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All Journal Paediatrica Indonesiana Indonesian Journal of Cardiology ACI (Acta Cardiologia Indonesiana)
Raymond Pranata
Universitas Pelita Harapan
Health Professions Medicine & Pharmacology

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Efek Akut Manuver Slow Deep Breathing terhadap Penderita Hipertensi Esensial Derajat 1 dan 2 Wendy Wiharja; Raymond Pranata; Abraham Fatah; Bertha Bertha; Ivani C Kurniadi; Hadrian Deka; Vito A Damay
Jurnal Kardiologi Indonesia Vol. 37, No. 2 April - Juni 2016
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v37i2.566

Abstract

Background: Hypertension remains one of the most common health issues in Indonesia. Slow deep breathing maneuver is a non-pharmacological therapy that achieves systolic and diastolic blood pressure lowering effect through sympathetic and parasymphathetic firing rate.Methods: This study was done using cross-sectional design, with consecutive sampling. Sample population was patients with hypertension stage 1 and 2, age range 40-55 years old, who came to Puskesmas Balaraja.Results: Systolic blood pressure lowered from 148.04+5.82 mmHg to 138.15+5.9 mmHg (p<0.05) and diastolic pressure lowered from 85+5.05 mmHg to 78.47+5.46 mmHg (p<0.05). This study showed that there is a relation between the manuever and lowering the systolic and diastolic blood pressure (p=0.000, on T-Test analytical study).Conclusion: Based on the data, the slow deep maneuver can be used as a non-pharmacological therapy for patients with hypertension. Because the effect is acute, it can be considered for hypertension crisis, but further studies are still needed.
Komplikasi Kardiovaskular dan Neurologis yang Berhubungan dengan Fibrilasi Atrium Raymond Pranata; Hadrian Deka; Bambang Budi Siswanto
Jurnal Kardiologi Indonesia Vol. 37, No. 3 Juli - September 2016
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v37i3.580

Abstract

Atrial fibrillation (FA) is the most common type of sustained-arrhythmia and one of the leading causes of mortality and morbidity globally, with estimated five million incidents. FA was associated with increased all-cause mortality (RR 1.46), cardiovascular mortality (RR 2.03), major cardiovascular events (RR 1.96), stroke (RR 2.42), ischemic stroke (RR 2.33), dementia (HR 1.42) and cognitive decline, ischemic heart disease (RR 1.61), sudden cardiac death (RR 1.88), heart failure (RR 4.99), chronic kidney disease (RR 1.64), and peripheral artery disease (RR 1.31). Overall, all-cause and cardiovascular mortality increased. Cognitive decline and dementia are also a concern since they impair function and quality of life. Overall, FA has bidirectional association with other cardiovascular diseases hence it acts as a marker for them. Therefore, prevention and control of risk factors are of utmost importance.
Peran Asam Lemak Omega-3 pada Dislipidemia dan Penyakit Kardiovaskular Grace Fonda; Raymond Pranata; Hadrian Deka
Jurnal Kardiologi Indonesia Vol. 37, No. 4 Oktober - Desember 2016
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v37i4.586

Abstract

Globally, coronary heart disease (CHD) is a leading cause of mortality and morbidity, especially in developing countries. Both marine and plants sources of omega-3 fatty acids has been shown to be beneficial in reducing CHD mortality. Beside of anti-arrhythmic effects, omega-3 has been shown anti-thrombotic and anti-atherosclerotic effect. In 2011, US population spent about 25 billion US dollar for omega-3 supplement; it is projected to be 35 billion US dollar in the year 2016. Several reviews on randomized controlled trial conclude that omega-3 fatty acids reduced plasma triglyceride level consistently in a dose-dependent fashion. Other beneficial effects on blood pressure, endothelial function and high density lipoprotein (HDL) level participate in lowering CHD mortality. American Heart Association (AHA) recommended routine fish consumption as secondary prevention in patient at risk. Omega-3 fatty acids role in primary prevention is inconclusive and need further investigation regarding cost-benefit and bleeding risk.
Comparison of Roles between Alcohol Ablation and Surgical Myectomy in Hypertrophic Cardiomyopathy Nico Kusuma; Raymond Pranata; Rachel Vania; Bambang Budi Siswanto
Jurnal Kardiologi Indonesia Vol. 38, No. 2 April-June 2017
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v38i2.733

Abstract

Hypertrophic cardiomyopathy is a genetic myocardial disease that may extend to leftventricular outflow tract obstruction. Alcohol septal ablation (ASA) is preferred for itsnon-surgical, agreed as the safest way for advanced aged, or those with high risk for surgicalprocedure or comorbidities. On the other hand, surgical myectomy (SM) remainsas gold standard, established to be the most consistent to achieve optimal hemodynamicand spare longevity, regardless selective use. This article reviews the advantages anddisadvantages between SM and ASA ablation from its outcome, mortality, pre- and postprocedural,and patient’s profile selection.
A Case Report of Elderly Woman with Supraventricular Tachycardia associated with Intracranial Bleeding Raymond Pranata; Veresa Chintya; Emir Yonas; Vito Damay
Jurnal Kardiologi Indonesia Vol 38 No 3 (2017): July - September 2017
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v38i3.782

Abstract

Background The neurogenic cardiac injury is related to brain injury-induced cat­echolamine and neuro-inflammatory responses and is more likely in those with the most severe neurological insult. Case Report A 78 years-old female presented to the emergency department after being found lying on the floor with a laceration on the head. On physical examination GCS 3, BP 140/90 mmHg, HR 190 bpm, respiratory rate 25x/minute. PMH of hypertension and diabetes were denied. ECG showed supraventricular tachycardia of 186 bpm. Labora­tory exams showed hyponatremia, hypokalemia, and leukocytosis. CT scan revealed subarachnoid hemorrhage, intracerebral hematomas, chronic subdural hematoma, midline shift and subfalcine herniation. The systemic catecholamine ‘storm’ driven by the central neuroendocrine axis massively increases sympathetic outflow, activates the adrenal gland and may lead to arrhythmia. Increased ICP, Midline shift, and subsequent physical compression of the brainstem and hypothalamic autonomic centers can trigger catecholamine responses that could instigate an arrhythmia. Suboptimal cardiac output and cerebral perfusion worsen secondary brain injury leading to a worse prognosis. Since cardioversion failed, amiodarone was administered. Cardioversions failed to convert to sinus rhythm and amiodarone was administered. Therapy to reduce intracranial pressure was also administered. The patient passed away 4 hours after admission. Conclusion Arrhythmia related to brain injury may lead to suboptimal cerebral perfu­sion and leads to further autonomic derangements leading to a vicious cycle of cerebral and cardiovascular injuries. This condition should be accounted for swiftly to prevent secondary brain injuries and myocardial ischemia. Abstrak Latar Belakang Respons katekolamin dan radang terhadap cedera otak menyebabkan cedera jantung neurogenik yang lebih sering terjadi pada kerusakan neurologis yang berat. Laporan Kasus Seorang perempuan 78 tahun datang ke IGD setelah ditemukan tergeletak di lantai dengan robek pada kulit kepala. Pada pemeriksaan fisik ditemukan GCS 3, TD 140/90 mmHg, detak jantung 190 kali/menit, laju pernafasan 25 kali/menit. Riwayat hipertensi dan diabetes disangkal. EKG menunjukan takikardia supraventrikular takikardi 186 kali/menit. Pemeriksaan laboratorium menunjukan hipona­tremia, hipokalemia dan leukositosis. CT scan menunjukan perdarahan subaraknoid, perdarahan intraserebral, perdarahan subdural kronis, midline shift dan herniasi subfalcine. Badai katekolamin sistemik yang dicetuskan oleh aksis neuroendokrin pusat meningkatkan outflow simpatetik yang mengaktifkan kelenjar adrenal dan menyebabkan aritmia. Peningkatan tekanan intrakranial, midline shift, dan penekanan batang otak serta pusat autonomik hipotalamus dapat mencetuskan respon katekolamin yang dapat menyebabkan aritmia. Curah jantung yang tidak optimal dan perfusi otak yang buruk menyebabkan cedera otak sekunder yang mengarah pada prognosis yang buruk. Karena kardioversi gagal merubah irama menjadi sinus maka amiodaron diberikan. Pengobatan untuk menurunkan tekanan intrakranial juga diberikan. Pasien meninggal 4 jam setelah masuk rumah sakit. Kesimpulan Aritmia yang berhubungan dengan cedera otak dapat menyebabkan perfusi otak yang suboptimal serta menyebabkan ketidaktera­turan otonom dan menyebabkan lingkaran setan kerusakan otak dan jantung-pembuluh darah. Hal ini harus segera ditangani untuk mencegah cedera otak sekunder dan iskemi miokardial.
Pulmonary Atresia with Intact Ventricular Septum in a Neonate Emir Yonas; Raymond Pranata; Nuvi Nusarintowati
Jurnal Kardiologi Indonesia Vol 38 No 4 (2017): October - December 2017
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v38i4.787

Abstract

Introduction: Pulmonary atresia with an intact ventricular septum is a condition that is characterized by a complete obstruction to right ventricular outflow with varying degrees of right ventricular and tricuspid valve hypoplasia. This condition is uniformly fatal if untreated. In this case report, we present a case of a neonate with a pulmonary atresia with intact ventricular septum Case Presentation: A 2 days-old female Indonesian newborn was referred to our facility. The newborn was delivered from a G4P3A0 mother with a gestational age of 39 weeks (term delivery). Chest x-ray done at the referring facility is significant for a seemingly right heart hypertrophy, casting a “boot-shaped” appearance of the right heart border. Laboratory results done at the referring facility is significant for a neutrophilia of 82% and lymphocytopenia of 13% An episode of hypoglycemia was reported on referring facility with a blood sugar level of 50 mg/dl. Multiple episodes of cyanosis were reported at referring facility, CPAP was administered but the improvement was limited. Pulse oximetry averaged between 72-80% at the referring facility. Physical examina­tion shows an actively moving neonate, with a strong cry. Perioral cyanosis was seen. Vital signs were as follows; heart rate 128 x / minute, temperature 37oC, respiratory rate 54 x / minute, pulse oximetry 74%, capillary refill time < 3 seconds. The rest of the physical examination was within normal limits. Laboratory result on admission at our facility is significant for low hematocrit, low erythrocyte count, leukopenia with neutrophilia and thrombocytopenia. Patient was admitted to NICU and given CPAP. Echocardiography 2 days upon arrival at our facility reveals a patent ductus arteriosus with the pressure of 4-5 mmHg and diameter of 0.3 cm, no forward flow from the right ventricle to the pulmonary artery, doppler mode demonstrated pulmonary artery filling from ductus arteriosus. The rest of the findings were within normal limits. Conclusion: Pulmonary atresia with an intact ventricular septum is a condition that relies on the patent ductus arteriosus for pulmonary blood supply, the patency of it is of paramount importance. Abstrak PENDAHULUAN: Atresia arteri pulmonalis dengan septum ventrikel yang utuh merupakan kondisi yang dikarakterisasikan dengan sumbatan total pada right ventricular outflow dengan berat hipoplasia ventrikel kanan dan trikuspid kanan yang beratnya bervariasi. Pada umumnya kondisi tersebut fatal apabila tidak ditangani. Pada laporan kasus ini, kami melaporkan suatu kasus neonates dengan atresia arteri pulmonalis dengan septum ventrikel yang utuh. PRESENTASI KASUS: Neonatus perempuan berumur 2 hari dirujuk ke rumah sakit kami. Bayi dilahirkan dari G4P3A0 usia kehamilan 39 minggu. Ronsen thoraks yang dilakukan oleh fasilitas kesehatan yang merujuk memperlihatkan hipertrofi jantung kanan serta bentuk “boot-shaped” pada batas jantung kanan. Hasil laboratorium pada fasilitas kesehatan tersebut menunjukan neutrofilia dan limfositopenia. Terdapat juga riwayat hipoglikemi. Episode sianosis berulang terjadi pada fasilitas kesehatan yang merujuk. Pemasangan CPAP kurang membuahkan hasil dengan saturasi O2 72-80% ketika tiba pada rumah sakit kami. Pemeriksaan fisik menunjukan tangis kuat dan gerak aktif dengan sianosis perioral. Detak jantung 128 kali/menit, suhu 37oC, laju naas 54 kali/menit, oksimetri nadi 74% dan waktu isi kapiler <3 detik. Pemeriksaan laboratorium saat pasien dating menunjukan hematocrit, hitung eritrosit, leukosit dan thrombosit yang rendah. Pasien dirawat di NICU dan diberikan CPAP. Ekokardiografi 2 hari kemudian menunjukan duktus arteriosus patent dengan tekanan 4-5 mmHg dan diameter 0.3 cm, tidak ada aliran maju dari ventrikel kanan kepada arteri pulmonalis, mode Doppler menunjukan pengisian arteri pulmonalis dari duktus arteriosus. Pemeriksaan lainnya dalam batas normal. KESIMPULAN: Atresia arteri pulmonalis dengan septum ventrikel yang utuh merupakan suatu kondisi dimana aliran darah menuju paru bergantung pada duktus arteriosus yang paten sehingga patensi daripada duktus tersebut sangatlah penting
Exercise training in heart failure: role, prescription and program Raymond Pranata; Emir Yonas; Bambang B. Siswanto; Budhi S. Purwowiyoto
Jurnal Kardiologi Indonesia Vol 38 No 4 (2017): October - December 2017
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v38i4.788

Abstract

Heart failure is one of the most common cardiovascular diseases and is a final pathway of various cardiac pathologies. Exercise intolerance and dyspnea accompanied by dete­riorating quality of life are common issues in those suffering from heart failure and may persist despite optimal medical therapy. Exercise training in heart failure theoretically helps to slow down the deterioration of the heart by antagonizing excess neurohormonal activity in heart failure, which translated into better functional capacity and quality of life. Exercise prescription is a mean of assessing and interpreting clinical information and applying the principles of training to develop an appropriate regimen and should be tailored to patient’s clinical condition. Resistance training improves peak VO2, exercise capacity and quality of life in heart failure patients. Both continuous and interval exercise training are linked to better quality of life despite ambiguous results in mortality. The aim of this article is to discuss the benefits of exercise in patients with congestive heart failure, exercise prescription, and exercise program including high-intensity interval training, continuous training and resistance exercise. Abstrak Gagal jantung adalah salah satu penyakit kardiovaskular yang paling sering ditemui dan merupakan akhir daripada banyak jenis patologi jantung. Intoleransi olahraga dan sesak nafas disertai dengan memburuknya kualitas hidup merupakan beberapa masalah yang sering dihadapi oleh pasien gagal jantung, meskipun telah diberikan pengobatan yang optimal. Latihan olahraga pada gagal jantung secara teoritis dapat memperlambat menurunnya fungsi jantung dengan melawan aktivitas neurohormonal yang meningkat pada kondisi gagal jantung yang dicerminkan dengan kapasitas fungsional dan kualitas hidup yang lebih baik. Preskripsi olahraga meliputi pemeriksaan dan interpretasi dari informasi klinis dan aplikasi dari prinsip latihan untuk membentuk regimen yang sesuai dan harus di sesuaikan dengan keadaan klinis pasien. Latihan beban memperbaiki fungsi VO2 puncak, kapasitas olahraga dan kualitas hidup pada pasien dengan gagal jantung. Kedua metode olahraga baik secara kontinu ataupun interval dihubungkan dengan kualitas hidup yang lebih baik meskipun masih ambigu dalam hal mortalitas. Tujuan artikel ini adalah membahas manfaat latihan fisik pada pasien dengan gagal jantung kongestif, cara peresepan serta membahas program high intensity interval training, continuous training serta latihan beban.
Role of Highly Sensitive Cardiac Troponin T Assay in Stable Coronary Artery Disease Raymond Pranata; Nico Kusuma; Rachel Vania; Bambang Budi Siswanto
Jurnal Kardiologi Indonesia Vol 39 No 1 (2018): January - March 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39i1.794

Abstract

Cardiac troponins (cTn) are the preferred biomarkers of myocardial necrosis, usually used for diagnosis and risk stratification in acute coronary syndromes. Highly sensitive troponin T (hs-cTnT) may be elevated in stable coronary artery disease (SCAD), in which subclinical plaque erosion or rupture and distal embolization and subclinical ischemic episode. hs-cTnT may be used as a prognostic marker in SCAD and can predict cardiovascular events and patient’s mortality rate. In this article, plaque characteristic that is linked to hs-cTnT, it’s used as prognostic biomarker and comparison to other indicators are the focus of discussion. Abstrak Troponin adalah biomarker yang paling disukai untuk mendeteksi nekrosis miokardium dan untuk mendiagnosis dan stratifikasi risiko pada sindrom koroner akut. Highly sensitive troponin T (hs-cTnT) dapat meningkat pada penyakit jantung koroner stabil dimana terjadi ruptur plak atau erosi dan embolisasi distal sublklinis, dan episode iskemik subklinis. Sehingga biomarker tersebut dapat digunakan sebagai marker prognostik pada penyakit jantung koroner stabil dan dapat memprediksi angka kejadian kardiovaskular dan tingkat mortalitas pasien. Pada artikel ini akan dibahas mengenai karakteristik plak yang dihubungkan dengan peningkatan hs-cTnT, pengunaan sebagai biomarker prognostik dan serta perbandingan dengan indikator lainnya.
Systematic Reviews and Meta-Analyses ISICAM ISICAM; Mahdi BA; Purnamasari Y; Fajar JK; Raymond Pranata; Emir Yonas
Jurnal Kardiologi Indonesia Vol 39 No Suppl_B (2018): Indonesian Journal of Cardiology Supplement_B
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39iSuppl_B.856

Abstract

Systematic Reviews and Meta-Analyses; Abstracts of the 10th Indonesian Society of Interventional Cardiology Annual Meeting Jakarta, 23-25 November 2018
Pediatric infective endocarditis initially presenting as hemorrhagic stroke Emir Yonas; Raymond Pranata; Vito Damay; Nuvi Nusarintowati
Paediatrica Indonesiana Vol 60 No 3 (2020): May 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (346.179 KB) | DOI: 10.14238/pi60.3.2020.167-72

Abstract

Infective endocarditis refers to infection of the heart valves. While its incidence is low, it may cause serious complications. Despite advances in its management and diagnosis, this condition still retains high mortality and significant morbidity. Considerable controversy remains regarding antimicrobial prophylaxis to prevent infective endocarditis in patients with congenital heart disease. Neurologic complications are the second most common complication in patients with infective endocarditis, occurring in approximately 33% of cases.1 These include encephalopathy, meningitis, stroke, brain abscess, cerebral hemorrhage, and seizures. The vegetation formed as a consequence of endocarditis may dislodge and cause embolization. Vegetation size alone is an unreliable marker for embolization risk, however, size, in addition to location, mobility, infecting agent, and presence of antiphospholipid antibodies have the potential to be prognostic markers. The brain is the most frequent site of embolization. Furthermore, advances in medical approaches have resulted in an increase of patients at risk of endocarditis due to the now common and widely available indwelling intravascular approaches in medicine. In this report, we present a case of infective endocarditis in a child first presenting with hemorrhagic stroke.1,2
Co-Authors Abraham Fatah Bambang Budi Siswanto Bertha Bertha Budhi S. Purwowiyoto Emir Yonas Emir Yonas Emir Yonas Fajar JK Grace Fonda Hadrian Deka ISICAM ISICAM Ivani C Kurniadi Mahdi BA Nico Kusuma Nico Kusuma Nuvi Nusarintowati Nuvi Nusarintowati Purnamasari Y Rachel Vania Rachel Vania Veresa Chintya Vito A Damay Vito Damay Vito Damay Vito Damay Wendy Wiharja Wendy Wiharja