini

Department Of Cardiology And Vascular Medicine, Faculty Of Medicine, Public Health And Nursing Universitas Gadjah Mada – Dr. Sardjito Hospital, Yogyakarta, Indonesi

Author-ID : 2970873

Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

Published : 22 Documents Claim Missing Document

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Articles

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Clinical Characteristics of Adult Uncorrected Secundum Atrial Septal Defect, A Pilot Study Lucia Krisdinarti; Anggoro Budi Hartopo; Dyah Wulan Anggrahini; Ahmad Hamim Sadewa; Abdus Samik Wahab; Budi Yuli Setianto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 2 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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.

Association between serum soluble ST2 level and right ventricle systolic function on pulmonary hypertension due to atrial septal defect Firandi Saputra; Anggoro Budi Hartopo; Hariadi Hariawan; Dyah Wulan Anggrahini; Lucia Kris Dinarti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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.

Pulmonary artery hypertension patients and the coronavirus disease of 2019 (COVID-19): are they protected from severe disease? Anggoro Budi Hartopo; Dyah Wulan Anggrahini; Bambang Budi Siswanto; Lucia Kris Dinarti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020): Special Issue: COVID-19
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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.

Pulmonary arterial hypertension after atrial septal defect closure: a case report Lucia Kris Dinarti; Dyah Wulan Anggrahini; Muhammad Reyhan Hadwiono; Abdul Majid Halim Wiradhika; Vera Dewanto; Anggoro Budi Hartopo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 4 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005304202111

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.

Pulmonary vascular resistance/systemic vascular resistance (PVR/SVR) ratio changes after sildenafil therapy in uncorrected congenital heart disease-associated pulmonary arterial hypertension Evita Devi Noor Rahmawati; Putrika Prastuti Ratna Gharini; Anggoro Budi Hartopo; Lucia Kris Dinarti; Dyah Wulan Anggrahini
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202305

Pulmonary vascular resistance (PVR) to systemic vascular resistance (SVR) ratio is a prognostic predictor in congenital heart disease (CHD)-associated pulmonary arterial hypertension (PAH) after defect correction. Sildenafil, widely used as a PAH drug, can decrease PVR with minimal or without changes in SVR, resulting in decreased PVR/SVR ratio after treatment. However, there is limited evidence that PVR/SVR ratio reduced after sildenafil therapy in uncorrected CHD-associated PAH patients. This study aimed to investigate the decreasing of the PVR/SVR ratio after ≥ 1-year oral sildenafil therapy in adult uncorrected CHD-associated PAH. A total of 30 uncorrectable CHD-associated PAH subjects derived from the COHARD-PH registry were included in this study. Right heart catheterization (RHC) was performed during the first visit and further evaluations were conducted after ≥1-year oral sildenafil therapy. The PVR/SVR ratio at the baseline and after the evaluation was collected. The primary outcome of this study was the changes in PVR/SVR ratio from baseline to evaluated RHC. Characteristic analysis of subjects with decreased PVR or PVR/SVR ratio was perforemd as the secondary outcome. The mean PVR and SVR were not different from baseline and evaluated RHC (15.98± 10.67 vs. 18.38±13.93 WU, p=0.206 and 36.65±13.99 vs. 39.34±15.46 WU, p=0.262). There was no significant difference in the baseline PVR/SVR ratio and the evaluated PVR/SVR ratio after ≥1-year sildenafil therapy (0.48 ±0.32 vs. 0.49±0.36; p=0.882). As much as 15 subjects (50%) experienced decreased PVR/SVR ratio. However, there was no significant difference in the characteristics, including age, Eisenmenger syndrome, type of shunts, baseline PVR, PAH-specific treatment, and baseline NT-proBNP level (p>0.05). In conclusion, sildenafil therapy does not change PVR/SVR ratio in adults with uncorrected CHD-associated PAH.

Reconsidering the limited role of right heart catheterization on severe pulmonary hypertension-due to progressive interstitial lung disease in young male patient : a case report Megawati Abubakar; Anggoro Budi Hartopo; Ika Trisnawati; Eko Budiono; Dyah Wulan Anggrahini; Lucia Kris Dinarti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 2 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005502202307

Pulmonary hypertension (PH)-associated with interstitial lung disease (ILD) develops as a consequence of progressive underlying lung disease or disproportionately to the underlying disease. The PH investigation by right heart catheterization (RHC) for defining PH severity is recommended in patients with ILD who show more severe symptoms than expected from lung disease, appearance of right heart failure, and clinical deterioration not matched by the declining lung function. In patient with progressive ILD, RHC is only considered if it affects the future treatment such as lung transplantation or enrollment in clinical trial/registry. The decision to undertake the RHC in progressive ILD was still fraught with doubts. Here we reported a young adult male patient with ILD whom developed progressive signs and symptoms. By RHC, he had severe precapillary PH with hemodynamic parameters indicated the presence of pulmonary vascular disease. A PH-specific treatment, sildenafil citrate, was administered, and patient responded well and was clinically stable during the addition of sildenafil citrate. This case highlights the clinical implication of performing RHC in progressive ILD, which can change the treatment decision by PH-specific drugs. Therefore, the RHC decision making in patient with progressive ILD need reconsideration.

Co-Authors Abdul Majid Halim Wiradhika Abdul Majid Halim Wiradhika Abdus Samik Wahab Ahmad Hamim Sadewa Aisyah Ratna Yuniarti Alifia Salsabila Anggia Endah Satuti Anggoro Budi Hartopo Anggoro Budi Hartopo Anggoro Budi Hartopo Anggoro Budi Hartopo Anggoro Budi Hartopo Anggoro Budi Hartopo Anggoro Budi Hartopo Anggoro Budi Hartopo Anggoro Budi Hartopo Anggoro Budi Hartopo Armalya Pritazahra Armalya Pritazahra Azhafid Nashar Bambang Budi Siswanto Bambang Irawan Budi Yuli Setianto Citra Dewi Wahyu Fitria Detty Siti Nurdiati Diah Saraswati Eko Budiono Erika Maharani Erna Ashlihah Rochmat Evita Devi Noor Rahmawati Fika Humaeda Assilmi Firandi Saputra Gharini, Putrika Prastuti Ratna Hariadi Hariawan Hasanah Mumpuni Hendry Purnasidha Bagaswoto Ika Trisnawati Ira Puspitawati Krisdinarti, Lucia Lucia Kris Dinarti Lucia Kris Dinarti Lucia Kris Dinarti Lucia Kris Dinarti Lucia Kris Dinarti Lucia Krisdinarti Lucia Krisdinarti Maemonah, Maemonah Megawati Abubakar Muhammad Gahan Satwiko Muhammad Gahan Satwiko Muhammad Reyhan Hadwiono Muhammad Reyhan Hadwiono Muhammad Reyhan Hadwiono Ni Made Elva Mayasari Noriaki Emoto Nu Pravitasari Putri, Naila Vinidya Rochmat, Muflihatul Baroroh Setyawati Setyawati Vera Dewanto Vera Dewanto Vienna Rosalinda Windhi Dwijanarko

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