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INDONESIA
ACI (Acta Cardiologia Indonesiana)
Published by Universitas Gadjah Mada
ISSN : 24605700     EISSN : 25794345     DOI : -
Core Subject : Health,
Medicine & Pharmacology
ACI (Acta Cardiologia Indonesiana) is published twice a year (biannually) by the Department of Cardiology and Vascular Medicine Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Arjuna Subject : -
Articles 7 Documents
 1 
Search results for , issue "Vol 3, No 2 (2017)" : 7 Documents clear
Diagnostic Values of P-Wave Dispersion to Detect Diastolic Function in Patient with Hypertension Braghmandaru Adhi Bhaskara; Rano Irmawan; Lucia Kris Dinarti; Hasanah Mumpuni
ACI (Acta Cardiologia Indonesiana) Vol 3, No 2 (2017)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.33574

Abstract

Background: Hypertension is one of the main causes of cardiovascular disease. Patients with hypertension have increase risk of heart failure compared to populations with normal blood pressure. Clinical evidence shows diastolic dysfunction (DD) can lead to heart failure. Diagnostic of DD with echocardiography is important but access to echocardiography machines is limited compared to electrocardiography (ECG). ECG research correlates P-wave dispersion (PWD) with DD. The aim of this study is to determine the value of PWD to diagnose DD in patients with hypertension.Methods: A cross sectional study was conducted in patients with hypertension at Dr. Sardjito Hospital. Patients received echocardiography, ECG, blood pressure measurement and data recording. The diastolic dysfunction was determined based on 2016 ASE/EACVI criteria. We conducted ROC analysis to determine the cut-off point of P-wave dispersion and the area under the curve (AUC) value, and bivariate analysis on demographic and clinical factors related to PWD. Multivariate analysis was performed to determine the independent factors affecting PWD.Results: 113 patients met the criteria of the study subjects, with 47 men (37.2%), mean age 58.32±11.17 years. Thirteen (11.5%) subjects had DD and 37 subjects (32.7%) with increased PWD. Results showed increased PWD above 71.4 m.s with AUC 76.2%, sensitivity 75%, specifcity 72.2%, positive predictive value 33.3%, negative predictive value 96%, and accuracy of 72.5% in diagnosing DD.Conclusion: This is the frst study to examine the diagnostic value of PWD to detect diastolic function based on 2016 ASE/EACVI criteria. We found PWD above cut-off point 71.4 m.s has a moderate diagnostic value for detecting DD in patients with hypertension.
The Past, Present, and Future of Myocardial Revascularization Budi Yuli Setianto
ACI (Acta Cardiologia Indonesiana) Vol 3, No 2 (2017)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.33550

Abstract

One of the important diagnostic modalities in cardiology is cardiac catheterization, which is onetool for myocardial revascularization. This examination is particularly useful in the aspect ofcardiac hemodynamic evaluation, among other utilities. This review describes the advance ofcardiac catheterization from the beginning of its discovery to future development.
Correlation between Carotid Intimal-Media Thickness and Coronary Artery Disease Severity in Stable Coronary Artery Disease Patients Muhammad Haris; Hariadi Hariawan; Muhamad Taufik Ismail; Abdus Samik Wahab
ACI (Acta Cardiologia Indonesiana) Vol 3, No 2 (2017)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.33575

Abstract

Background: Atherosclerosis is a fundamental process in the natural course of coronary heart disease (CHD), carotid artery disease and peripheral artery disease. Atherosclerosis is caused by an imbalance of homeostasis in the level of the endothelial layer and the presence of risk factors. The manifestations of coronary atherosclerosis have a wide spectrum of diseases, ranging from subclinical to clinical phases. In patients without CHD symptoms, changes incarotid artery morphology include carotid intimal-media thickness (CIMT) and carotid plaques which correlated with CHD. This study aims to see the relationship between CIMT with the severity of coronary lesions in stable coronary artery disease.Methods: The study was an analytical observational research using cross sectional design. Data was taken by consecutive sampling from outpatient hospital clinic. The CIMT score was obtained from the examination of a communis carotid artery using a B-mode ultrasound device. The value ofCIMT is divided into 2 groups based on the value of the sensitivity curve and the specifcity curve. The value of Syntax was obtained from the catheterization laboratory and the factors that influenced it were recorded. Pearson correlation test is used to analyze the relationship of CIMT and Syntax value. The logistic regression test used for multivariate test.Results: Of the 58 patients, there were 33 subjects who had a CIMT score of > 0.71 mm and 25 subjects who had a CIMT score of ≤0.71 mm. There is a positive correlation (r = 0.403; p <0.05) between CIMT value and Syntax value. Subjects who have high Syntax value in the group with a CIMT value >0.71 mm compared to CIMT values ≤0.71 mm were 29 versus 4 (RR: 1.831; CI 95%:1.194-2.807; p = 0.01). A multivariate test showed CIMT consistently as a independent risk factor of Syntax value in stable coronary artery disease with RP 5.27 (CI 95%: 1.306-25.047; p = 0.021).Conclusion: The increase in CIMT value has a signifcant positive correlation with the Syntax value. A CIMT > 0.71 mm is a independent risk factor of high Syntax value in stable coronary artery disease with prevalence ratio 5.27
Intracerebral and Subarachnoid Hemorrhage as a Result of Infective Endocarditis: A Case Report Alviani Februana Waluyani Putri; Jagaddhito Probokusumo; Wahyu Widjanarko; Ririn Faujiah
ACI (Acta Cardiologia Indonesiana) Vol 3, No 2 (2017)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.33551

Abstract

Infective endocarditis (IE) may have devastating and life-threatening neurological complications. The incidence of intracranial hemorrhage (e.g. subdural hematoma, subarachnoid hemorrhage (SAH), and intracerebral hemorrhage(ICH)) is rare. A 39 years old male, came to emergency unitwith heart failure clinical features, accompanied with fever for 2 weeks, and apical systolic murmur found in the physical examination. In the second day of admission, the patient experienced a sudden decrease of conciousness, weakness of the right limbs, and slurred speech. CT scan examination showed left parietal lobe ICH with volume ± 20 cc, and SAH in left parietal lobe, basalsystern, to pontine systern. Echocardiography revealed AML flail with severe mitral regurgitation and vegetation in AML. Empirical parenteral antibiotics ceftriaxone and gentamicin were given. In the following day, the conciousness was increasing. Later, the blood culture examination showed growing of Staphylococcus saprophyticus.Intracranial hemorrhage may cause worseningin patient’s condition, and require withdrawal in anticoagulant therapy. Cardiac surgery should be delayed.Despite of its uncommon incidence, physician should be aware of the neurological complication of IE to recognize and do the prompt treatment of the disease.
Atrio-Ventricular Septal Defect in Pregnant Women, How to Deal with It : A Case Study Devie Caroline; Moh. Yogiarto
ACI (Acta Cardiologia Indonesiana) Vol 3, No 2 (2017)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.33576

Abstract

Pregnancy is not always well tolerated in women with congenital heart disease (CHD) such as atrio-ventricular septal defect (AVSD), predominantly due to heart failure deterioration and increasing pulmonary hypertension (PH). Managements of those patients are challenging, especially during third trimester and after delivery care. Decision about time of termination, mode of delivery and anesthetic management are also debatable. In this article we report two similarcases of pregnant women with AVSD and severe PH. The frst patient was 27 years old, 28-29 weeks pregnant came with shortness of breath. She had history of miscarriage once. Based on her transthoracal echocardiography, she was diagnosed with AVSD partial type (primum ASD) with severe PH and then treated with intravenous furosemide, oral beraprost and oral sildenafl. The second patient was 27 years old 30-31 weeks pregnant with shortness of breathand appeared cyanotic. She delivered her frst child spontaneously without any symptoms. Based on her transthoracal echocardiography she was diagnosed with AVSD transitional type (large primum ASD with small inlet VSD) and Eisenmenger syndrome. She was treated with intravenous furosemide and oral beraprost. Those two patients underwent planned C-section under general anesthesia, both babies were survived but the patient did not survived severaldays after the procedure due to PH crisis. Until now, management PH associated with CHD in pregnant women is complex. Fluid management and pulmonary artery hypertension (PAH)- targeted therapies are important. Mode of delivery on this cases is also remain debated. Some studies stated planned C-section might be a better choice and combination epidural and lowdose spinal anesthesia might be better than general anesthesia. At the end, when a woman with CHD and PH chooses to continue pregnancy, multidisciplinary team approach is crucial to achieve good outcomes.
Acute Changes on Pulmonary Pressure Following Percutaneous Closure of Secundum Atrial Septal Defect Jessica Wiryanto; Ingrid M. Pardede; Sunanto Ng
ACI (Acta Cardiologia Indonesiana) Vol 3, No 2 (2017)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.33553

Abstract

Pulmonary hypertension is a common complication of congenital heart disease due to systemic – pulmonary circulation shunt which if left uncorrected leads to increased pulmonary artery pressure, vascular remodeling and further increase of pulmonary vascular resistance. Percutaneous closure of the defect interrupts this shunt thus reducing right heart and pulmonary circulation load and pulmonary artery pressure. In this paper we present two cases of percutaneous secundum atrial septal defect closure complicated by pulmonary hypertension along with echocardiographic evaluation of cardiopulmonary hemodynamic changes before and shortly after device closure. Forty years old and thirty three years old females presented to our clinics with classical symptoms of atrial septal defects, assessment revealed TVG of 37 mmHg and 30 mmHg,shortly after the procedure patient was re-evaluated and revealed TVG of 39 mmHg and 23 mmHg respectively. From these cases we conclude that changes in pulmonary artery pressure is not constantly found after device closure. However both patients display improvements in functional capabilities.
Interval TpTe Diagnostic Value in Diastolic Dysfunction of Patients with Hypertension Rano Irmawan; Braghmandaru Adhi Bhaskara; Hasanah Mumpuni; Nahar Taufiq
ACI (Acta Cardiologia Indonesiana) Vol 3, No 2 (2017)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.33547

Abstract

Introduction: Diastolic dysfunction has been shown to be associated with an increase in mortality rates in both normal and decreased systolic function. In patients with hypertension, there is elongation of transmural repolarization dispersion in left ventricular, which will cause heart diastolic relaxation disorders. The elongation of the transmural repolarization dispersion is indicated by the increase of the TpTe interval. We conducted this study to fnd out whether the TpTe interval had a good diagnostic value in detecting diastolic dysfunction in patients with hypertension.Methods: This is an analytic observational research using cross sectional design on hypertensive patients in whom echocardiography was performed. The study conducted in February 2017 until March 2017 in Dr. Sarjito general hospital Yogyakarta. Electrocardiography examination was taken after the patient was performed echocardiography. The TpTe interval was calculated using the ‘tail’ method at lead V5. Diastolic dysfunction was established using echocardiographywith the ASE / EAE 2016 algorithm.Results: Of the 112 patients met the criteria of the study subjects. The cut-off value for TpTe was 103.97 m.s., based R.O.C curve analysis. TpTe interval ≥ 103.97 m.s. had a moderate diagnostic value for detecting diastolic dysfunction with 73% accuracy, 83% sensitivity, 64% specifcity, 22% positive predictive value, and 97% negative predictive value. There were 66 (58.9%) subjectswith TpTe interval <103.97 m.s. and 46 subjects (41.1%) with TpTe interval ≥103.97 m.s. There were 12 subjects (10.7%) with diastolic dysfunction. Bivariate and multivariate analyzes showed no demographic and clinical factors that independently affected the TpTe interval.Conclusion: The TpTe interval ≥ 103.97 m.s. had a moderate diagnostic value for detecting diastolic dysfunction in patients with hypertension

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