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All Journal Indonesian Journal of Cardiology eJournal Kedokteran Indonesia
Renan Sukmawan
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Challenges in Diagnosis & Management of Type B Interrupted Aortic Arch Maruli Butarbutar; Ganesja M. Harimurti; Oktavia Lilyasari; Renan Sukmawan
eJournal Kedokteran Indonesia Vol. 10 No. 2 - Agustus 2022
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Abstract Interrupted aortic arch (IAA) is a rare genetic disorder of the cardiovascular system, present in approximately 2 cases per 100,000 live births and comprising 1.5% of all cases of congenital heart disease (CHD). Its hallmark feature is a lack of luminal continuity between the ascending aorta and the descending aorta. In the absence of surgical repair, mortality approaches 75% in the first month of life and 90% by one year. A four months old female baby was referred with dyspnea, failure to thrive and recurrent respiratory infection. Physical examination revealed blood pressures and oxygen saturation were lower at upper right arm and both legs. The CXR examination revealed absent of aortic knob. The echocardiography showed aortic interruption between the left common carotid artery (LCCA) and left subclavian artery (LSCA). Cardiac MSCT showed LSCA and descending aorta come from PDA. The patient was managed with two stages surgery. Bilateral PA banding was done as first stage surgery. IAA repair and VSD closure are planned as second stage surgery.
Insiden gejala menetap dan gambaran ekokardiografi pasca infensi COVID-19 ringan Almazini, Prima; Soesanto, Amiliana M; Kuncoro, Ario S; Ariani, Rina; Rudiktyo, Estu; Sukmawan, Renan
Jurnal Kardiologi Indonesia Vol 43 No 1 (2022): Indonesian Journal of Cardiology: January - March 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1160

Abstract

Background: Survived from COVID-19 infection, some patients yet have residual symptoms. Multi-organ and mechanisms of disease can be involved. The data regarding echocardiographic dimension and function of the cardiac in the COVID-19 survivors remains scarce. Method: This was a descriptive cross-sectional study that involves a total of 63 subjects. Subjects were employees and medical residents at National Cardiovascular Center Harapan Kita, who previously get infected by COVID-19. Each subject was examined transthoracic echocardiography once at the time of recruitment. Echocardiographic parameters obtained in this study included dimension and systolic function of the left ventricle and right ventricle, global longitudinal strain by 2D speckle tracking echocardiography, and myocardial work index. Result: More than a half of the subjects experienced persistent symptoms after recovery from COVID-19 infection and mainly was fatigue (33.3%). The timing of data acquisition on the median was 32 days after the negative of the COVID-19 test result. 2D echocardiography measurement of left ventricle indicated mean of end-diastolic diameter and end-systolic diameter was 45 mm and 27 mm, respectively. The mean ejection fraction (EF) of the left ventricle by Simpson’s biplane method was 61%. The median of tricuspid annular plane systolic excursion (TAPSE) parameter was 23 mm and the fractional area change (FAC) parameter was 39%. The mean of global longitudinal strain (GLS) was -19.6%. Conclusion: After recovery from COVID-19 infection, some survivors may have post-acute infectious consequences of COVID-19 such as fatigue, dyspnea, and malaise. However, echocardiographic findings in those patients with mild symptoms, including 2D echocardiography, myocardial strain analysis, and myocardial work index, indicate normal dimension and systolic function in both left ventricle and right ventricle.
Triglyceride Glucose Index as a Predictor of 30-Day Readmission and 6 Months Mortality After Hospitalization in Acute Decompensated Heart Failure Rezeki, Arindya; Widyantoro, Bambang; Rossimarina, Vienna; Dwiputra, Bambang; Danny, Siska Suridanda; Santoso, Anwar; Sukmawan, Renan
Jurnal Kardiologi Indonesia Vol 44 No 2 (2023): Indonesian Journal of Cardiology: April - June 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1380

Abstract

Background: Acute decompensated heart failure (ADHF) is a cardiovascular disease with high mortality and readmission rates. Currently, insulin resistance has been reported to predict prognosis of ADHF patients. Triglyceride glucose index (TyG) has now been proposed as an independent predictor of cardiovascular risk and a simple marker of insulin resistance. However, the association between TyG and 30-days readmission and 6 months mortality after hospitalization remains unclear. Objective: To investigate TyG as a predictor of 30-day readmission and 6 months mortality after hospitalization in ADHF patients. Methods: The study was conducted in a retrospective cohort. Data were taken from medical records based on the admission of patients who met the inclusion criteria from January 2018 – November 2021. The clinical outcomes were 30-days readmission and 6 months mortality. The data were analyzed by multivariate analysis and the survival rate of the subjects. Results: This study included 467 subjects, with 158 subjects have clinical outcomes. The readmission rate is 29% (135 subjects), and 6 month mortality after hospitalization is 5% (23 subjects). Multivariate analysis showed that the factors associated with 30-days readmission were hypertension (p 0.03, HR 1.547, CI 95% 1.044 – 2.291), systolic blood pressure > 140 mmHg on admission (p< 0.001, HR 0.441, CI 95% 0.296 – 0.658), triglyceride ³ 150 mg/dL (p 0.012, HR 1.812, CI 95% 1.139 – 2.881), and TyG index (p <0.001, OR 4.594, CI 95% 2.717 – 7.767). Independent factors for 6 months mortality were only no diuretic medication (p 0.02, HR 6.015, CI 95% 1.975 – 18.320). Conclusion: Triglyceride glucose index can predict 30-days readmission, but does not associated with 6-months mortality in ADHF patients.
Longitudinal Strain Assessment Of Myocardial Dysfunction In Covid-19 Patients: Correlating Clinical Symptoms And Laboratory Results At Admission And Four Months Post-Treatment Liastuti, Lies Dina; Tanto, Ines Vidal; Rachman, Aditya; Robot, Marselly Maria; Dwiputra1, Bambang; Ariani, Rina; Danny, Siska Suridanda; Taofan, Taofan; Sukmawan, Renan
Jurnal Kardiologi Indonesia Vol 45 No 1 (2024): January - March, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1685

Abstract

Background: Myocardial dysfunction is increasingly recognized as a complication of COVID-19 infection, with implications for patient prognosis and long-term cardiovascular health. Longitudinal strain, measured via echocardiography, is a sensitive marker of myocardial function that may provide valuable insights into cardiac involvement in COVID-19 patients. This study aimed to assess myocardial dysfunction using longitudinal strain analysis in COVID-19 patients, correlating clinical symptoms and laboratory results at admission and four months post-treatment. Methods : This study compared clinical and laboratory parameters in COVID-19 patients post-recovery with and without myocardial dysfunction. Adult COVID-19 survivors were included if they were hospitalized and met certain criteria. Independent variables included clinical factors and laboratory factors at admission, while the dependent variable was myocardial dysfunction assessed through longitudinal strain of the left and right ventricles on speckle tracking echocardiography. The study was conducted at the Harapan Kita Heart and Blood Vessel Center (RSJPDHK - FKUI)/Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Jakarta. Results: This study examined the cardiovascular health of 162 participants three months after getting infected with COVID-19. Those with comorbidities had the lowest LV GLS levels. Admission factors like obesity, SpO2, and PaO2 levels were linked to decreased LV GLS levels. These findings suggest that these admission factors may predict the progression of COVID-19 syndrome and its implications on cardiovascular health. Conclusion: COVID-19 patients with cardiovascular comorbidities have lower LV-GLS values. CAD status during admission affects LV GLS values 3-6 months after COVID-19 infection, indicating myocardial dysfunction. Basal lateral LV-GLS correlates with obesity status, SpO2, and PaO2 during admission. Closely monitor COVID-19 patients with cardiovascular comorbidities and recognize the implications of CAD status on myocardial function post-infection.
Dyslipidemia management among patients with high and very high cardiovascular risk in Indonesia: a multi-center registry Ng, Sunanto; Santoso, Anwar; Sukmawan, Renan; Erwinanto, Erwinanto; Adam, Erika; Desandri, Dwita Rian; Zahra, Rita; Wicaksono, Sony Hilal; Putra, Magma Purnawan; Heriansyah, Teuku; Tiksnadi, Badai Bhatara; Pintaningrum, Yusra
Jurnal Kardiologi Indonesia Vol 46 No 2 (2025): April - June, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1880

Abstract

Background Indonesia, the world's largest archipelago, faces significant challenges in equitable healthcare delivery due to its geographical and infrastructural disparities. Atherosclerotic Cardiovascular Disease (ASCVD) remains the leading cause of mortality, with over 659,000 deaths recorded in 2019. Effective dyslipidemia management is crucial for preventing adverse ASCVD events. Unfortunately, the lack of implementation of an updated national lipid management registry might hinder optimal strategy for the adverse events. This study evaluated dyslipidemia cholesterol management practices among high- and very high-risk patients across the country. Methods The study recruited 322 patients from eight centers across six provinces in Indonesia between May 2022 and March 2023. Patients were stratified based on the ASCVD risk and followed over three visits. Baseline clinical characteristics, lipid profiles, and treatment regimens were analyzed. Descriptive statistics summarized continuous and categorical variables, and low-density lipoprotein cholesterol (LDL-C) achievement was assessed. Results Of the 322 patients, 98.8% were very high-risk, with only 4.9% achieving <55 mg/dL and 21.2% achieving <70 mg/dL. Moderate-intensity statins were the most prescribed (51.2%), followed by high-intensity (36.6%). LDL-C reduction was most pronounced in private insurance patients, achieving a mean LDL-C of 69.8 mg/dL at the third visit compared to 98.9 mg/dL in National Health Insurance (Jaminan Kesehatan Nasional/JKN) participants. Missed visit rates increased over time, with 57.5% of patients missing the third visit, predominantly among JKN participants and low-income groups. Conclusion Majority of the population failed to achieve the recommended target of LDL-C levels. Dyslipidemia management in Indonesia remains suboptimal, with disparities driven by socioeconomic factors. Improved policies addressing medication availability, national lipid registry establishment, and equitable healthcare access are essential to enhance lipid management and reduce the burden of ASCVD in Indonesia.
Co-Authors Adam, Erika Aditya Rachman, Aditya Amiliana M Soesanto Anwar Santoso Ariani, Rina Badai Bhatara Tiksnadi Bambang Widyantoro Desandri, Dwita Rian Dwiputra, Bambang Dwiputra1, Bambang Erwinanto, Erwinanto Ganesja M. Harimurti Kuncoro, Ario S Liastuti, Lies Dina Maruli Butarbutar Oktavia Lilyasari Pintaningrum, Yusra Prima Almazini Putra, Magma Purnawan Rezeki, Arindya Robot, Marselly Maria Rossimarina, Vienna Rudiktyo, Estu Siska Suridanda Danny Sunanto Ng Tanto, Ines Vidal Taofan, Taofan Teuku Heriansyah, Teuku Wicaksono, Sony Hilal ZAHRA, RITA