Articles
Hubungan Kadar Soluble Intercellular Adhesion Molecule-1 dan Soluble Vascular Cell Adhesion Molecule-1 dengan Gradasi Trombosis Atrium Kiri pada Stenosis Mitral
Elen Elen;
Pramono Sigit;
Yoga Yuniadi;
Ismoyo Sunu
Jurnal Kardiologi Indonesia Vol. 36, No. 2 April - Juni 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i2.461
Background. The relationship between inflammation and coagulation has been widely described, which adhesion molecules play important role in inflammation. Soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) seem to be related to thrombosis in few previous studies. The level of those molecules were increased in mitral stenosis (MS), however their relationship with left atrial thrombosis gradation is still unknown.Methods. Patients with moderate-severe MS (without any significant mitral regurgitation) who underwent transesophageal echocardiography were recruited consecutively in September-October 2013. They were divided into 3 categories of left atrial thrombosis gradation: non-thrombus without dense left atrial spontaneous echo contrast (LASEC) group, and non-thrombus with dense LASEC group, and thrombus group.Results. A total of 39 subjects were enrolled in the study with a mean age of 40.97±9.61 year. Moreover, 71.8% of them were female and 67.7% of them had atrial fibrillation (AF). Evaluation on left atrial thrombosis gradation as mentioned above showed that sICAM-1 levels were 284.74 (218.79-321.00) ng/mL, 346.86 (125.68-698.12) ng/mL, and 395.93 (171.44-1021.53) ng/mL, consecutively (p=0.280). While sVCAM-1 levels gradually increased based on those groups consecutively: 729.01 (543.93-967.80) ng/mL, 1066.00 (581.36-2470.60) ng/mL, and 1158.00 (668.66-2498.30) ng/mL (p=0.016). Multivariate analysis showed that AF and mitral valve area (MVA) influence thrombosis gradation.Conclusion. Difference in sVCAM-1 levels were found among left atrial thrombosis gradation groups in mitral stenosis, but its effect on thrombosis gradation was influenced by AF and MVA.
Fibrilasi Atrium pada Penyakit Paru Obtruktif Kronik
Silmi Kaffah;
Yoga Yuniadi;
Erlang Samoedro
Jurnal Kardiologi Indonesia Vol. 36, No. 2 April - Juni 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i2.464
Chronic Obstructive Pulmonary Disease (COPD) often coexists with cardiovasculae disease (comorbidities) that may have a significant impact in prognosis. Atrial fibrillation (AF) is the most common comorbid, which is supraventricular tachyarrhythmias uncoordinated and ineffective atrial activation. Emergence of atrial fibrillation if not handled properly associated with morbidity and mortality are high . Exact pathogenesis of AF in COPD but may associated with atrial factors , inflammation ,activation of the renin - angiotensin - aldosterone system (RAAS), coronary heart disease , disorders of the autonomic tone and pharmacological. Complications of AF consisted of thromboembolic events including stroke. The management of AF with COPD should be adjusted to optimize therapeutic result
Evaluasi Alat Pacu Jantung Permanen Dari Elektrokardiogram
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 36, No. 2 April - Juni 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i2.467
KasusSeorang pria, 67 tahun datang ke poli jantung di RSU Jambi dengan riwayat pemasangan alat pacu jantung di RSU Bengkulu 6 bulan yang lalu. Tidak terdapat keluhan dan pasien dapat melakukan aktivitas sehari-hari sebagai seorang pensiunan pegawai negri sipil.Rekaman EKG diperlihatkan pada gambar di bawah ini,
Ekstraksi lead crt ventrikel kiri yang patah
Isyana Miranti;
Made Satria Yudha Dewangga;
Widyo Mahargo;
Sulistiyati Bayu Utami;
yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 36, No. 3 Juli - September 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i3.478
In recent years, implantation of cardiac resynchronization therapy (CRT) devices has significantly increased. Left ventricular (LV) pacing through the Coronary Sinus (CS) is the standard approach for CRT. Many LV lead placement techniques to get lead stability and optimal threshold, one with wire PCI. We presented a case with LV lead CRT extraction were broken after being fitted with wire PCI with stabilization purpose and to obtain an appropriate threshold, the extraction was done by snaring techniques.
LONG RP TACHYCARDIA: What is the mechanism?
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 36, No. 3 Juli - September 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i3.484
Seorang anak perempuan, 11 tahun dikonsulkan ke poli Aritmia dengan keluhan sesak dan berdebar. Rasa berdebar sudah dirasakan sejak lebih dari satu tahun yang lalu. Akhir-akhir ini pasien juga mengeluh sesak dan mudah capek. Pada pemeriksaan fisik didapatkan batas jantung kiri yang membesar dengan fixed wide split bunyi jantung kedua. Tidak terlihat sianosis. Ekokardiografi menunjukkan sebuah atrial septal defek sekundum yang besar dengan diameter 2.5 cm. Pasien mengalami takikardia incessant yang tidak respon dengan beberapa anti-aritmia dengan rekaman EKG 12 sadapan diperlihatkan di bawah ini.Tampak suatu takikardia regular dengan laju 115 kpm. Durasi QRS sempit (110 mdet) dengan morfologi gelombang P di belakang setiap kompleks QRS. Jarak awitan kompleks QRS ke awitan gelombang P
Kontroversi peran studi elektrofisiologi pada sindrom brugada
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 36, No. 4 Oktober - Desember 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i4.500
Sindrom Brugada adalah suatu abnormalitas sistem listrik jantung yang merupakan predisposisi terjadinya takikardia ventrikel dan hilang kesadaran. Takikardia ventrikel dapat berhenti spontan dan pasien pulih dari sinkop lalu berobat dengan keluhan sinkop, atau takikardia berdegenerasi menjadi fibrilasi ventrikel (FV)dan menyebabkan kematian jantung mendadak. Oleh karena itu sangat penting mengenal gambaran EKG sindrom Brugada lalu melakukan stratifikasi risiko yang cermat.Salah satu yang menjadi perdebatan hangat adalah stratifikasi risiko sindrom Brugada melalui tindakan studi elektrofisiologi (SEF). Nilai prediktif induksi aritmia ventrikel saat SEF masih kontroversial. Studi yang melibatkan 408 pasien sindrom Brugada tanpa riwayat henti jantung menunjukkan bahwa pasien dengan indusibilitas FV memiliki risiko kematian jantung mendadak karena FV enam kali lipat dalam pengamatan 2 tahun.1 Akan tetapi studi multisenter dari Eropa,2, 3 Jepang4, 5 dan beberapa metaanalisis6, 7 tidak menunjukkan hasil yang positif sehingga indikasi SEF untuk stratifikasi risiko sindrom Brugada hanya IIb pada tahun 2013 (Gambar 1). Metaanalisis8 yang lain memperlihatkan hasil yang positif yaitu ketika presentasi klinis pasien sindrome Brugada dipisahkan antara sinkop dan asimtomatik dalam analisanya.
Pengaruh Trimetazidine Terhadap Jumlah Netrofil Pasca IKPP
Taka Mehi;
Yoga Yuniadi;
Nur Haryono
Jurnal Kardiologi Indonesia Vol. 36, No. 4 Oktober - Desember 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i4.503
Background: Reperfusion strategy, either with thrombolytic or Primary Percutaneous Coronary Intervention (PPCI), is the core treatment for Acute ST-Segment Elevation Myocardial Infarct (STEMI). The goal of PPCI is to restore the patency of infarcted epicardial artery and establish microvascular reperfusion as soon as possible so that necrotic myocardial area can be reduced. However, successful restoration of infarcted epicardial artery is not always followed by enough reperfusion to the microvascular part. Trimetazidine can reduce neutrophil which was mediated by tissue trauma during ischemic heart condition. Unfortunately, its influence over neutrophil accumulation in acute STEMI patients which undergo PPCI is not well understood.Method: There were 68 consecutive-selected acute STEMI patients which undergo PPCI since January 2015 until Juni 2015. They were admitted in emergency department. Peripheral vein blood sampling was taken to measure neutrophil before PPCI was performed. Six hour after PPCI was conducted, another peripheral vein blood sampling was taken for another neutrophil measurement. Neutrophil measurement was performed with Sysmex 2000i. Statistical analysis was performed by using SPSS 17.Result: Among 68 patients, divided in two groups, trimetazidine 28 patients and plasebo 40 patients. There were no differences amount of neutrophils in trimetazidine or plasebo group, before or after PPCI. Neutrophil pre PPCI in trimetazidine vs plasebo group 10.71 ± 3.263 vs 10.99 ± 3.083, p:0,341. Neutrophil post PPCI in trimetazidine vs plasebo group 9.49 ± 3.135 vs 9.92 ± 3.463, p:0,664.Conclusion: There were no reducing amount of neutrophils after trimetazidine was given in patients STEMI which underwent PPCI
Intermitten PR Interval Changes
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 36, No. 4 Oktober - Desember 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i4.508
Seorang anak perempuan usia 10 tahun dikonsulkan ke Divisi Aritmia dengan keluhan palpitasi berulang. Ekokardiografi menunjukkan anatomi dan fungsi jantung yang normal. Rekaman EKG diperlihatkan pada gambar 1.Takikardia QRS sempit dengan pola P-QRS-T yang menetap dapat merupakan suatu atrial atau sinus takikardia. Perhatikan bahwa gelombang P pada saat takikardia sama sekali berbeda dengan morfologi gelombang P saat irama sinus. Hal ini lebih menunjukkan suatu atrial takikardia daripada suatu irama sinus.Atrial takikardia bisa merupakan suatu fokal atau makroreentri. Suatu atrial makroreentri atau atrial flutter umumnya mempunyai panjang siklus antara 200–150 mdet, sedangkan pasien ini mempunyai panjang siklus (interval PP) sekitar 380 mdet sehingga suatu atrial takikardia yang fokal lebih memungkinkan. Di antara mekanisme atrial takikardia fokal dapat berupa otomatisasi, mikroreentri atau bahkan triggered activity. Perhatikan pola terminasi dan induksi
Gagal Jantung Kongestif dan Fibrilasi Atrium: Apa Terapi Terbaik?
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 37, No. 1 Januari - Maret 2016
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v37i1.549
Gagal jantung bukan menurun bahkan meningkat prevalensinya.1 Terapi sindrom koroner akut yang lebih baik dan makin banyaknya populasi manula ditengarai sebagai penyebab peningkatan tersebut. Gagal jantung sistolik menimbulkan peningkatan tekanan akhir diastolik ventrikel kiri yang akhirnya akan meningkatkan pula tekanan atrium kiri sehingga terjadi remodeling atrium yang kemudian menyebabkan terjadinya fibrilasi atrium (FA). Sebaliknya FA dengan respon ventrikel yang cepat dan tidak terkontrol juga akan menyebabkan remodeling ventrikel yang berujung pada gagal jantung. Selain itu FA juga meningkat pada manula, sejalan dengan peningkatan kejadian gagal jantung.
Alat Pacu Jantung Tanpa Kabel
Albert Sudharsono;
Dicky A. Hanafy;
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 37, No. 1 Januari - Maret 2016
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v37i1.556
The development of health technology benefits in the treatment of heart rhythm abnormalities. Cardiac pacemakers with nonsurgical methods plays a critical role in the management of patients with heart rhythms disorders. The discovery of a leadless pacemaker provides many benefits compared to conventional pacemaker where the device can be implanted by transcatheter delivery. Various studies have been done and still continued to monitor the efficacy and safety of this device. In principle, Indonesia is ready to participate in the advance technology of leadless pacemaker. National Health Covarage policy will play an important role in this new technology in the future.