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Effect of Short Term Cardiac Rehabilitation Program on Quality of Life in Patients with Coronary Artery Disease Marita, Ina; Sastradimaja, Sunaryo B.; Tiksnadi, Badai Bhatara
Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (623.052 KB)

Background: Cardiac rehabilitation (CR) programs are known to be one of the effective managements which aim to improve the quality of life (QoL) in coronary artery disease (CAD). However, there is still controversy about the effect on QoL dimension. The purpose of this study is to determine the effect of short term cardiac rehabilitation program on quality of life in patients with coronary artery disease.Methods: The study design used was a quasi experimental study with repeated measurements in consecutive sampling involving 11 subjects with CAD from SeptemberâNovember 2015 in Cardiorespiratory Clinic and Gymnasium of Physical Medicine and Rehabilitation and Cardiac Unit Services, Dr. Hasan Sadikin General Hospital Bandung. The cardiac rehabilitation program was performed for 4 weeks. The quality of life was scored using medical outcomes study short form 36 (SF-36) questionnaire before and after CR program. Statistics obtained in this study were analyzed using paired t-test and Wilcoxon test.Results: This study involved 11 male patients with CAD with an average age of 58 (11) years old with the diagnosis of CAD post CABG (n=6), CAD post PCI (n=4), and CAD unrevascularized (n=1). The average total score of quality of life questionnaire SF-36 demonstrated a significant increase (p<0.001) after CR program 87.27(8.5) as compared to before CR program 49.09(8.4). This improvement occurred in all QoL dimensions.Conclusions: Short term cardiac rehabilitation program can improve the quality of life in patients with coronary artery disease.Â

Association between Neutrophil-Lymphocyte Count Ratio and Matrix Metalloproteinase-9 in Patients with Acute Myocard Infarction Tiksnadi, Badai Bhatara; Akbar, Muhammad Rizki; Yahya, Achmad Fauzi; Hidayat, Syarief; Purnomowati, Augustine; Aprami, Toni Mustahsani
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

The correlation between metalloproteinase-9 (MMP-9) level and neutrophil-lymphocyte count ratio (NLCR) in AMI patients has not been studied despite the fact that they are both known to predict ventricular remodeling. This study aimed to evaluate the correlation between the MMP-9 level and NLCR in patients with acute myocardial infarction. A cross-sectional study was conducted by recruiting acute coronary syndrome patients (onset within 24 hours) who were admitted to the emergency department in several hospitals around Bandung during October-December 2012. The relationship between the MMP-9 level and NLCR was analyzed using Pearson correlation test. Linear regression analysis was used to measure the strength of NLCR in MMP-9 level prediction. Thirty seven patients aged 55.8 + 11 years old were included in this study with mostly male patients (78%). Seventy-six percents of the sample were ST-elevation myocardial infarct (STEMI) patients with the onset of symptoms of 6 (3-14) hours. The mean lymphocyte-neutrophil ratio was 5.24 (1ÏƒÂ±2.4) and the MMP-9 plasma concentration was 370 (240-530) ng/mL. One-sided Pearson correlation showed a positive correlation between the two variables (r=0.44, p=0.003). The linear regression analysis conceived the formula of MMP-9 = 40.87 (NLCR) + 211.3 which was used to show the relationship between the MMP-9 level and lymphocyte-neutrophil ratio. There was a positive moderate correlation between the MMP-9 level and NLCR in patients with AMI. Linear regression analysis shows that NLCR is the only independent variable to predict the MMP-9 plasma level.Key words: Acute myocardial infarct, left ventricular remodeling, matrix metalloproteinase (MMP)-9, neutrophyl-lymphocyte count Ratio (NLCR)Â Korelasi Rasio Neutrofil-Limfosit (NLCR) dengan Kadar Matriks Metaloproteinase-9 pada Penderita Infark Miokardium AkutKorelasi antara matriks metaloproteinase-9 (MMP-9) dan rasio netrofil-limfosit masih belum pernah dipelajari, meskipun kedua variable tersebut diketahui dapat memprediksi remodeling ventrikel kiri. Studi ini bertujuan mengevaluasi korelasi antara kadar MMP-9 dan rasio netrofil-limfosit pada penderita infark miokardium akut. Penelitian dilakukan secara potong lintang menggunakan sampel darah pasien dengan diagnosis kerja infark miokardium akut (IMA) (onset nyeri dada <24 jam) yang diambil dari beberapa rumah sakit di sekitar Kota Bandung dari periode Bulan Oktoberâ€“Desember 2012. Hubungan antara kadar MMP-9 dan rasio neutrofil leukosit dianalisis menggunakan uji korelasi Pearson. Analisis regresi linier digunakan untuk mengukur kekuatan pengaruh konsentrasi rasio neutrofil-limfosit pada kadar MMP-9. Sebanyak 37 pasien berusia 55,8 +11 tahun, dan 78% di antaranya adalah pria menjadi subjek dalam penelitian ini. Tujuh puluh enam persen sampel diantaranya merupakan pasien infark miokardium dengan elevasi ST dengan onset gejala 6 (3â€“14) jam.Â Rerata rasio limfosit-neutrofil adalah 5,24 (1Ïƒ Â±2,4), dan kadar konsentrasi MMP-9 sebesar 370 (240â€“530) ng/ml. Uji Korelasi Pearson menunjukkan hubungan positif antara kedua variabel tersebut dengan nilai r=0,44 (p=0,003).Â Dari analisis regresi linier didapatkan rumus MMP-9= 40,87 (NLCR) + 211,3, yang digunakan untuk menunjukkan hubungan antara kadar MMP-9 dan rasio limfosit-netrofil. Terdapat hubungan positif antara kadar MMP-9 dan rasio neutrofil-limfosit pada pasien penderita IMA. Analisis regresi linier menunjukkan bahwa hanya rasio neutrofil-limfosit yang menjadi variabel prediktor independen kadar MMP-9.Kata kunci: Infark neutrofil akut, matriks-metaloproteinase 9 (MMP-9), rasio limfosit-neutrofil, remodeling ventrikel kiri

Cardiovascular Risk Profile in Health Cadres in Jatinangor, West Java Badai Bhatara Tiksnadi; Rien Afrianti; Yulia Sofiatin; Arif Ridha; Faris Yuflih Fihaya; Rully M. A. Roesli; Mohammad Rizki Akbar
Althea Medical Journal Vol 6, No 2 (2019)
Publisher : Faculty of Medicine Universitas Padjadjaran

Background: Cardiovascular disease has very high morbidity and mortality, therefore, prevention of this disease becomes a national priority in the health programs. Health cadres, as an agent in community primary prevention, should have a good health condition. This study aimed to describe the cardiovascular risk profile in health cadresin Jatinangor, West Java.Methods: This was a cross-sectional study, conducted in Cilayung Village, Jatinangor, in September 2018. Consecutive sampling was performed on 20 health cadres aged 25 - 64 years old who did not have previous cardiovascular events such as coronary heart disease or stroke. Clinical data were collected consisting of blood pressure, body mass index (BMI), random blood glucose, history of diabetes mellitus, physical activity and active smoking habits. Cardiovascular risk was assessed using Jakarta cardiovascular scores and European Relative Risk Score.Results: Only 17 of 20 health cadres fulfilled the inclusion criteria with a systolic and diastolic blood pressure of 133.5±27.8 mmHg and 81.1±14.8 mmHg, respectively, and BMI of 27.4±5.3 kg/m2.The risk of cardiovascular disease in healthy cadres was at low (47.1%), moderate (41.2%) and high risk (11.7%). The average of the European Relative Risk score was 1.88±0.9. BMI >30 has a 40% high risk of cardiovascular disease.Conclusions: Most of the health cadres in Jatinangor, West Java have a low and moderate risk of cardiovascular disease, even though there is a small percentage that is at a high risk. The awareness for prevention and management programs for risk factors needs to be raised among health cadres. .

Effect of Short Term Cardiac Rehabilitation Program on Quality of Life in Patients with Coronary Artery Disease Ina Marita; Sunaryo B. Sastradimaja; Badai Bhatara Tiksnadi
Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (623.052 KB)

Background: Cardiac rehabilitation (CR) programs are known to be one of the effective managements which aim to improve the quality of life (QoL) in coronary artery disease (CAD). However, there is still controversy about the effect on QoL dimension. The purpose of this study is to determine the effect of short term cardiac rehabilitation program on quality of life in patients with coronary artery disease.Methods: The study design used was a quasi experimental study with repeated measurements in consecutive sampling involving 11 subjects with CAD from September–November 2015 in Cardiorespiratory Clinic and Gymnasium of Physical Medicine and Rehabilitation and Cardiac Unit Services, Dr. Hasan Sadikin General Hospital Bandung. The cardiac rehabilitation program was performed for 4 weeks. The quality of life was scored using medical outcomes study short form 36 (SF-36) questionnaire before and after CR program. Statistics obtained in this study were analyzed using paired t-test and Wilcoxon test.Results: This study involved 11 male patients with CAD with an average age of 58 (11) years old with the diagnosis of CAD post CABG (n=6), CAD post PCI (n=4), and CAD unrevascularized (n=1). The average total score of quality of life questionnaire SF-36 demonstrated a significant increase (p<0.001) after CR program 87.27(8.5) as compared to before CR program 49.09(8.4). This improvement occurred in all QoL dimensions.Conclusions: Short term cardiac rehabilitation program can improve the quality of life in patients with coronary artery disease.

Comparison of Cognitive Functions between Paroxysmal and Persistent Atrial Fibrillation Patients without Clinical Stroke Caepy Gomer; Paulus Anam Ong; Sobaryati Sobaryati; Badai Bhatara Tiksnadi
International Journal of Integrated Health Sciences Vol 8, No 1 (2020)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v8n1.1974

Objective: To compare cognitive functions between paroxysmal and persistent atrial fibrillation patients without clinical stroke, in terms of MoCA-Ina total score and MoCA-Ina cognitive subdomains scores. Methods: A comparative study that compared MoCA-Ina scores between paroxysmal and persistent AF patients without clinical stroke, who came for treatment at the Cardiology Clinic Dr. Hasan Sadikin General Hospital, Bandung and Dustira Hospital, Cimahi from September 2018–January 2019. Results: Sixty four subjects were recruited, consisted of 24 paroxysmal and 40 persistent AF patients. There were no difference in clinical characteristics between two groups, except that there were more subjects in the persistent AF group using anticoagulants therapy: 97.5% vs 62.5% (p=0.005) and more prevalence of type 2 Diabetes Mellitus in the paroxysmal AF group: 25% vs 2.5% (p=0.009). Cognitive impairment (MoCA-Ina score <25) were seen in 70.8% of paroxysmal AF group and 82.5% of persistent AF group (p=0.274). The mean MoCA-Ina total score in the paroxysmal and persistent AF groups were 21.04±4.75 vs 20.70±4.21 (p=0.989), respectively. The median MoCA-Ina cognitive subdomains scores were similar for the two groups (p>0.05).Conclusion: There were no differences in cognitive functions between paroxysmal and persistent AF patients, both in terms of MoCA-Ina total score and MoCA-Ina cognitive subdomains scores, although in both groups had cognitive decline.

Uji Jalan 6 Menit (UJ6M) pada Pasien Pasca Sindrom Koroner Akut Badai Bhatara Tiksnadi; Ade Meidian Ambari; Meity Adriana
Jurnal Kardiologi Indonesia Vol 40 No 1 (2019): Indonesian Journal of Cardiology: January-March 2019
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v40i1.913

Kualitas hidup dan prognosis pasien dengan penyakit kardiovaskular merupakan hal yang penting dan direkomendasikan untuk dievaluasi, salah satunya melalui pengukuran kapasitas fungsional. Uji jalan 6 menit (UJ6M) merupakan sebuah metode non-invasif sederhana dan reliabel untuk mengukur kapasitas fungsional yang sebelumnya telah banyak diaplikasikan pada penderita penyakit paru-paru dan gagal jantung. Saat ini, penggunaannya terus dikembangkan, salah satunya pada pasien pasca Sindrom Koroner Akut (SKA). Uji jalan 6 menit (UJ6M) dapat dilakukan secara dini, selain berguna untuk menentukan jenis aktivitas dan latihan di rumah untuk pasien, juga dapat memberikan prediksi morbiditas dan mortalitas pada kasus sindrom koroner akut tertentu. Walaupun studi prognostik mengenai UJ6M pada pasien pasca SKA masih terbatas, pasien dengan jarak tempuh UJ6M yang lebih rendah dapat dipertimbangkan memiliki risiko terjadinya kejadian jantung yang tidak diinginkan yang lebih tinggi di kemudian hari.

Olahraga Rutin Untuk Meningkatkan Imunitas Pasien Hipertensi Selama Masa Pandemi COVID-19 Badai Bhatara Tiksnadi; Nova Sylviana; Adi Imam Cahyadi; Alberta Claudia Undarsa
Jurnal Kardiologi Indonesia Vol 41 No 2 (2020): Indonesian Journal of Cardiology: April - June 2020
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1016

Hipertensi merupakan salah satu komorbid yang paling banyak ditemukan pada Coronavirus disease-19 (COVID-19) dan berasosiasi dengan prognostik buruk dari infeksi tersebut. Olahraga rutin ternyata dapat meningkatkan imunitas tubuh, sehingga dapat berperan dalam pencegahan infeksi COVID-19 selain efeknya terhadap penurunan tekanan darah. Olahraga tipe aerobik dengan intensitas sedang 30-60 menit, dengan cara tetap melakukan pembatasan jarak, ataupun dengan teknik home exercise dan virtual dengan daring, dapat dilakukan oleh penderita hipertensi dalam meningkatkan imunitas selama masa pandemi COVID-19.

Gambaran Geometri Ventrikel Kiri pada Pasien Hipertensi yang Menjalani Ekokardiografi di RSUD Al-Ihsan Bandung Tahun 2018–2019 Putri Wulandari; Badai Bhatara Tiksnadi; Tony S. Djajakusumah
Jurnal Integrasi Kesehatan dan Sains Vol 3, No 2 (2021): Jurnal Integrasi Kesehatan dan Sains
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29313/jiks.v3i2.7433

Hipertensi dapat menginduksi perubahan struktur dan fungsi jantung sebagai hypertension mediated organ damage (HMOD). Gejala subklinis HMOD tersering adalah left ventricle hypertrophy (LVH) yang merupakan salah satu geometri ventrikel kiri. Tujuan penelitian ini mengetahui gambaran geometri ventrikel kiri pada pasien hipertensi yang menjalani ekokardiografi. Penelitian deskriptif ini dilakukan secara potong lintang dengan metode total samplingmenggunakan data rekam medik dan hasil ekokardiografi pasien hipertensi di RSUD Al-Ihsan Bandung pada bulan Januari 2018–Desember 2019 yang memenuhi kriteria inklusi sebanyak 123 sampel. Gambaran geometri ditentukan dengan penghitungan tebal dinding relatif dan indeks massa ventrikel kiri. Hasil penelitian menunjukkan bahwa karakteristik pasien hipertensi mayoritas perempuan (66,7%), usia 45–64 tahun dan >65 tahun (89,4%), serta obesitas (49,6%). Gambaran geometri ventrikel kiri yang didapat adalah LVH konsentrik (40%), LVH eksentrik (33%), normal geometri (18%), dan konsentrik remodeling (9%). Simpulan, geometri ventrikel kiri pasien hipertensi mayoritas telah mengalami LVH dengan tipe terbanyak LVH konsentrik. LVH konsentrik cenderung terjadi pada pasien dengan karakteristik usia >65 tahun, perempuan, dan obesitas. LVH eksentrik cenderung terjadi pada pasien dengan komorbid penyakit arteri koroner, penyakit katup jantung, penurunan ejeksi fraksi, dan diabetes melitus tipe II. Geometri konsentrik remodeling dan geometri normal tidak pernah dominan sebagai tipe geometri terbanyak pada pasien hipertensi yang diteliti.DESCRIPTION OF LEFT VENTRICLE GEOMETRY IN HYPERTENSION PATIENTS WHO UNDERTAKING ECHOCARDIOGRAPHY AT AL-IHSAN HOSPITAL BANDUNG IN 2018–2019Hypertension can induce changes in structures and functions of the heart as hypertension mediated organ damage (HMOD). The most common subclinical symptoms of HMOD are left ventricular hypertrophy (LVH) as one of the left ventricle geometries. This study aims to determine the description of left ventricle geometry in hypertension patients undertaking echocardiography. This descriptive study was conducted with cross-sectional and total sampling methods using medical record data and the echocardiography result of hypertension patients at Al-Ihsan Hospital Bandung in January 2018–December 2019 who met the inclusion criteria of 123 samples. The description of geometry was determined by the calculation of relative wall thickness and left ventricular mass index. The results showed that the majority characteristics of hypertension patients were women (66.7%), age 45-64 years and >65 years (89.4%), and obese (49.6%). Geometric patterns of the left ventricle obtained were concentric LVH (40%), eccentric LVH (33%), normal geometry (18%), and concentric remodeling (9%). In conclusion, the left ventricle geometry of hypertension patients majority has experienced LVH, with the most pattern is concentric LVH. Concentric LVH tends to occur in patients with characteristics age >65 years, women, and obesity. Eccentric LVH tends to occur in patients with comorbid coronary artery diseases, valvular heart diseases, reduction ejection fraction, and type II diabetes mellitus. The concentric remodeling and normal geometry were never dominant as the most common geometry pattern in the hypertension patients studied.

The Differences requency of Lower Extremities Muscle Strength and Functional Capacity on the difference Supervised Exercise Frequency in Post Cardiac Bypass Graft Surgery Dewi Nur Fiana; Sunaryo B Sastradimaja; Badai Bhatara Tiksnadi
Indonesian Journal of Physical Medicine & Rehabilitation Vol 6 No 01 (2017): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Introduction: The optimal time to do exercise in adaptation phase was 36 to 72 hours. Patients with cardiovasculardisease may have an extended adaptation phase to 96 hours and above. It was necessary to know the mosteffective supervised exercise in phase II cardiac rehabilitation between three times/week for 36-hours, and twotimes/week for 96-hours.Method: This study involved 30 patients post-Cardiac Bypass Graft Surgery (CABG) participated in phase IIcardiac rehabilitation at Hasan Sadikin Hospital, Bandung. Subjects divided into two groups; that have done twotimes/week (group 1) and three times/week of the supervised exercised (group 2) for four weeks. The Lowerextremity muscle strength (LEMS) examined by conducting a chair standing test, while functional capacity (FC)evaluated by the 6-minute walking test.Result:Subjects were 58,54±5,90 y.o (group 1) and 61,66±6,36(group 2). The FC and the LEMS before andafter exercise were 10,98 and 15,96 ml/kg(<0,001) on the FC; 7,8 and 12,9 times (<0,001) on the LEMS in group1, besides 9,6 and 14,9 ml/kg(<0,001) on the FC; 8,7 and 13,0 times (<0,001) on group 2,Conclusion. Both groups have increased of the FC and the LEMS after exercise. There were no differencebetween 2 times and 3 times of supervised exercises a week on post CABG pasientsKeywords: coronary artery bypass graft, the frequency of exercise, functional capacity, muscle strength =

The Differences requency of Lower Extremities Muscle Strength and Functional Capacity on the difference Supervised Exercise Frequency in Post Cardiac Bypass Graft Surgery Dewi Nur Fiana; Sunaryo B Sastradimaja; Badai Bhatara Tiksnadi
Indonesian Journal of Physical Medicine & Rehabilitation Vol 6 No 01 (2017): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Introduction: The optimal time to do exercise in adaptation phase was 36 to 72 hours. Patients with cardiovasculardisease may have an extended adaptation phase to 96 hours and above. It was necessary to know the mosteffective supervised exercise in phase II cardiac rehabilitation between three times/week for 36-hours, and twotimes/week for 96-hours.Method: This study involved 30 patients post-Cardiac Bypass Graft Surgery (CABG) participated in phase IIcardiac rehabilitation at Hasan Sadikin Hospital, Bandung. Subjects divided into two groups; that have done twotimes/week (group 1) and three times/week of the supervised exercised (group 2) for four weeks. The Lowerextremity muscle strength (LEMS) examined by conducting a chair standing test, while functional capacity (FC)evaluated by the 6-minute walking test.Result:Subjects were 58,54±5,90 y.o (group 1) and 61,66±6,36(group 2). The FC and the LEMS before andafter exercise were 10,98 and 15,96 ml/kg(<0,001) on the FC; 7,8 and 12,9 times (<0,001) on the LEMS in group1, besides 9,6 and 14,9 ml/kg(<0,001) on the FC; 8,7 and 13,0 times (<0,001) on group 2,Conclusion. Both groups have increased of the FC and the LEMS after exercise. There were no differencebetween 2 times and 3 times of supervised exercises a week on post CABG pasientsKeywords: coronary artery bypass graft, the frequency of exercise, functional capacity, muscle strength =

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