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Mochamad Arif Nugroho
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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Late Presentation of Arrhythmogenic Right Ventricular Cardiomyopathy : Role of Non Invasive Modalities for The Diagnosis Sungkar, Safir; Nugroho, Mochamad Arif
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 2 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (663.321 KB) | DOI: 10.36408/mhjcm.v6i2.394

Abstract

Background : Arrhythmogenic right ventricular cardiomyopathy(ARVC) is an inherited myocardial disease affecting predominantly young people and manifests as sustained ventricular tachycardia, sudden cardiac death (SCD) or heart failure. However, its first manifestation in older patients is infrequent. Diagnosis of ARVC remains a clinical challenge and need further investigation. Our case report investigated role of non invasive modalities for diagnosis of ARVC patient. Case Presentation : A 65 year old man was admitted to the hospital with symptoms of palpitationand near syncope. An Electrocardiogram (ECG) showed a sustained VT with LBBB morphology and inferior axis. The patient was cardioverted to sinus rhytm with a single 100J shock. Postcardioversion ECG showed an epsilon wave in right precordial leads. Echocardiography revealed extensive RV enlargement and reduce function. Our patient had three major (RV aneurysm, epsilon wave and T wave inversion) and one minor criteria (sustained LBBB type-VT with inferior axis)making the diagnosis of ARVC definite according to the revised Task Forced Criteria. Conclusion: ARVC may have a very late presentation and this diagnosis should be considered as a potential cause of sustained VT of RV origin among the elderly. ECG and echocardiography as non invasive modalities have an important role for the diagnosis of patients with suspected ARVC. Keywords :Arrhythmogenic right ventricular cardiomyopathy,ventricular tachycardia, sudden cardiac death, diagnosis.
Korelasi Antara Jumlah Cd4 Dengan Global Longitudinal Strain Ventrikel Kiri Pada Penderita Human Immunodeficiency Virus Pratama, Yanuar Surya; Chairunnisa, Andita; Bahrudin, Udin; Uddin, Ilham; Nugroho, Mochamad Arif; Sofro, Muchlis Achsan Udji; Kristina, Tri Nur
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 1 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (316.326 KB) | DOI: 10.36408/mhjcm.v8i1.495

Abstract

Latar Belakang: Jumlah CD4 merupakan parameter penting pada penderita HIV dan berhubungan dengan peningkatan risiko disfungsi sistolik. Hingga saat ini, korelasi antara jumlah CD4 dengan parameter global longitudinal strain (GLS) sebagai indikator fungsi sistolik subklinis masih belum jelas. Metode: Penelitian ini merupakan studi observasional dengan metode belah lintang. GLS ventrikel kiri diperiksa menggunakan ekokardiografi dua dimensi. Jumlah CD4 baseline dan nadir diperoleh dari rekam medis sedangkan jumlah CD4 aktual dan CD4 percentage (CD4%) diperiksa menggunakan metode flow cytometry. Hasil: Total 37 pasien HIV asimptomatik mengikuti penelitian dengan rerata umur 31,95± 7,54 tahun dan median durasi penggunaan ARV adalah 34 bulan. Median CD4 baseline dan CD4 nadir adalah 272 sel/uL dan 223 sel/uL, sedangkan rerata CD4 aktual dan CD4% adalah 516,08±252,03 sel/uL dan 19,66±7,97 %. Semua subyek penelitian memiliki fungsi sistolik normal. Rerata GLS ventrikel kiri adalah 17,02±0,71. GLS ventrikel kiri berkorelasi positif dengan CD4 aktual (r=0,43; p=0,008) dan CD4% (r=0,349; p=0,034). Penderita HIV dengan jumlah CD4 aktual ?400 sel/uL memiliki GLS ventrikel kiri yang lebih baik dibandingkan dengan yang <400 sel/uL (p=0,022). Kesimpulan: Jumlah CD4, terutama CD4 aktual dan CD4 percentage berkorelasi dengan disfungsi sistolik subklinis yang diukur dengan global longitudinal strain pada penderita HIV asimtomatik. Hal ini mungkin dapat menjelaskan peran CD4 terhadap patogenesis gagal jantung pada penderita HIV.
Co-Authors Chairunnisa, Andita Hardian Hardian Ignatius Faizal Yuwono Ilham Uddin Ilham Udin Misbah Hari Cahyadi Muchlis Achsan Udji Sofro Pratama, Yanuar Surya Sahal Fatah Sodiqur Rifqi Sungkar, Safir Susi Herminingsih Tri Nur Kristina Udin Bahrudin Udin Bahrudin, Udin Yan Herry