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Predictive value of PaCO2 on mortality in patients with acute heart failure Afifah, Yuri; Prasetya, Indra; Baskoro, Shalahuddin Suryo; Anjarwani, Setyasih
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.9

Abstract

Background: Patients with AHF may experience fluctuations in carbon dioxide levels, resulting in either hypercapnia or hypocapnia. Recent research has highlighted the significance of the relationship between CO2 fluctuation and patient outcomes. Objective: The aim of this study was to explore the relationship between arterial carbon dioxide pressure (PaCO2) upon admission to the ICCU in patients with AHF. Methods: A single centre retrospective observational study was performed, the patient were enrolled from patient medical record between 2021 and 2023. Participants were divided into three groups based on PaCO2 levels. The study end point was length of hospitalization, mortality at ICCU and mortality in hospital. Statistical analysis used various tests to compare outcomes, with significance set at p<0.05, and ROC analysis evaluated mortality prediction. Result: The study included 150 patients: 97 with hypocapnia, 33 with normal PaCO2, and 19 with hypercapnia. In-hospital mortality was 37.5%, and 1-month mortality was 33.3% in the hypercapnia group. PaCO2 >45 mmHg was linked to higher in-hospital mortality (OR 6.900, p <0.001) and 30-day mortality (OR 5.600, p <0.001), PaCO2 <35 mmHg showing a protective association in ICCU and in-hospital mortality (OR 0.202, p<0.001) and 30-day mortality (OR 0.237, p<0.001). Length of stay was not significantly affected by either hypocapnia or hypercapnia. The ROC for predicting in-hospital mortality was 0.648 and for 30-day mortality was 0.626 in the PaCO2 >45 mmHg group. Conclusion: PaCO2 levels at ICCU admission predict mortality in AHF patients. Hypercapnia is associated with higher in-hospital and 30-day mortality, while hypocapnia appears protective.
Proposed Marketing Strategy to Increase Sales Performance (Case Study: PT. Laku Emas Indonesia) Prasetya, Indra
Eduvest - Journal of Universal Studies Vol. 3 No. 10 (2023): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v3i10.929

Abstract

Laku Emas is a digital gold platform in Indonesia, where people can buy-sell-trade-pawn gold on the platforms. Upon its digitalization era, online investment is growing and massively popular. The problem however is that they are lacking customers and wish to increase the e-commerce sales. To analyze and research this both qualitative research methodology is used in this research to gain information and identify behavior, preferences and alternatives for improvement of actions. The primary data gathered is from interviewing potential customers of Lakuemas who know the brand and secondary through online reviews. For analysis technique, descriptive analysis is performed. Upon the research the main issue problems are identified based on customer experience journey and AARRR framework analysis. Lakuemas should further enhance their marketing strategy to be able to capture customers acquisition and retention.
Correlation Analysis of Mortality and Length of Stay in Sepsis Cases Among Heart Failure Patients with Low Ejection Fraction at Dr. Saiful Anwar General Hospital, East Java, Indonesia Sakti, Pradhika Perdana; Anjarwani, Setyasih; Rohman, Mohammad Saifur; Prasetya, Indra; Tjahjono, Cholid Tri
Berkala Kedokteran Vol 21, No 2 (2025)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/jbk.v21i2.24597

Abstract

In Indonesia, heart failure (HF) prevalence reaches 5%, contributing to over 1.8 million annual hospitalizations, accompanied by a 29% readmission rate and a 30-day mortality rate of 17%. The burden of infectious diseases, notably sepsis, further complicates the clinical landscape. Patients with sepsis residing in tropical regions often exhibit mortality rates surpassing global averages. Sepsis-associated coagulopathy (SAC) serves as a significant complication in this context. This study investigates the correlation between SAC, indicated by international normalized ratio (INR) levels, and outcomes in patients with heart failure with reduced ejection fraction (HFrEF) who develop sepsis. Utilizing a retrospective cohort approach, we analyzed medical records from Saiful Anwar Regional General Hospital, Malang, East Java, involving adult HFrEF patients who underwent INR testing. Purposive sampling was applied. Statistical analyses, including the Mann-Whitney Test, Kaplan-Meier Analysis, Log-Rank Test, Cox Proportional Hazards Regression, and Multiple Linear Regression, were conducted employing SPSS software. Results revealed a mean survival of 7.69 days in the Non-SAC group compared to 6.78 days in the SAC group, though the difference was not statistically significant (p=0.080). Notably, additional clinical complications predominantly influenced survival outcomes. This study elucidates that elevated INR levels, indicative of SAC, correlate with increased mortality and decreased survival in HFrEF patients with sepsis. Furthermore, the exacerbating effect of clinical complications on mortality highlights the imperative for early SAC detection and management of cardiovascular implications to enhance patient prognosis.
A case of cardiac myxoma with obstructive symptoms: Recognizing key early signs for improved diagnosis Filano, Marco; Kuhn, Corinna Maria; Zhao, Zihan; Laukkanen, Noora Julia; Rahimah, Anna Fuji; Karolina, Wella; Prasetya, Indra; Rohman, Mohammad Saifur
Heart Science Journal Vol. 7 No. 1 (2026): Accelerating Clinical Breakthroughs: The Journey from Molecular Discovery to Pa
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.01.21

Abstract

Background: LA myxoma is the most common primary cardiac tumor, often presenting with obstructive symptoms when the tumor prolapses into the mitral valve during diastole. On the other hand, rheumatic MS leads to fixed obstruction of the mitral valve. The coexistence of both conditions is extremely rare and can exacerbate the severity of mitral inflow obstruction. Early recognition of this dual pathology through careful clinical evaluation and echocardiographic assessment is crucial for timely and effective management. Case Presentations: A 66-year-old female patient presented with progressive dyspnea. Transthoracic echocardiography detected a mobile mass in the left atrium and later identified it as a cardiac myxoma. Further evaluation revealed severe rheumatic mitral stenosis (MS) with a mitral valve area (MVA) measured by planimetry at 1.23 cm², restricting the mass from slipping into the left ventricle during the diastolic phase. Based on the conference decision, tumor resection was performed, and the histopathological examination revealed a left atrial (LA) myxoma. The dual obstruction caused by mitral valve stenosis and a left atrial myxoma resulted in life-threatening symptoms due to diastolic obstruction of mitral inflow. In isolated LA myxoma, the tumor pushes into the mitral valve opening during the heart's relaxation phase, blocking blood flow from the left atrium to the left ventricle and raising pressure in the atrium and lungs. When significant MS is present, the narrowed valve further worsens this obstruction, leading to higher atrial pressure and more severe heart failure symptoms. Both conditions commonly present with early symptoms such as exertional dyspnea, palpitations, signs of heart failure like edema and pulmonary crackles, diastolic murmur, and sometimes syncope caused by reduced cardiac output. Conclusions: This case highlights the critical importance of identifying early obstructive symptoms indicative of cardiac myxoma. Timely identification of these clinical manifestations can facilitate earlier diagnosis, improve patient outcomes, and prevent potentially fatal complications.
HIPOTIROID SEBAGAI PEMICU GANGGUAN IRAMA JANTUNG: SEBUAH LAPORAN KASUS VENTRIKULAR TAKIKARDIA PADA PASIEN HIPOTIROID Abadi, Sahlan; Prasetya, Indra
Jurnal Klinik dan Riset Kesehatan Vol 5 No 2 (2026): Volume 5 No 2, Edisi Februari 2026
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.05.2.9

Abstract

Hypothyroidism was associated with bradyarrhythmia, conduction abnormalities, impaired myocardial function, and ventricular arrhythmia. The prevalence of ventricular tachycardia in hypothyroid was 2.6%. The patient was a 52-year-old woman who was experiencing palpitations, blurred vision, and syncope. ECG showed ventricular tachycardia (VT). Laboratory tests showed increased TSH and decreased T3 and FT4. Echocardiography showed global normokinetic, normal LV systolic function (EF 57%), normal RV systolic function, and normal heart chamber dimensions. DCA evaluation showed normal coronary artery. The patient underwent ablation of frequent PVCs originating from the anteroseptal RVOT. After ablation and hypothyroid treatment, there were no more VT episodes. The pathophysiological mechanism underlying the relationship between hypothyroidism and cardiac arrhythmias was the regulatory effect of thyroid hormones on cardiovascular hemodynamics and cardiac ion channels. Thyroid hormones directly regulate the function of ion channels such as sodium, calcium, and potassium channels. Ion channel dysfunction can prolong ventricular repolarization, which can trigger VT. This case report demonstrates the potential danger of thyroid dysfunction, especially hypothyroidism, in causing VT. Timely identification and treatment of hypothyroidism can prevent recurrence of arrhythmia and improve cardiac function.
Co-Authors Abadi, Sahlan Adlan El Fatih, Muhammad Afifah, Yuri Agung Sasongko Ahmad Aviv Mahmudi Aji, Nugroho Priyo Anjarwani, Setyasih Anna Fuji Rahimah Arista Candra Irawati Aryanugraha, Teguh Astiawati, Tri Atma Gunawan Bagaswoto, Hendry P. Bahar, Mokhamad Aswin Baskoro, Shalahuddin Suryo Burhan Burhan, Burhan Caesario, Fahreza Cholid Tri Tjahjono Cholid Tri Tjahjono Dadang Suprijatna Danny, Siska S. Dewi U. Djafar, Dewi U. Dewi Utari Djafar, Dewi Utari Dilla Maulida Dyah Puspita Saraswati Dzaki Ilhami, Muhammad Efendi, Rizki Arief Filano, Marco Firdaus, Achmad Jauhar firmansyah, Yoki Habib, Faisal Hakim, Dennis I. Hakim, Dennis Ievan Hedi Pudjo Santosa Hendry Purnasidha Bagaswoto Ilhami, Yose R. Ilhami, Yose Ramda Juzar, Dafsah A. Juzar, Dafsah Arifa Karolina, Wella Kuhn, Corinna Maria Kurnianingsih, Novi Kushandajani . Laukkanen, Noora Julia Lestari, Puspa Martini, Heny Millisani, Hayla Iqda Mohammad S. Rohman Mohammad Saifur Rohman Muhammad Sony Maulana Muzakkir, Akhtar F. Muzakkir, Akhtar Fajar Nita Sari, Nita Noverike, Nikhen Novi Rahmawati Nugraha, Tria Yudha Nugraha, Yudha Tria Nurudinulloh, Akhmad Isna Pamuna, Oktafin Srywati Pashira, Andranissa Amalia Perani Rosyani Prastya, Andhika Primada Qurrota Ayun Priyatno Harsasto Putri, Valerinna Yogibuana Swastika Raden Djuniarsono Rahimah, Anna Fuji Ratna Pancasari Rhiza Amdi, Muh Ririn Handayani Rizal, Ardian Rochmawati, Icmi Dian Rudi, Hasrian Sakti, Pradhika Perdana Saputri, Vemmy Lian Saskia Dyah Handari Satrijo, Budi Setiawan, Dion Setyowati, Danti Utami Siska Suridanda Danny Sungkar, Safir Wanty Eka Jayanti Widito, Sasmojo Windya Harieska Pramujati Wirawan, Hendy Yogibuana, Valerinna Yudha, Tria Zhao, Zihan zunardi, Lutfi hafiz