ACI (Acta Cardiologia Indonesiana)
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.
Articles
169 Documents
<![CDATA[Correlation between Tp-Te Interval and Myocardial Blush Grade Value in Anterior ST Elevation Myocardial Infarction Patient ]]>
<![CDATA[Rio Probo Kaneko]]>;
<![CDATA[Erika Maharani]]>;
<![CDATA[Nahar Taufiq]]>
<![CDATA[ ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018) ]]>
Publisher : <![CDATA[Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada ]]>
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DOI: 10.22146/aci.40849
<![CDATA[Background: Clinical manifestations of coronary herat disease (CHD) may be an ST-Elevation Myocardial Infarction (STEMI). In STEMI condition, there is a metabolic disorder and ion exchange disturbance which causes dispersion of transmural repolarization, as well as micro coronary circulation disturbance involving mechanism of microvascular dysfunction. The Tp-Te interval is an electrocardiogram paramener that could be described as the transmural dispersion of repolarization. Assessment of Myocardial Blush Grade (MBG) is a coronary angiography densitometry method that can be used to assess microvascular dysfunction. This study aims to examine the correlation between Tp-Te interval and MBG in anterior STEMI.Methods: The research desgin is cross sectional. Data were taken consecutive from August to November 2017. The Tp-Te interval assessment was performed on the basis of an electrocardiogram record from the subjects. The MBG value assessment was performed using a Quantitative Blush Evaluator (QuBE) computer program based on coronary angiography. The Tp-Te interval is divided into 2 groups: Tp-Te interval > 94 ms and Tp-Te interval ≤ 94 ms. The MBG values are divided into 3 groups: MBG QuBE 1, MBG QuBE 2 and MBG QuBE 3. The assessment of Tp-Te interval and MBG value was performed by observer in intra-observer which were acknowledged based on Kappa and blindness conformity test results against patient clinical data. Pearson correlation test was used to analyze the correlation between Tp-Te interval and MBG value, while logistic regression test was used for multivariate test.Results: Of the total 32 study subjects, there were 23 subjects with Tp-Te interval >94 ms and 9 subjects with Tp-Te interval ≤94 ms. There was a negative correlationwith moderate strength between the Tp-Te interval and the MBG value in the anterior STEMI patients (r =-0.501, p =0.004). There was a prevalence ratio of 4.304 between Tp-Te interval >94 milliseconds against MBG QuBE 1 (95%CI: 1.264-14.658, p <0.001). Multivariate tests showed Tp-Te intervals consistently as independent risk factors for MBG values in subjects with anterior STEMI.Conclusion: There is a negative correlation with moderate strength between the Tp-Te interval and the MBG value in the anterior STEMI patients.]]>
<![CDATA[Correlation between Triglyceride/HDL Ratio with Severity of Coronary Artery Lesion in Non-Diabetic Stable Angina Pectoris Patients ]]>
<![CDATA[Pramon Aditya Sudjana]]>;
<![CDATA[Chaerul Achmad]]>;
<![CDATA[Achmad Fauzi Yahya]]>;
<![CDATA[Januar W. Martha]]>;
<![CDATA[M. Rizki Akbar]]>
<![CDATA[ ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018) ]]>
Publisher : <![CDATA[Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada ]]>
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DOI: 10.22146/aci.40854
<![CDATA[Background: Triglycerides (TG) as a risk factor for coronary artery disease (CAD) is still a matter of controversy but when used as a single ratio with high density lipoprotein (HDL) the predictive value for CAD is better. The TG/HDL ratio is also associated with the presence of small dense LDL (sdLDL) in the body. SdLDL is a more atherogenic LDL subfraction and has been proven to be associated with CAD progression.Aims: This study aims to find the correlation between the TG/HDL ratio and the degree of coronary lesion severity based on the Gensini score in stable non diabetic angina pectoris patients.Methods: This study was a cross sectional study conducted at Dr. Hasan Sadikin Hospital and Hasna Medika Palimanan Hospital. Subjects were non diabetic stable angina pectoris patients ≥18 years old who underwent elective coronary angiography. Blood collection for TG and HDL examination was performed after coronary angiography. Gensini scoring system was used to assess the severity of coronary lesions. The relationship between the TG/HDL ratio and the Gensini score was analyzed using multiple linear regression tests against confounding variables.Results: This study involved 60 patients with stable angina pectoris with a mean age of 60±8 years. The mean TG/HDL ratio is 2.56 ± 1.04. The average Gensini score was 51 ± 36. The TG/HDL ratio was significantly associated with the Gensini score (R = 0.637; p <0.001). Analysis of confounding variables showed age, hypertension, and metabolic syndrome had a weak correlation with Gensini score (r values of 0.321, 0.270, and 0.333, p <0.05, respectively), while those correlating with TG/HDL ratios were men, hypertension, and metabolic syndrome (r values of 0.290, 0.287, and 0.362, p <0.05, respectively).Conclusion: TG/HDL ratio was significantly positively correlated significantly with the severity of coronary lesions based on Gensini score in non diabetic stable angina pectoris patients.]]>
<![CDATA[3 Dimensional Printing in Cardiology: Innovation for Modern Education and Clinical Implementation ]]>
<![CDATA[Putrika Prastuti Ratna Gharini]]>;
<![CDATA[Herianto Herianto]]>;
<![CDATA[Nur Arfian]]>;
<![CDATA[Ferdinandus Bayu Satria]]>;
<![CDATA[Nur Amin]]>
<![CDATA[ ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018) ]]>
Publisher : <![CDATA[Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada ]]>
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DOI: 10.22146/aci.40855
<![CDATA[Medical uses of three-dimension (3D) printing have advantages for many importances, such as tissue and organ fabrication, creation of prosthetics, and model structural anatomy. Visualization of 3-dimensional structure of heart for the importance of examination, management or education is not fully comprehensive describe toward the complexity of anatomical structure and also toward the illustration of medical procedure. The aim of this study was to identify the potential application of heart’s 3D printing for the enhancement of case understanding for doctor, medical students or residents and also for patient and its family. A normal model of heart is used in this research to stimulate next 3D object in cardiology area.We retrieved data from patients’ CT scan performed in Gadjah Mada University Hospital, Yogyakarta from December 2017 to March 2018. Our focus is on normal heart anatomy. Data from CT scan results are exported into Digital Imaging and Communications format (DICOM), then dimension measurement and threshold segmentation are performed using Mimics Medical 20.0 (Materialise) application. Finally the file must be exported into STL format due to final process to cut the desirable parts using Mesh editing application. After the final model has been done, then it will be printed by fuse deposition method to make a 3D object.The making and implementing 3D printingof heart model has many advantages for medical education especially for the doctor, medical students or residents and also for the patient and its family to be more aware on the condition of the heart. This study may stimulate another trial of using this technique into several heart abnormalities]]>
<![CDATA[Association Between Neutrophil to Lymphocyte Ratio and Left Ventricle Global Longitudinal Strain in Acute Myocardial Infarction ]]>
<![CDATA[Alfa Alfin Nursidiq]]>;
<![CDATA[Niniek Purwaningtyas]]>;
<![CDATA[Trisulo Wasyanto]]>
<![CDATA[ ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018) ]]>
Publisher : <![CDATA[Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada ]]>
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DOI: 10.22146/aci.40852
<![CDATA[Background: High neutrophil to lymphocyte ratio (NLR) is independently associated with lower EF, in hospital complications, and higher mortality rates in acute myocardial infarction (AMI). Global longitudinal strain (GLS) measurement after AMI demonstrated specific benefit compared with LVEF in evaluation of the extent of post MI left ventricular myocardial injury. The aim of this study was to determine the association between NLR and left ventricular GLS in AMI patients.Methods: An analytic observational study was conducted on August-December 2017 to patients who admited to Dr. Moewardi General Hospital which diagnosed STEMI or NSTEMI. Blood examination and transthoracic echocardiography were performed. They were divided into two groups according to GLS measurement result, GLS>-13.8% and GLS≤-13.8%. The cut-off value of NLR to predict GLS>-13.8%was determined by ROC curve analysis. Bivariate and multivariate analysis to assess whether high NLR was associated with GLS>-13.8% were performed.Results: As many as 57 patients were included in this study, 24 patients (mean age 56,21±9,43) in GLS ≤-13.8% group and 33 patients (mean age 56.67±8.24) in GLS >-13.8%. NLR was significantly higher in GLS>-13.8% group 6.06 (5.36-6.86) compare 4.20 (3.49-5.04),in GLS≤-13.8%, p=0.001. The cut-off value of NLR was 4.69. The bivariate analysis showed that NLR>4.69 associated with GLS>-13.8%, OR 2.70 (CI 95% 1.41-5.17, p=0.001). Multivariate analysis shown that higher NLR have more probability to develop GLS>-13.8%, OR 8.53 (CI 95% 2.38-30.60, p<0.001).Conclusion: There is an association between NLR and left ventricular GLS in AMI patients. AMI patients with high NLR are more likely to have worse GLS.]]>
<![CDATA[Pericardial and Pleural Effusion in Patient with Relapse Stage IV Breast Cancer: Same Pathology, Different Etiology? ]]>
<![CDATA[Vienna Rosalinda]]>;
<![CDATA[Anggoro Budi Hartopo]]>;
<![CDATA[Dyah Wulan Anggrahini]]>;
<![CDATA[Bambang Irawan]]>
<![CDATA[ ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018) ]]>
Publisher : <![CDATA[Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada ]]>
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DOI: 10.22146/aci.40856
<![CDATA[Pericardial effusion associated with malignacy has poor prognosis. The prompt identification of etiology is mandatory, such that timely management can be performed and survival can be increased. However, difficulty in etiology determination is commonly encountered. In this case, we report female patient with relapse stage IV breast cancer who develop massive pericardial and bilateral pleural effusion. The similar characteristics were found in both effusion fluids, however the identification of etiology was not similar. Metastatic cells were found in pleural effusion, whereas they were absent in pericardial effusion.]]>
<![CDATA[Addition of Risk Factors of Coronary Heart Disease in Diagnostic Value of Treadmill Score for Detecting Complexity of Coronary Arterial Lesions ]]>
<![CDATA[Mariyetty K.S. Nasution]]>;
<![CDATA[Abdullah A. Siregar]]>;
<![CDATA[Harris Hasan]]>;
<![CDATA[Zulfikri Mukhtar]]>;
<![CDATA[Abdul H. Raynaldo]]>;
<![CDATA[Nizam Akbar]]>
<![CDATA[ ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018) ]]>
Publisher : <![CDATA[Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada ]]>
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DOI: 10.22146/aci.40853
<![CDATA[Background: Coronary heart disease (CHD) is still the leading cause of death in the world. There are various risk factors for atherosclerosis leading to CHD. Duke Treadmill Score (DTS) is known to demonstrate prognostic stratification and has a diagnostic value in predicting the number of coronary arteries involved in patient populations with ischemic heart disease. However, DTS does not describe the role of risk factors for coronary heart disease to the complexity of coronary artery lesions. This study aims to add risk factors for coronary heart disease on DTS to detect the complexity of coronary artery lesions with stable angina pectoris.Methods: This study was a cross-sectional study in stable angina pectoris patient who comes to Haji Adam Malik Hospital Medan from January 2017 until February 2018. Patients who have done treadmill test and coronary angiography, and fulfill inclusion and exclusion criteria are included in the study. ECG examination and recording of risk factors for coronary heart disease were done. DTS assessment was performed based on a treadmill test and Syntax score based on coronary angiography results. Diagnostic tests were performed to assess the sensitivity and specificity of the addition of CHD risk factors to detect the complexity of coronary artery lesions.Results: Of the 76 people with stable angina pectoris, 55 people were found with low SYNTAX and 21 people with high Syntax. DTS is divided into 3 groups: mild (> -10), moderate (-10 to - 13.5), and severe (≤-13.6) based on the cut off of the ROC curve. Risk factors for CHD are divided into 3 groups, mild (≤3 CHD risk factors), moderate (4-6 CHD risk factors), and severe (7 CHD risk factors) based on the cut off of the ROC curve, then assessed the relationship with Syntax which has been divided into 2 groups, low Syntax, and high Syntax. Diagnostic test shows the addition of risk factors of CHD to DTS to detect the complexity of coronary artery lesions have greater sensitivity and specificity than DTS without the addition of risk factors of CHD, 95%, and 89%.Conclusion: The addition of risk factors for coronary heart disease on DTS can detect the complexity of coronary artery lesions.]]>
<![CDATA[Atrial Arrhythmia in Atrial Septal Defect Patient: A Case Report and Review of Literature ]]>
<![CDATA[Indah Paranita]]>;
<![CDATA[Lucia Kris Dinarti]]>;
<![CDATA[Bambang Irawan]]>
<![CDATA[ ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018) ]]>
Publisher : <![CDATA[Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada ]]>
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DOI: 10.22146/aci.40857
<![CDATA[Atrial fibrillation (AF) and atrial flutter are the most common cardiac arrhythmias associated with atrial septal defects (ASD) in adult patients. The incidence could be as high as 52% in patients ages 60 years or more.Patient with congenital heart disease who developed atrial arrhythmias had a >50% increased stroke risk. Nevertheless, studies regarding the pathophysiological mechanism underlying the high incidence of atrial fibrillation in adult patients with ASD remain relatively few. We reported a female 46 years referred to Sardjito hospital with chest discomfort and palpitation. ECG showed atrial flutter, 90 beat per minute, incomplete RBBB, RAD and RVH. Transthoracal echocardiography shown ASD left to right shunt with diameter 1.2 -1.8 cm, LA, RA and RV dilatation, with normal systolic function. From right heart catetherization, the result is ASD High Flow Low Resistance, with pulmonary hypertension (mPAP 44 mmHg).The consequences of left to right shunt across an ASD is RV volume overload and pulmonary overcirculation. Atrial arrhytmia are a common result of long standing right side heart volume and pressure overload. The idea of combining ASD closure and arrhythmia intervention is another approach to consider.]]>
<![CDATA[Significance of Mitral M-Mode Vp (Velocity Propagation) for Estimating Mitral Valve Area and Severity in Mitral Stenosis ]]>
<![CDATA[Bertha Gabriela Napitupulu]]>;
<![CDATA[Harris Hasan]]>
<![CDATA[ ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (2019) ]]>
Publisher : <![CDATA[Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada ]]>
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DOI: 10.22146/aci.44544
<![CDATA[Background: Confirming mitral valve area (MVA) by planimetry is one of the standard procedures for assessing mitral stenosis but MVA were frequently need to be confirmed by other echocardiography parameters that only available in sophisticated centers. Our aim was to evaluate the significance of a simple mitral inflow color M-mode velocity propagation (Vp) for estimating MVA and MS severity.Methods: The best color view of MS jet were taken from apical 4 chamber, the nyquist limit were adjusted for aliasing the central highest velocity, then M-mode were applied to MV to calculate Vp by measuring the slope of the blue jet with the first aliasing velocity. MVA,PHT and mean transmitral gradient were analyzed with Pearson correlation and linear regression. Predictive discrimination value of Vp were analyzed by ROC.Results: Thirty one MS patients had mean MVA planimetry 0.99 ± 0.35 cm2 and mean Vp 64.49 ± 21.63 cm/s. Vp that were found to have a strong negative correlation with MVA (Spearman rho -0.865, p < 0.01). Vp had a good predictive discrimination value as from AUC 0.931. Vp were found to have a moderate correlation with MVA by PHT ( Spearman rho -0.621, p <0.01). Vp more than 55 cm/s had 93.8% sensitivity and 86.7% specificity to distinguish severe MS.Conclusions: By making use of the high temporal resolution of M-mode, a simple color Mitral M-Mode Vp were found statistically significant for estimating MVA severity in MS. Interventional decision for MS could also consider Vp for its strong correlation with MVA on MS, especially for helping on targeting moderate to severe MS in rural and limited centers.]]>
<![CDATA[Mean Platelet Volume as a Predictor of Atherosclerotic Severity in Non ST Elevation Acute Myocardial Infarction ]]>
<![CDATA[Yuli Astuti]]>;
<![CDATA[Budi Yuli Setianto]]>;
<![CDATA[Nahar Taufiq]]>
<![CDATA[ ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (2019) ]]>
Publisher : <![CDATA[Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada ]]>
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DOI: 10.22146/aci.44546
<![CDATA[Background: Acute myocardial infarction (AMI) is the leading cause of death in the world. AMI is classified into ST-elevation myocardial infarction (STEMI) and Non-ST elevation myocardial infarction (NSTEMI). Diagnosis and prediction of severity of atherosclerotic in NSTEMI is a challenge. Despite the risk stratification, 14-20% of patients that undergo coronary angiography have normal or non significant coronary artery disease. The role of platelet and the extent of atherotrombosis in patients with NSTEMI are interesting field of research. Mean platelet volume (MPV) reflects platelet size and reactivity. It can be used as a diagnostic marker and may have predictive value. This study aims to prove the role of MPV as a predictor of the degree of atherosclerotic based on Syntax score in patients with NSTEMI undergoing coronary angiography.Methods: This is a cross sectional study enrolled 86 subjects with NSTEMI. Blood samples were taken at the time of admission to the hospital. An MPV was measured by automated machine. Subsequent coronary angiography was performed using standardized method. Syntax score was determined to reflect the atherosclerotic severity. Statistical analysis was used to assess whether an MPV as a predictor of atherosclerotic severity based on Syntax score.Results: The chi-square analysis showed that high MPV could not be used as a predictor of the atherosclerotic severity based on Syntax score in NSTEMI patients (p value =0.5, prevalence ratio 1.15 (95% CI: 0.755-1.753). From multivariate analysis, only smoking factor had an independent relationship with Syntax score (p value =0.047; Odds ratio 2.531(95% CI: 1.012-6.328).Conclusions: High MPV cannot be used as a predictor of atherosclerotic severity based on Syntax score in NSTEMI patients.]]>
<![CDATA[Functional Capacity Improvement Related to Inflammatory Marker Reduction After Phase II Cardiac Rehabilitation Program in Postrevascularization Coronary Artery Disease Patients ]]>
<![CDATA[Badai B. Tiksnadi]]>;
<![CDATA[Melisa Aziz]]>;
<![CDATA[Manda S. Chesario]]>;
<![CDATA[Mochamad Renaldi]]>;
<![CDATA[Ahmad Triadi]]>;
<![CDATA[Sunaryo B. Sastradimaja]]>;
<![CDATA[Augustine Purnomowati]]>;
<![CDATA[Toni M. Aprami]]>
<![CDATA[ ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (2019) ]]>
Publisher : <![CDATA[Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada ]]>
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DOI: 10.22146/aci.44548
<![CDATA[Background: Improved functional capacity (FC) and inflammatory marker reduction is a good prognostic factor in post-revascularization cardiac patients. However, there is still limited study investigated association of functional capacity and inflammatory marker after cardiac rehabilitation program. We studied the effects of cardiac rehabilitation (CR) program in the improvement of FC and high-sensitive-C Reactive Protein (hs-CRP) reduction and association between those variables.Methods: This was quasi experimental study in post-revascularization CAD patients who attended phase II CR program at CR gymnasium, Dr. Hasan Sadikin General Hospital, Bandung, from October 2014 to May 2015. The CR program included additional education sessions and consistently strict program intensity on 50-80% heart rate reserve based on formula and Borg scale 11 to 15. Functional capacity and hsCRP were measured before and after the program. Functional capacity was assessed by maximal treadmill test through indirect VO2 max measurement.Results: A total of 37 patients aged 56.05±7.3 years old were analyzed in this study. They consisted mainly of men (81.1%) which 78.4% of them underwent percutaneous coronary intervention (PCI). Our study revealed significant FC improvement after completion of this newly-modified CR program from an average of 6.76 to 8.68 METs (28.4%) ( p<0.001). Hs-CRP reduction was also occurred from mean of 0.49 mg/L to 0.20 mg/L (59.2%) of log hs-CRP level (p= 0.005). Linear regression analysis showed the improvement of fitness was associated with baseline FC (p<0.001) and reduction of hs-CRP was associated with baseline hs-CRP (p<0.001), and not influenced by age, gender, ejection fraction and type of procedure. There is moderate correlation (rs= 0.636, p<0.001) between functional capacity improvement and hs-CRP reduction. Each 1 METs improvement can reduce 9.317 mg/L of transformed hs-CRP level (p=0.006, 95%CI 2.942,15.693).Conclusions: CR program significantly increased functional capacity and reduce hsCRP level in post-revascularization CAD patient, and more prominent in a patient with low baseline functional capacity and high hs-CRP level. Functional capacity improvement and hs-CRP reduction were moderately correlated.]]>
