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All Journal Indonesian Journal of Cardiology Sumatera Medical Journal The Journal of Society Medicine (JSOCMED)
Purba, Joy Wulansari
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Alteration of Right Ventricular-Pulmonary Arterial Coupling Before and After Decongestion in Non-Preserved Fraction Acute Heart Failure Patients at Adam Malik Hospital Medan Brahmana, Andrew Timanta; Ketaren, Andre Pasha; Andra, Cut Aryfa; Lubis, Anggia Chairuddin; Haykal, Teuku Bob; Siregar, Yasmine Fitrina; Lubis, Hilfan Ade Putra; Purba, Joy Wulansari; Akbar, Nizam Zikri
Journal of Society Medicine Vol. 4 No. 1 (2025): January
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i1.190

Abstract

Objective: To assess whether there is right ventricular-pulmonary artery (RV-PA coupling by tricuspid annular plane systolic excursion/pulmonary artery systolic pressure TAPSE/PASP) changes in determining the clinical results of decongestion in patients with acute heart failure (AHF) with non-preserved ejection fraction (non-HFpEF) before and after decongestive at Adam Malik Hospital Medan. Methods: This study is an observational study with a prospective approach and consecutively collected, in patients AHF with non-HFpEF at Adam Malik Hospital Medan in the period from September 2023 until November 2024d. The sample is an eligible population that meets the inclusion and exclusion criterias. Results: This study consisted total 44 subjects with majority of 37 men (75%), an average age of 61 years old. A total of 28 subjects (63.6%) had hypertension as comorbid. There were 33 people (75%) who had sinus rhythm. The most acute heart failure phenotype commonly found was acute decompensated heart failure (ADHF) with 21 subjects. The longest length of stay AHF was cardiogenic shock with a median of 9 days. A significant decrease in median heart (p 0.0001), tricpuspid valve gradient (TVG) examination showed a significant decrease in (p 0.0001), PASP examination had a significant decrease in the average (p 0.0001), RV-PA coupling showed a significant increment (p 0.0001). A significant relationship was found between RV-PA coupling changes and decongestion in all acute heart failure groups (p 0.005). No significant relationship between RV-PA coupling ratio with length of stay was found. Conclusion: There were differences found in RV-PA coupling as increment with significant value in complete and partial decongestion groups, with a RV-PA coupling cut-off value of 0.65 and sensitivity and specificity of 68.8% and 67.9%, respectively.
Renal Function and Left Ventricular Ejection Fraction in Diabetic Patients with Acute Heart Failure Hutapea, Mery Natalia; Hasan, Refli; Raynaldo, Abdul Halim; Siregar, Abdullah Afif; Haykal, Teuku Bob; Sarastri, Yuke; Ardini, Tengku Winda; Ketaren, Andre Pasha; Purba, Joy Wulansari; Akbar, Nizam Zikri; Andra, Cut Aryfa
Sumatera Medical Journal Vol. 9 No. 1 (2026): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v9i1.22989

Abstract

Background: Acute heart failure (AHF) in patients with type 2 diabetes mellitus (T2DM) is frequently complicated by renal dysfunction, which may aggravate cardiac impairment. Serum creatinine may reflect this cardio–renal interaction, but its association with left ventricular ejection fraction (LVEF) in AHF patients with T2DM remains unclear. Objective: To investigate the correlation between serum creatinine and left ventricular ejection fraction (LVEF) in patients with acute heart failure (AHF) and type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study of 52 hospitalized AHF patients with T2DM. Clinical data, serum creatinine, A1C, and echocardiographic LVEF (assessed by two independent consultants) were collected. Correlation and multivariable linear regression analyses were performed. Results: The patients were middle-aged and predominantly male. Mean LVEF was 33.2 ± 9.1%, and mean serum creatinine was 1.58 ± 0.31 mg/dL. Higher serum creatinine levels were strongly associated with lower LVEF. Glycemic status (A1C) and urea levels also showed negative associations with LVEF. After adjustment, serum creatinine and A1C remained independent predictors of reduced LVEF. Conclusion: In AHF patients with T2DM, higher serum creatinine and A1C levels are independently associated with reduced LVEF, underscoring the cardio-renal-metabolic interplay in this population and highlighting the need for integrated management strategies.
Non - Fluoroscopic Transesophageal Echocardiography Guided Transcatheter Closure of Atrial Septal Defects: Single Centre Experience in The North of Sumatra Island, Indonesia Nasution, Ali Nafiah; Napitupulu, Bertha Gabriela; Ardini, Tengku Winda; Purba, Joy Wulansari; Andra, Cut Aryfa; Lubis, Anggia Chairuddin; Siregar, Abdullah Afif
Jurnal Kardiologi Indonesia Vol 47 No 1 (2026): January - March, 2026
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1985

Abstract

Background: Non-fluoroscopic, transesophageal-guided percutaneous closure of Atrial Septal Defect (ASD) can be a first-line strategy to reduce radiation exposure and its cumulative effects. We report our experience as the first center located far from the capital city of Indonesia that routinely performs transcatheter closure of ASD under the guidance of Transesophageal Echocardiography (TEE) without fluoroscopy. Methods: We collected data of patients whose ASD was successfully closed percutaneously from May 2020 to August 2024. For a total of 116 patients of secundum ASD that are suitable for device closure, we routinely intend to do non-fluoroscopy transcatheter ASD closure guided by TEE. Results: The zero-fluoroscopy technique was successfully performed in 111 patients. The ASD diameter is 10-40 mm, and the mean size of the occluding device is 9-42 mm. The mean procedural times are 55.81 ± 22.7 minutes. The success rate is 95% with only one case of pericardial effusion. Five cases were excluded as they were finally assisted by fluoroscopy due to the limitation of the echocardiographic view. Conclusion: A thorough transcatheter ASD closure technique guided by TEE can routinely be performed without fluoroscopy.
Co-Authors Akbar, Nizam Zikri Andra, Cut Aryfa Ardini, Tengku Winda Brahmana, Andrew Timanta Hasan, Refli Hutapea, Mery Natalia Ketaren, Andre Pasha Lubis, Anggia Chairuddin Lubis, Hilfan Ade Putra Napitupulu, Bertha Gabriela Nasution, Ali Nafiah Raynaldo, Abdul Halim Sarastri, Yuke Siregar, Abdullah Afif Teuku Bob Haykal Yasmine Fitrina Siregar