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All Journal Heart Science Journal
Baskoro, Shalahuddin Suryo
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Health Professions Immunology & microbiology Medicine & Pharmacology

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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.
Case series analysis: Atrial fibrillation ablation with normal vs. left atrium enlargement Baskoro, Shalahuddin Suryo; Saerang, Gebryel Dennis; Saputri, Vemmy Lian; Rizal, Ardian; Wikananda, Adhika Prastya; Waranugraha, Yoga
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.15

Abstract

Background: Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, and its incidence is gradually increasing worldwide. It can develop such life-threatening conditions as heart failure, myocardial infarction, and thromboembolism. Catheter ablation, as a minimally invasive procedure to eliminate AF triggers, demonstrates different levels of success, particularly in relation to the size of the left atrium (LA). Even though left atrium enlargement (LAE) associates with worse ablation outcomes, its mechanisms are poorly understood. Case Illustration: This case report investigated the treatment results in AF ablation cases with normal LA size and LAE. This case report described two paroxysmal AF patients who underwent catheter ablation. The patient of the first case is a 45-year-old male with normal LA Size, while the second case is a 55-year-old male with LAE. Both of these patients underwent pulmonary vein isolation (PVI) using a 3D mapping system. Sinus rhythm was gained in both patients before the discharge and both performed the ablation successfully. Conclusion: Left Atrial Enlargement (LAE) exposed patient to more difficult procedures and greater risk of recurrence. LA size is one of the predictor of long term outcome in AF ablation patients, but with proper management, the prognosis might still be favourable. More studies need to determine how to manage AF ablation in patients with high-risk characteristics 
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.
Co-Authors Afifah, Yuri Anjarwani, Setyasih Indra Prasetya Rizal, Ardian Saerang, Gebryel Dennis Saputri, Vemmy Lian Wikananda, Adhika Prastya Yoga Waranugraha