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INDONESIA
Indonesian Journal of Cardiology
Published by Indonesian Heart Association
ISSN : 28303105     EISSN : 29647304     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Indonesian Journal of Cardiology (IJC) is a peer-reviewed and open-access journal established by Indonesian Heart Association (IHA)/Perhimpunan Dokter Spesialis Kardiovaskular Indonesia (PERKI) [www.inaheart.org] on the year 1979. This journal is published to meet the needs of physicians and other health professionals for scientific articles in the cardiovascular field. All articles (research, case report, review article, and others) should be original and has never been published in any magazine/journal. Prior to publication, every manuscript will be subjected to double-blind review by peer-reviewers. We consider articles on all aspects of the cardiovascular system including clinical, translational, epidemiological, and basic studies. Subjects suitable for publication include but are not limited to the following fields: Acute Cardiovascular Care Arrhythmia / Cardiac Electrophysiology Cardiovascular Imaging Cardiovascular Pharmacotherapy Cardiovascular Public Health Policy Cardiovascular Rehabilitation Cardiovascular Research General Cardiology Heart Failure Hypertension Interventional Cardiology Pediatric Cardiology Preventive Cardiology Vascular Medicine
Arjuna Subject : Kedokteran - Cardiology and Cardiovascular Medicine
Articles 671 Documents
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Correlation of Waist to Height Ratio with Leptin Serum Level in Coronary Artery Disease Damay, Vito; Undarsa, Alberta Claudia
Indonesian Journal of Cardiology Vol 38 No 4 (2017): October - December 2017
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.30701/ijc.v38i4.784

Abstract

Background: Adiposity assessment plays an important role in coronary artery disease (CAD) prevention. One of the adiposity parameter in major CAD management guide­line is waist to height ratio (WHtR). Adiposity promotes the pathogenesis of coronary atherosclerosis by involving adipokines released by adipose tissue. Leptin is obesity identic adipokine which is used as prognostic predictor of cardiovascular event. This study aims to analyze correlation between WHtR and leptin serum level. Method: A cross sectional study was performed to 37 stable CAD patients undergone elective coronary angiography in Heart Catheterization Laboratory Dr Hasan Sadikin Hospital, Bandung, West java in July 2014 Results: Mean age of the subjects was 56.7± 9.12 years old with mean age of men (n=32) and women (n=5) were 55.9±9.47 years old and 62±3.54 years old consecu­tively. There were 30 (81%) subjects classified as obese (WHtR≥0.5) with mean WHtR 0.54±0,06. Median value of leptin serum was 8599.90 pg/ml (780-36929.3 pg/ml). Based on rank-spearman correlation test, a positive moderate correlation was significantly found between WHtR and Leptin serum level (Spearman’s rho = 0.5, p= 0.001). Conclusion: Positive correlation was found between WHtR and leptin serum level. Hence, WHtR might be useful as indicator of leptin serum level which has been used as a prognostic biomarker in CAD patients   Abstrak Latar belakang: Penilaian adipositas merupakan bagian dari upaya preventif penyakit jantung koroner (PJK). Salah satu parameter antropometri adipositas yang digunakan pada panduan tatalaksana PJK adalah pengukuran rasio lingkar pinggang/tinggi badan (LP/TB). Adipositas diketahui berperan dalam patomekanisme terbentuknya aterosklerosis koroner melalui pelepasan adipositokin oleh jaringan adiposa. Leptin merupakan adipositokin identik adiposit yang digunakan sebagai biomarka indikator prognostik kejadian kardiovaskular. Penelitian ini bertujuan untuk menganalisa korelasi LP/TB dengan kadar leptin serum. Metode: Studi potong lintang dengan menganalisis antropometri LP/TB dan kadar leptin serum pada 37 pasien PJK yang menjalani angiografi elektif di Laboratorium Kateterisasi Jantung RSUP Dr.Hasan Sadikin, Bandung, Jawa Barat pada bulan Juli 2014. Hasil: Rerata usia subjek adalah 56.7± 9.12 tahun dengan rerata usia pria (n=32) dan wanita (n=5) secara berurutan adalah 55.9±9.47 tahun dan 62±3.54 tahun. Terdapat 30 (81%) subjek tergolong obesitas (nilai LP/TB ≥0,5) dengan rata-rata LP/TB 0.54±0,06. Nilai median leptin serum 8599.90 pg/ml (780-36929.3 pg/ml). Berdasarkan uji korelasi rank-spearman, terdapat korelasi positif bermakna antara LP/TB dengan kadar leptin serum (Spearman rho = 0.5, p= 0.001). Kesimpulan: Terdapat korelasi positif bermakna antara pemeriksaan antropometri LP/TB dengan kadar leptin serum. Rasio lingkar pinggang/tinggi badan dapat digunakan sebagai salah satu indikator kadar leptin serum yang merupakan biomarka prognostik kardiovaskular.
Effect of Myocardial Fibrosis on Left Ventricular Function in Rheumatic Mitral Stenosis: A Preliminary Study with Cardiac Magnetic Resonance Elen, Elen; Atmadikoesoemah, Celly A.; Kasim, Manoefris
Indonesian Journal of Cardiology Vol 38 No 4 (2017): October - December 2017
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.30701/ijc.v38i4.785

Abstract

Background: Left ventricular (LV) dysfunction was frequently found in rheumatic mitral stenosis. Myocardial fibrosis had been revealed in rheumatic heart disease and could be associated with LV dysfunction. We evaluate myocardial fibrosis profile related to LV function in rheumatic mitral stenosis with cardiac magnetic resonance (CMR). Methods: Eighteen patients with severe rheumatic mitral stenosis without history of coronary artery disease or its risk factors underwent 1.5T CMR examination. LV ejection fraction (LVEF), right ventricular ejection fraction (RVEF), myocardial fibrotic tissue were evaluated with CMR. Other hemodynamic data was derived from echocar­diography results. Results: These patients (40.4±10.5 years old, 72.2% female, 66.7% atrial fibrillation) had LVEF of 50.9±15.9% and RVEF of 37.7±13.9%. Volume of fibrotic tissue in these patients were 16.6 (5.5-55.8)%. In multivariate analysis, volume of fibrotic tissue was a significant predictor of LVEF that myocardial fibrotic tissue of 1% was associated with LVEF reduction of 0.87% (95% CI 0.51%-1.24%). Conclusion: LV function was determined by the extent of myocardial fibrosis in rheu­matic mitral stenosis.   Abstrak Latar Belakang: Disfungsi ventrikel kiri (LV) sering ditemukan pada mitral stenosis rematik. Fibrosis miokardium ditemukan pada penyakit jantung rematik. Fibrosis miokardium pada penyakit jantung rematik juga dihubungkan dengan disfungsi LV. Kami mengevaluasi profil fibrosis miokardium yang berhubungan dengan fungsi LV pada mitral stenosis rematik dengan cardiac magnetic resonance (CMR). Metode: Dilakukan pemeriksaan 1.5T CMR pada delapanbelas pasien dengan mitral stenosis rematik berat tanpa riwayat penyakit jantung koroner atau faktor resikonya. Fraksi ejeksi LV (LVEF), fraksi ejeksi RV (RVEF), dan jaringan fibrotik miokardium dievaluasi menggunakan CMR. Data hemodinamik lainnya didapatkan dari pemeriksaan ekokardiografi. Hasil: Pasien tersebut (40.4±10.5 tahun, 72.2% perempuan, 66.7% fibrilasi atrium) memiliki LVEF 50.9±15.9% dan RVEF 37.7±13.9%. Vol­ume jaringan fibrotic pada pasien tersebut adalah 16.6 (5.5-55.8)%. Dalam analisis multivariat, volume jaringan fibrotic adalah prediktor LVEF yang signifikan yaitu 1% jaringan fibrotic miokardium dihubungkan dengan menurunan LVEF sebesar 0.87% (95% CI 0.51%-1.24%). Kesimpulan: Fungsi LV dipengaruhi seberapa besar fibrosis miokardium pada mitral stenosis rematik
SMASH Score as a Predictor off-in Hospital Mortality for Acute Heart Failure Patients Syahputra, Zunaidi; Lubis, Hilfan Ade Putra; Safri, Zainal; Hasan, Harris
Indonesian Journal of Cardiology Vol 38 No 4 (2017): October - December 2017
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.30701/ijc.v38i4.786

Abstract

Background: The prognosis of AHF patients remain poor. The aim of this study is to design a simple, bedside clinical prognostic scoring model and validate its ability to predict hospital mortality for patients with AHF. Methods: 255 patients with AHF were enrolled, divided into dead (n=121) and sur­vival (n=134) cohorts. The data were collected from January 2015 to September 2016.Data were collected restropectively. Multivariable analysis was applied to determine independent risk factors and develop the scoring system. Results: The Multivariate logistic regression analysis, hospital mortality was employed as dependent variable, while age umur (p=0.014,OR 4.314 CI 95%(1.346-13.822)), Diastolic Blood Pressure (p= 0.001 OR 6.213 CI 95%(2.1210-18.205 )), Systolic Blood Pressure ( p=0.002 OR 5.043 CI 95%( 1.854-13.717)), Heart Rate ( p=0.002 OR 3.933 CI 95%(1.658-9.332)), haemoglobin ( p = 0.044 OR 2.530 CI95%(1.026-6.242)), arrhytmia ( p=0.001 OR 7.658 CI 95%(2.217-26.457)), creatinine on admission ( p=0.002 OR 4.385 CI 95% (1.731-11.104)), QRS duration (p=0.00 OR 7.684, CI 95% (3.063-19.279)), as independent variables.According to each OR of these variables, we set the new scoring system of hospital mortality for AHF with good calibration by Hosner-lemeshow test ( p =1) and discrimination by AUC 0.925 (p<0.01 CI 95 % 0.891-0.959). The optimal cutt off for prediction mortality was total 6 points, sensitivity 81% and specificity 89%. We divided the patients with AHF as low risk whom total score 0-3 points (mortality in hospital 0-2%), moderate risk whom total score 4-5 points (mortality in hospital 13-46%), and 6-12 point as high risk. In the validation cohort indicated that SMASH score as new scoring system was effective with bootstrapping. Conclusion : The SMASH Score is a new scoring system of hospital mortality for AHF can predict with good performance in terms of discrimination, calibration and internally validation.   Abstrak Latar Belakang : Prognosis pasien dengan gagal jantung akut ( GJA ) masih buruk, dan stratifikasi resiko mungkin dapat membantu para klinisi dalam penatalaksanaan, dimana pasien yang tergolong buruk, harus dilakukan tindakan agressif dan pemantauan yang ketat. Namun ketersediaan sistem skoring pada GJA masih terbatas. Studi ini bertujuan untuk membuat model skoring prognostik yang sederhana dan validasinya dalam prediksi kematian di rumah sakit pada pasien GJA. Metode : 255 pasien GJA dibagi 2 kelompok yang mengalami kematian kardiovaskular dan survival di rumah sakit. Data dikumpulkan dari Januari 2015 sampai September 2016. Kriteria inklusi memenuhi panduan GJA berdasarkan ESC guidelines 2016. Dilakukan analisa multivariat dalam mencari faktor resiko yang bebas dan pembuatan sistem skoring. Hasil : Setelah dilakukan analisa multivariat logistik regressi, kematian di Rumah Sakit sebagai variable bebas, sementara umur (p=0.014,OR 4.314 KI 95%(1.346-13.822)) Tekanan darah diastolik saat masuk ( p= 0.001 OR 6.213 KI 95%(2.1210-18.205 )), tekanan darah sistolik saat masuk ( p=0.002 OR 5.043 KI 95%( 1.854-13.717)), Denyut nadi( p=0.002 OR 3.933 KI 95%(1.658-9.332)), hemoglobin ( p = 0.044 OR 2.530 KI95%(1.026-6.242)), arritmia ( p=0.001 OR 7.658 KI 95%(2.217-26.457)), kreatinin masuk ( p=0.002 OR 4.385 KI 95% (1.731-11.104)), QRS duration (p=0.00 OR 7.684, KI 95% (3.063-19.279)) sebagai variabel independen.Berdasarkan masing-masing OR dari variabel ini, diformulasikan sebuah sistem skoring . Sistem skoring yang baru memiliki kalibrasi dan diskriminasi yang sangat memuaskan menurut Hosner-lemeshow test ( p =1) dan AUC 0.925 (p<0.01 CI 95 % 0.891-0.959). Nilai titik potong yang optimal untuk prediksi kematian di rumah sakit adalah 6 poin dengan sensitivitas 81% and spesifisitas 89%. Kami menggolongkan pasien GJA sebagai resiko kematian rendah dengan total skor 0-3 poins (mortalitas di Rumah sakit 0-2%), resiko sedang dengan total skor 3-5 points (mortalitas di Rumah Sakit 13-46%), and 6-14 poin sebagai resiko tinggi. Pada validasi internal bahwa SMASH score sebagai sistem skoring kematian yang baru menunjukan nilai optimisme yang baik secara bootsrapping. Kesimpulan : SMASH Score adalah sebuah Sistem Skorring baru dalam Prediksi Kematian di Rumah Sakit pada Sindroma Gagal Jantung Akut dengan kalibrasi dan diskriminasi serta validasi yang baik.
Pulmonary Atresia with Intact Ventricular Septum in a Neonate Yonas, Emir; Pranata, Raymond; Nusarintowati, Nuvi
Indonesian Journal of Cardiology Vol 38 No 4 (2017): October - December 2017
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.30701/ijc.v38i4.787

Abstract

Introduction: Pulmonary atresia with an intact ventricular septum is a condition that is characterized by a complete obstruction to right ventricular outflow with varying degrees of right ventricular and tricuspid valve hypoplasia. This condition is uniformly fatal if untreated. In this case report, we present a case of a neonate with a pulmonary atresia with intact ventricular septum Case Presentation: A 2 days-old female Indonesian newborn was referred to our facility. The newborn was delivered from a G4P3A0 mother with a gestational age of 39 weeks (term delivery). Chest x-ray done at the referring facility is significant for a seemingly right heart hypertrophy, casting a “boot-shaped” appearance of the right heart border. Laboratory results done at the referring facility is significant for a neutrophilia of 82% and lymphocytopenia of 13% An episode of hypoglycemia was reported on referring facility with a blood sugar level of 50 mg/dl. Multiple episodes of cyanosis were reported at referring facility, CPAP was administered but the improvement was limited. Pulse oximetry averaged between 72-80% at the referring facility. Physical examina­tion shows an actively moving neonate, with a strong cry. Perioral cyanosis was seen. Vital signs were as follows; heart rate 128 x / minute, temperature 37oC, respiratory rate 54 x / minute, pulse oximetry 74%, capillary refill time < 3 seconds. The rest of the physical examination was within normal limits. Laboratory result on admission at our facility is significant for low hematocrit, low erythrocyte count, leukopenia with neutrophilia and thrombocytopenia. Patient was admitted to NICU and given CPAP. Echocardiography 2 days upon arrival at our facility reveals a patent ductus arteriosus with the pressure of 4-5 mmHg and diameter of 0.3 cm, no forward flow from the right ventricle to the pulmonary artery, doppler mode demonstrated pulmonary artery filling from ductus arteriosus. The rest of the findings were within normal limits. Conclusion: Pulmonary atresia with an intact ventricular septum is a condition that relies on the patent ductus arteriosus for pulmonary blood supply, the patency of it is of paramount importance.   Abstrak PENDAHULUAN: Atresia arteri pulmonalis dengan septum ventrikel yang utuh merupakan kondisi yang dikarakterisasikan dengan sumbatan total pada right ventricular outflow dengan berat hipoplasia ventrikel kanan dan trikuspid kanan yang beratnya bervariasi. Pada umumnya kondisi tersebut fatal apabila tidak ditangani. Pada laporan kasus ini, kami melaporkan suatu kasus neonates dengan atresia arteri pulmonalis dengan septum ventrikel yang utuh. PRESENTASI KASUS: Neonatus perempuan berumur 2 hari dirujuk ke rumah sakit kami. Bayi dilahirkan dari G4P3A0 usia kehamilan 39 minggu. Ronsen thoraks yang dilakukan oleh fasilitas kesehatan yang merujuk memperlihatkan hipertrofi jantung kanan serta bentuk “boot-shaped” pada batas jantung kanan. Hasil laboratorium pada fasilitas kesehatan tersebut menunjukan neutrofilia dan limfositopenia. Terdapat juga riwayat hipoglikemi. Episode sianosis berulang terjadi pada fasilitas kesehatan yang merujuk. Pemasangan CPAP kurang membuahkan hasil dengan saturasi O2 72-80% ketika tiba pada rumah sakit kami. Pemeriksaan fisik menunjukan tangis kuat dan gerak aktif dengan sianosis perioral. Detak jantung 128 kali/menit, suhu 37oC, laju naas 54 kali/menit, oksimetri nadi 74% dan waktu isi kapiler <3 detik. Pemeriksaan laboratorium saat pasien dating menunjukan hematocrit, hitung eritrosit, leukosit dan thrombosit yang rendah. Pasien dirawat di NICU dan diberikan CPAP. Ekokardiografi 2 hari kemudian menunjukan duktus arteriosus patent dengan tekanan 4-5 mmHg dan diameter 0.3 cm, tidak ada aliran maju dari ventrikel kanan kepada arteri pulmonalis, mode Doppler menunjukan pengisian arteri pulmonalis dari duktus arteriosus. Pemeriksaan lainnya dalam batas normal. KESIMPULAN: Atresia arteri pulmonalis dengan septum ventrikel yang utuh merupakan suatu kondisi dimana aliran darah menuju paru bergantung pada duktus arteriosus yang paten sehingga patensi daripada duktus tersebut sangatlah penting
Exercise training in heart failure: role, prescription and program Pranata, Raymond; Yonas, Emir; Siswanto, Bambang B.; Purwowiyoto, Budhi S.
Indonesian Journal of Cardiology Vol 38 No 4 (2017): October - December 2017
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.30701/ijc.v38i4.788

Abstract

Heart failure is one of the most common cardiovascular diseases and is a final pathway of various cardiac pathologies. Exercise intolerance and dyspnea accompanied by dete­riorating quality of life are common issues in those suffering from heart failure and may persist despite optimal medical therapy. Exercise training in heart failure theoretically helps to slow down the deterioration of the heart by antagonizing excess neurohormonal activity in heart failure, which translated into better functional capacity and quality of life. Exercise prescription is a mean of assessing and interpreting clinical information and applying the principles of training to develop an appropriate regimen and should be tailored to patient’s clinical condition. Resistance training improves peak VO2, exercise capacity and quality of life in heart failure patients. Both continuous and interval exercise training are linked to better quality of life despite ambiguous results in mortality. The aim of this article is to discuss the benefits of exercise in patients with congestive heart failure, exercise prescription, and exercise program including high-intensity interval training, continuous training and resistance exercise.   Abstrak Gagal jantung adalah salah satu penyakit kardiovaskular yang paling sering ditemui dan merupakan akhir daripada banyak jenis patologi jantung. Intoleransi olahraga dan sesak nafas disertai dengan memburuknya kualitas hidup merupakan beberapa masalah yang sering dihadapi oleh pasien gagal jantung, meskipun telah diberikan pengobatan yang optimal. Latihan olahraga pada gagal jantung secara teoritis dapat memperlambat menurunnya fungsi jantung dengan melawan aktivitas neurohormonal yang meningkat pada kondisi gagal jantung yang dicerminkan dengan kapasitas fungsional dan kualitas hidup yang lebih baik. Preskripsi olahraga meliputi pemeriksaan dan interpretasi dari informasi klinis dan aplikasi dari prinsip latihan untuk membentuk regimen yang sesuai dan harus di sesuaikan dengan keadaan klinis pasien. Latihan beban memperbaiki fungsi VO2 puncak, kapasitas olahraga dan kualitas hidup pada pasien dengan gagal jantung. Kedua metode olahraga baik secara kontinu ataupun interval dihubungkan dengan kualitas hidup yang lebih baik meskipun masih ambigu dalam hal mortalitas. Tujuan artikel ini adalah membahas manfaat latihan fisik pada pasien dengan gagal jantung kongestif, cara peresepan serta membahas program high intensity interval training, continuous training serta latihan beban.
Coronary CT Angiography in Emergency Department: Can We Use It? Purwowiyoto, Sidhi Laksono
Indonesian Journal of Cardiology Vol 38 No 4 (2017): October - December 2017
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.30701/ijc.v38i4.789

Abstract

Acute chest pain syndrome is the main cause of patients come to emergency department. Identifying those with anamneses, risk factors, physical examination, ECG and laboratory remain challenging to exclude the acute coronary syndrome, especially those with low risk probability. Early imaging examination is important for risk stratification of these groups. Utilization of coronary CT angiography quickly identifies a group of low risk patients and allows safe and expedited discharge.   Abstrak Sindroma nyeri dada akut merupakan penyebab utama pasien datang ke unit gawat darurat. Mengidentifikasi mereka dengan anamnesis, faktor risiko, pemeriksaan fisik, EKG dan laboratorium tetap menantang untuk dapat menyingkirkan sindroma koroner akut, terutama yang dengan probabilitas risiko rendah. Pemeriksaan pencitraan awal penting untuk stratifikasi risiko kelompok ini. Penggunaan angiografi CT koroner dengan cepat mengidentifikasi kelompok pasien dengan risiko rendah dan memungkinkan pasien dipulangkan secara aman dan cepat.
Detailed Precision of Computed Tomography Angiography Compared to Invasive Angiography in Different Coronary Vessels: Overestimate, Underestimate, or Concordance? Haykal, TM; Elen, Elen; Atmadikoesoemah, Celly A.; Putra, Abhirama N; Parlautan, Andrew; Saragih, Wendy M; Kasim, Manoefris
Indonesian Journal of Cardiology Vol 39 No 1 (2018): January - March 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.30701/ijc.v39i1.790

Abstract

Background: Quantitative analysis of stenosis lesions by Computed Tomography angiography (CTA) show good correlation with Invasive Coronary Angiography (ICA) examination. However, detailed precision whether CTA overestimate or underestimate have not been explored thoroughly. Objectives: This research is performed to analyze the precision of CTA compared to ICA. Materials & Methods: There are 195 patients examined by both CTA and ICA from October 2014 until December 2015 in our hospital. CTA was analyzed by a team of cardiovascular imaging cardiologists. Quantitative grading of stenosis was determined visually using 2014 Society of Cardiovascular Computed Tomography (SCCT) guidelines classification. Quantitative measurement of stenosis during ICA was classified with the same criteria so that it can be comparable. The final comparison of both tests was clas­sified as concordance, overestimate and underestimate. Results: Lesion of stenosis was found in 573 coronary vessels. Coronary vessels are significantly associated with detailed precision of quantitative analysis comparison in CTA and ICA. LM coronary stenosis quantification from CTA is predominantly overestimate (concordance in 6% vessels and overestimate in 75.9% vessels), while stenosis analysis by CTA in other major coronary vessels is spread without conspicuous domination (p<0.001). Sensitivity, specificity, PPV, and NPV of CTA to detect obstructive lesion (stenosis ≥ 50%) found by ICA is 81.4%, 80.4%, 73.9%, and 86.3%, respectively (780 vessels). Conclusions: Degree of stenosis in LM is predominantly overestimate by CTA. The precision of stenosis grading in CTA in different coronary vessels is not the same.   Abstrak Latar Belakang: Analisis kuantitatif lesi stenosis pada pembuluh koroner menggunakan modalitas Computed Tomography Angiography (CTA) memiliki korelasi yang baik dengan pemeriksaan Invasive Coronary Angiography (ICA). Namun, presisi CTA terhadap ICA masih belum ter­eksplorasi dengan baik. Terutama dari sisi apakah CTA menunjukkan presisi yang overestimate atau underestimate. Tujuan: Penelitian ini dilakukan untuk menganalisis presisi CTA terhadap ICA dalam mendeteksi lesi stenosis pada pembuluh koroner. Metode Penelitian: Terdapat 195 pasien yang diperiksa menggunakan CTA dan ICA sejak Oktober 2014 hingga Desember 2015 di RS Jan­tung dan Pembuluh Darah Harapan Kita, Jakarta. Analisis kuantitatif CTA dilakukan oleh tim kardiolog pencitraan kardiovaskular. Klasifikasi derajat stenosis ditentukan secara visual menggunakan pedoman dari Society of Cardiovascular Computed Tomography (SCCT) 2014. Analisis kuantitatif lesi stenosis dari pemeriksaan ICA diklasifikasikan menggunakan pedoman yang sama sehingga keduanya dapat diperbandingkan. Data hasil perbandingan kedua modalitas diklasifikasikan sebagai concordance, overestimate dan underestimate. Hasil Penelitian: Lesi stenosis ditemukan pada 573 pembuluh koroner. Pembuluh koroner yang berbeda secara signifikan berhubungan dengan perbandingan klasifikasi analisis semi-kuantitatif CTA dan ICA. Pembuluh koroner LM terutama menunjukkan lesi dengan kategori overestimate (75.9%). Sementara analisis stenosis pada pembuluh koroner lainnya tidak menunjukkan perbedaan yang mencolok (p < 0,001). Sensitivitas, spesifisitas, PPV, dan NPV CTA dalam mendeteksi lesi koroner obstruktif (stenosis ≥50%) terhadap ICA adalah sebesar 81.4%, 80.4%, 73.9%, dan 86.3% (780 pembuluh kroner). Kesimpulan: Analisis stenosis semi-kuantitatif pada LM terutama adalah overestimate berdasarkan pemeriksaan CTA. Presisi analisis perband­ingan derajat stenosis CT angiografi pada setiap pembuluh koroner tidak sama.
The Pulse Wave Velocity is Linearly Correlated with Resting Systolic and Diastolic Blood Pressure in Hypertensive Patients Elka, Kana; Rotty, Monique; Winata, Johan; Pangemanan, Janry; Panda, A. Lucia
Indonesian Journal of Cardiology Vol 39 No 1 (2018): January - March 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.30701/ijc.v39i1.791

Abstract

Introduction: Aortic stiffness is an independent predictor for cardiovascular event. If arteries lose their natural elasticity, systolic blood pressure become higher and dia­stolic blood pressure become lower. Method of evaluating arterial stiffness is aortic pulse wave velocity (PWV). Therefore, PWV has a potential application for screening vascular damage in large population.2 Recent reports have shown that PWV obtained by noninvasive automatic devices (i.e. tonometry, cuff pressure) is not only a marker of vascular damages, but also a prognostic predictor in patients with hypertension.3 The aim of this study is to investigate the correlation between PWV and systolic and diastolic blood pressure. Methods : Male hypertensive patients, aged 40-60 years old who underwent Doppler Vascular were included in this study. The measurement of carotid-femoral PWV is made by dividing the distance (from the carotid point to the femoral point) by the so-called transit time (the time of travel of the foot of the wave over the distance). Hence, PWV = D (meters)/Dt (seconds). The correlation between PWV and systolic and diastolic blood pressure were analysed using linear regression test. Results : A total 40 patients were included in this study. Those were significant correla­tion between PWV and systolic (R=0.473, p=0.002) and diastolic (R=0.454, p=0.003) blood pressure. Conclusion : increasing PWV is linearly associated with systolic and diastolic blood pressure.   Abstrak Pendahuluan: Kekakuan aorta adalah prediktor independen untuk kejadian kardiovaskular. Jika elastisitas alami arteri hilang, tekanan darah sistolik menjadi lebih tinggi dan tekanan darah diastolik menjadi lebih rendah. Metode evaluasi kekakuan arteri adalah kecepatan gelombang pulsasi (pulse wave velocity/PWV). Oleh karena itu, PWV dapat diterapkan untuk skrining kerusakan vaskular pada populasi besar.2 Laporan terbaru menunjukkan bahwa PWV yang diperoleh dengan perangkat otomatis non-invasif (yaitu tonometri, tekanan manset) tidak hanya merupakan penanda kerusakan vaskular, tetapi juga prediktor prognostik pada pasien dengan hipertensi.3 Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara PWV dan tekanan darah sistolik dan diastolik. Metode: Pasien pria dengan hipertensi, berusia 40-60 tahun yang menjalani Doppler Vascular dimasukkan dalam penelitian ini. Pengukuran PWV karotid-femoralis dilakukan dengan membagi jarak (dari titik karotid ke titik femoral) dengan waktu transit. Oleh karena itu, PWV = D (meter) / Dt (detik). Korelasi antara tekanan darah PWV dan sistolik dan diastolik dianalisis dengan menggunakan uji regresi linier. Hasil: Sebanyak 40 pasien dimasukkan dalam penelitian ini. Itu adalah korelasi yang signifikan antara tekanan darah PWV dan sistolik (R = 0,473, p = 0,002) dan diastolik (R = 0,454, p = 0,003). Kesimpulan: Peningkatan PWV berhubungan linear dengan tekanan darah sistolik dan diastolik.
E-Point Septal Separation as a Surrogate Marker for Global Longitudinal Strain in Predicting MACE after ST Elevation Myocardial Infarction Sarahazti, Mustika Fadhilah; Hasan, Harris; Ketaren, Andre Pasha
Indonesian Journal of Cardiology Vol 39 No 1 (2018): January - March 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.30701/ijc.v39i1.792

Abstract

Background: Global Longitudinal Strain (GLS) is a sensitive measurement and has been studied as a parameter to assess myocardial deformity and had a prognostic value in STEMI patient, but this measurement is usually taken at echocardiography laboratory with software installed only, a simple parameter of systolic function that had been known is EPSS, the aim of this study is to determine the prognostic value of this simple parameter as a surrogate marker of myocardial deformity for mayor adverse cardiac event (MACE). Methods: This is an analytic observational study using ambispective cohort study, basic and echocardiographic data were collected from 66 adult subjects of acute STEMI from July 2016 until April 2017. Each subjects were followed-up for MACE (mortality, heart failure, ventricular arrhytmia and cardiogenic shock) 30 days since admission. Cut off point were taken from ROC curve. Statistical analysis test were used to examine the association between two variables and obtained odds ratio (OR) for EPSS. To obtain the degree of relationship between EPSS and GLS we were using corelation test with the value of p<0.05 was considered statistically significant. Result: In this study the optimum cut off value for EPSS was 7 mm with sensitivity and specificity of 72% and 71%, respectively. Bivariate analysis showed among EPSS >7 mm and GLS >-10,6% were associated with MACE in 30 days after STEMI. In multivariate analysis, GLS >-10,6% (OR 10,6 95%IK 2,5-44,7 p=0,001) and EPSS >7 mm (OR 5, 95%IK 1,12-22,56 p=0,035) remained significantly associated and had 83% probability for MACE in 30-days after STEMI. Using the corelation test we found that EPSS had a stronger relationship with GLS (r=0,795, p<0,001). Conclusion: Our data show that EPSS >7 mm had a strong relationship with myocardial deformity parameter and appears to be a strong predictor for MACE in 30-days after acute STEMI. Therefore, it can be taken earlier to help the cardiologist in emergency unit for futher appropriate management planning.   Abstrak Latar Belakang: Global Longitudinal Strain (GLS) adalah parameter deformitas miokardium yang telah banyak diteliti untuk menilai fungsi sistolik ventrikel kiri serta kaitannya terhadap prognosis pasien IMA-EST, sayangnya pemeriksaannya cenderung terbatas dilakukan di laboratu­rium ekokardiografi dengan alat ekokardiografi tertentu. Parameter fungsi sistolik lainnya yang cukup dikenal karena tekniknya yang sederhana dan dapat dilakukan di Unit Gawat Darurat adalah E-Point Septal Separation (EPSS), tujuan dari penelitian ini adalah melihat nilai prognosis EPSS sebagai indikator tidak langsung deformitas ventrikel kiri terdahap Kejadian Kardiovaskular Mayor (KKvM). Metode: Penelitian ini merupakan studi kohort ambispektif, 66 orang subjek IMAEST yang memenuhi kriteria inklusi dan eksklusi yang dirawat di Rumah Sakit Haji Adam Malik mulai Juli 2016 sampai April 2017 diambil data dasar dan ekokardiografinya, kemudian pasien diikuti selama 30 hari untuk KKvM (kematian, gagal jantung, aritmia ventrikel dan syok kardiogenik). Nilai titik potong EPSS diambil dari kurva ROC. Uji statistik dilakukan untuk menilai hubungan antara variabel untuk mendapatkan nilai rasio odds (RO) EPSS, uji korelasi digunakan untuk menilai kekuatan hubungan antara EPSS dengan GLS, p<0,05 dianggap bermakna. Hasil: Nilai titik potong EPSS yang didapatkan adalah 7 mm dengan sensitivitas 72%, spesifisitas 71%. Analisis bivariat menunjukkan nilai EPSS >7 mm dan GLS >-10,6% berhubungan dengan KKvM. Pada analisis multivariat, GLS >-10,6% (RO 10,6 95%IK 2,5-44,7 p=0,001) dan EPSS >7 mm (RO 5, 95%IK 1,12-22,56 p=0,035) secara signifikan tetap berhubungan dan memiliki probabilitas sebesar 83% dalam memprediksi KKvM 30 hari setelah IMAEST. Adapun nilai EPSS dan nilai GLS memiliki hubungan yang kuat (r=0,795, p<0,001). Kesimpulan: Data menunjukkan bahwa nilai EPSS >7 mm memiliki hubungan yang kuat dengan parameter deformitas ventrikel kiri dan suatu prediktor kuat pula terhadap KKvM dalam 30 hari setelah IMAEST. Hal ini menguntungkan kita sebagai klinisi karena dengan pemer­iksaan EPSS yang sederhana ini dapat menjadi indikator adanya deformitas miokardium ventrikel kiri yang bernilai prognosis sehingga dapat dilakukan lebih dini untuk dapat menentukan strategi tatalaksana pada pasien IMAEST.
Acute Pericarditis in Patient with Systemic Lupus Erythematosus: A Case Report Ratri, Anudya Kartika; Alsagaff, Mochamad Yusuf; Asmarawati, Tri Pudy
Indonesian Journal of Cardiology Vol 39 No 1 (2018): January - March 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.30701/ijc.v39i1.793

Abstract

Acute pericarditis is a common disorder caused by inflammation of the pericardium and can occur as an isolated entity or as a manifestation of an underlying systemic disease. The diagnosis of acute pericarditis is established when a patient has at least two of the following symptoms or signs: chest pain consistent with pericarditis, pericardial friction rub, typical ECG changes, or a pericardial effusion of more than trivial size. Systemic Lupus Erythematosus (SLE) is a chronic autoimmune systemic disorder with unknown etio-pathogenesis. Upon the susceptible genetic, hormonal and abnormal immunologic background, the environmental factors may play role as trigger to permit disease development. Cardiovascular complications occur in more than half of the patients with SLE. Pericarditis is the most studied cardiovascular manifestation, although often not evident clinically, and it is included in the American College of Rheumatology (ACR) classification criteria for SLE. We report a clinical case of initially unremarkably findings which progressed to SLE complicated by full-blown acute pericarditis. A brief review of acute pericarditis, including etiology, clinical presentation, ECG criteria, echocardiographic manifestation, and treatment is presented.   Abstrak Perikarditis akut adalah penyakit yang disebabkan oleh inflamasi dari perikard, dapat terjadi sebagai entitas penyakit primer maupun sekunder sebagai manifestasi dari penyakit sistemik yang mendasarinya. Diagnosis perikarditis akut ditegakkan saat pasien mengalami setidaknya dua dari tanda atau gejala berikut: nyeri dada spesifik perikarditis, pericardial friction rub, perubahan EKG tipikal, atau adanya efusi perikard dengan ukuran lebih dari trivial. Lupus Eritematosus Sistemik (LES) adalah penyakit autoimun sistemik kronis dengan etiopatogenesis yang belum diketahui. Adanya kepekaan genetik, latar belakang imunologis abnormal dan hormonal, serta faktor lingkungan memegang peran sebagai pemicu perkembangan penyakit. Komplikasi kardiovaskular terjadi pada lebih dari setengah pasien dengan SLE. Perikarditis merupakan manifestasi kardiovaskular yang paling sering dijumpai, meskipun jarang ditemukan patognomonis secara klinis, dan termasuk dalam kriteria klasifikasi LES menurut American College of Rheumatology (ACR). Berikut kami laporkan kasus dengan presentasi klinis febris dan takikardia yang kemudian mengarah pada LES dengan komplikasi perikarditis akut. Kami sertakan juga ulasan tentang perikarditis akut, termasuk etiologi, presentasi klinis, kriteria EKG, manifestasi ekokardiografis, dan terapi.

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