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ACI (Acta Cardiologia Indonesiana)

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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.

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Articles 169 Documents

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Moderated Research Presentation Moderated Research Presentation
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (S) (2019): Supplements Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Moderated Poster for Research Presentation

Poster Presentation Poster Presentation
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (S) (2019): Supplements Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Abstracts of Poster Presentation

Relationship of P Terminal Force V1 on Electrocardiogram with Left Atrial Function in Chronic Kidney Failure Patients on Hemodialysis Kartika Apshanti; Putrika Prastuti Ratna Gharini; Hasanah Mumpuni
ACI (Acta Cardiologia Indonesiana) Vol 5, No 2 (2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Background: Chronic kidney failure is a worldwide public health problem.Cardiovascular disease is a common complication and the main cause of mortality in this population.Impaired left atrial function is an early marker of cardiovascular involvement and a prognostic factor that correlated with mortality in chronic kidney disease patients. We aimto investigate the relationship between P terminal force V1 (PTFV1), an ECG parameter, with left atrial function in chronic kidney failure patients on hemodialysis.Method: This cross sectional study was done in chronic kidney failure patients on hemodialysis in Dr. Sardjito General Hospital Jogjakarta. Electrocardiogram and echocardiography were done after hemodialysis procedure. P terminal force V1 was measured by multiplying amplitude and duration of negative deflection of terminal P wave in V1. Abnormal PTFV1 was defined as PTFV1 value ≥ 40 mm.msec. Left atrial function was measured using left atrial peak global longitudinal strain (LA PGLS).Results: This study was done in 71 patients with mean age 50 years old. Forty three subjects (61%) were men. Sixty four subjects (90%) had hypertension. Forty four subjects (62%) had abnormal PTFV1 on ECG. Mean LA PGLS was 24.89 ± 8.23%. No significant correlation was found between PTFV1 value with LA PGLS (r= -0.178; p=0.138). By multivariate analysis, left ventricular ejection fraction, left atrial diameter and hemodialysis duration (in months) were variables that independently correlated with LA PGLS. In subanalysis, amplitude of negative deflection of terminal P wave in V1 was significantly correlated with LA PGLS(r= -0.257, p= 0.031).Conclusions: This study reveals no correlation between P terminal force V1 and left atrial function in chronic kidney failure patients on routine hemodialysis. There is significant correlation between amplitude of negative deflection of terminal P wave in V1 with LA PGLS.

Hemoglobin Variability as Risk Factor of Left Ventricle Dilation in Chronic Kidney Disease Patient on Routine Hemodialysis Iqbal Maulana; Hasanah Mumpuni; Irsad Andi Arso
ACI (Acta Cardiologia Indonesiana) Vol 5, No 2 (2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Background: Several patients with chronic kidney disease (CKD) undergoing routine hemodialysis (HD) have abnormalities of left ventricle (LV) morphology with feature LV dilation due to volume overload and chronic ischemia, which has high risk of mayor adverse cardiovascular event. Anemia causes LV dilation through high output state mechanism. Anemia management in CKD patients causes hemoglobin (Hb) fluctuations or hemoglobin variability (Hb-Var) which is thought to cause LV dilation through relative repetitive ischemia mechanisms. Research linking Hb-Var as risk factor for LV dilation has never been done.Method: Matched case-control study was carried out by taking echocardiographic data of CKD patients undergoing routine HD in HD Unit Dr. Sardjito hospital. The LV diameter is divided into samples with LV (+) dilated profile as a case group, and LV (-) dilated as a control group. Matching was done on variables of age, gender and HD frequency. The HbVar parameter was calculated by the residual SD method based on the Hb value in the last 6 months. Fisher-Exact hypothesis test was used to assess the relationship between Hb-Var and LV dilation, while the logistic regression test was used for multivariate testing.Result: Total of 79 subjects entered in this study, there were 23 subjects of case groups and 28 subjects of control group after matching and adjusting the control formula. The proportion of high Hb-Var in the group with dilated LV (+) and dilated LV (-) were 21.7% and 17.9%, respectively. The Fisher-Exact test shows that there is no relationship between HbVar and LV dilation, with OR 1.28 (95% CI 0.32-5.10). Logistic regression test shows that there are no variables that affect independently of LV dilation.Summary: CKD patients undergoing routine HD with high Hb-Var profiles do not have a higher risk of LV dilation than patients with low Hb-Var profiles.

Correlation between HbA1c Levels with Carotid Intima Media Thickness in Newly Diagnosed Type 2 Diabetes Mellitus Patients Reza Pramayudha; Chaerul Achmad; Erwinanto Erwinanto; Januar W. Martha; M.Rizki Akbar
ACI (Acta Cardiologia Indonesiana) Vol 5, No 2 (2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Background: Type 2 diabetes mellitus (T2DM) is the most common chronic disease in the world. Macrovascular complications such as cardiovascular and cerebrovascular diseases can be detected early, one of them by using an ultrasound examination to assess carotid intima-media thickness (CIMT). HbA1c examination had a strong predictive value for the occurrence of T2DM complications. HbA1c levels are associated with CIMT in the non-DM group. In the T2DM group there was an increase in CIMT compared to the non DM group. HbA1c levels can be used as a predictor of the progression of CIMT improvement in the T2DM group, but there is no study on populations with newly diagnosed T2DM.Aims: This study was conducted to find out the correlation between HbA1c in newly diagnosed T2DM and CIMT.Methods: This was a cross-sectional study with correlation analysis carried out on newly diagnosed T2DM in four Primary Health Centers in the city of Bandung who were randomly selected from July to August 2018. HbA1c measurement was carried out at Dr. Hasan Sadikin hospital. The CIMT examination was done according to the Manheim Consensus by a cardiologist. Pearson correlation analysis was performed to assess the relationship between those two variables.Results: This study involved 32 subjects with a median age of 52 (40 - 60) years. The mean value of CIMT was 0.77±0.22 mm, while the median value of HbA1c was 6.7 (5.2- 12.3). Bivariate analysis showed a moderate positive correlation between HbA1c and CIMT in newly diagnosed patients with T2DM. (r= 0.567, p<0.001).Conclusion: There was a significant positive correlation between HbA1c in newly diagnosed T2DM and CIMT.

Relationship between Carotid Intima-Media Thickness and Left Ventricular Hypertrophy Yusrina Saragih; Harris Hasan; Zainal Safri; Zulfikri Mukhtar; Refli Hasan; Nizam Akbar
ACI (Acta Cardiologia Indonesiana) Vol 5, No 2 (2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Background: Hypertension is a 50% cause of cardiovascular disease and stroke, 40% of cause of death in Diabetics, and is a major risk of kidney failure, pregnancy and dementia. Left ventricular hypertrophy (LVH) is a preclinical manifestation of cardiovascular disease and a strong predictor of cardiovascular morbidity and mortality. Examination of carotid intima-media thickness (CIMT) is one method that can be used to Evaluate the occurrence of coronary heart disease and in Several studies reported that CIMT is also associated with left ventricular function and hypertrophyMethods: This cross-sectional study conducted on hypertensive patients in the outpatient unit in Cardiac Center Haji Adam Malik General Hospital since March 2018-August 2018. Examination of Carotid B-Mode ultrasound was conducted to obtain CIMT values. LVH is assessed by left ventricle mass index (LVMI) as measured by M-mode method using the Cube formulas from echocardiography. Then the analysis is done using the Spearman correlation test to see the relationship between CIMT and LVHResults: The CIMT >0.5 mm have a positive correlation with LVM (r = 0.594, p <0.001), LVMI (r = 0.618, p <0.001), RWT (r = 0.364, p <0.001), and LVH (r = 0484, p <0.001). The CIMT >0.5 mm has a sensitivity of 83.6%, specificity 90.4%, PPV NPV 76% and 93.8%. The CIMT value of 0:55 mm is considered to be the optimal value in diagnosing LVH in hypertensive patients in our subjects based on the ROC curve with a sensitivity of 83.6% and specificity of 90.5%, and area under the curve of 0.9.Conclusion: There is a positive correlation between carotid intima-media thickness and left ventricular hypertrophy in hypertensive patients

Comparison of TIMI Flow in STEMI Patients With and Without Resolution on Reciprocal ST Segment Depression Obtaining Fibrinolytic Alteplase Therapy Aldino Satria Adhitya; Harris Hasan; Refli Hasan; A. Afif Siregar; Zulfikri Mukhtar; Ali Nafiah Nasution
ACI (Acta Cardiologia Indonesiana) Vol 5, No 2 (2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Background: STEMI patients need revascularization to improve blood flow and myocardial reperfusion. Further information can be obtained from the ECG including infarct size and prognosis of STEMI patients. ST segment depression (STSD) in reciprocal leads isassociated with poorer prognosis. STEMI patients with STSD resolution have a better TIMI flow compared with no STSD resolution. The aim of this study was to look for TIMI flow for STEMI subjects who received fibrinolytic therapy with and without resolution of STSD shortly after fibrinolytic.Methods: This study is a prospective cohort study, in which 60 STEMI subjects, patients performed coronary angiography diagnostics to assess TIMI flow. The resolution on reciprocal STSD is defined as a decrease of 50% in the amount of reciprocal STSD in 90- minute after fibrinolytic therapy started.Results: Bivariate analysis showed that ejection fraction <40% with p = <0.001; QRS duration, p = <0.001; anterior STEMI with p = <0.001; are significant factors for STSD resolution. QRS Fragmentation with p = <0.001; STSD resolution with p = <0.001; ST elevation resolution with p = <0.001; are significant factors for TIMI Flow. In the TIMI Flow comparison with reciprocal STSD resolution; the resolution of reciprocal STSD has a better TIMI flow with OR 28 [(5.5-141.9), p = <0.001].Conclusion: There were differences in TIMI Flow in STEMI patients with reciprocal STSD resolution and without reciprocal STSD resolution who received fibrinolytic alteplase therapy, where STEMI patients with reciprocal STSD resolution had a better TIMI Flow compared with STEMI patients without reciprocal STSD resolution.

Correlation between High-Sensitive C-Reactive Protein and HighSensitive Troponin I with 6-Minute Walk Distance in Acute Myocardial Infarction Putri Septiani; Heru Sulastomo; Niniek Purwaningtyas
ACI (Acta Cardiologia Indonesiana) Vol 5, No 2 (2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Background: Biomarker has a role in diagnosis and risk stratification of ischemic heart disease patients. Troponin has become the reference biomarker for acute myocardial infarction (AMI). However, some other biomarkers have benefit on prognostic value, such as C-Reactive Protein (CRP). Six-minute walk test (6MWT) could be performed to assess functional capacity in patients with heart disease.Aim: To assess the correlation between hsCRP and hsTroponin I with 6-minute walk distance (6MWD) in AMI patients.Method: This is an observational analytic study with prospective cohort design, conducted in August-September 2018. The subjects were AMI patients at Dr. Moewardi district general hospital, Surakarta. The hsCRP and hsTroponin I sampling was carried out on admission. 6MWT was performed before discharge. Statistical analysis was performed to assess the correlation. Then the ROC curve was used to determine the cut-off point, sensitivity and specificity.Result: 6MWD of 40 subjects was divided into 2 groups based on the mean distance (<378 m and ≥378 m). There was a significant negative correlation between hsCRP and 6MWD (r =-0.475, p =0.002), but no significant correlation between hsTroponin I and 6MWD (r =-0.048, p = 0.244). However, hsCRP together with hsTroponin I have a significant correlation with 6MWD (r =0.491, p =0.006). Using the ROC curve, obtained AUC of 0.725 and a cut-off point of 0.555 mg/l, as well as a sensitivity of 69.6% and specificity of 88.2%Conclusion: There was a significant negative relationship between hsCRP and 6MWD, but no significant relationship between hsTroponin I with 6MWD.HsCRP together with hsTroponin I have a significant correlation with 6MWD in AMI

The BMPR2, ALK1 and ENG Genes Mutation in Congenital Heart DiseaseAssociated Pulmonary Artery Hypertension Anggoro Budi Hartopo; Dyah Wulan Anggrahini; Noriaki Emoto; Lucia Kris Dinarti
ACI (Acta Cardiologia Indonesiana) Vol 5, No 2 (2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

The gene mutation is one of the background underlie the pathogenesis of pulmonary artery hypertension (PAH). Several genes have been recognized to be responsible for the development of PAH. The mutation in transforming growth factor-β (TGF-β) pathway is considered to be major genotype background in heritable PAH. The genetic mutation in bone morphogenetic protein receptor-2 (BMPR2), activin receptor-like kinase 1 (ALK-1) and endoglin (ENG) are known to cause heritable PAH. In congenital heart disease–associated PAH (CHDAPAH), their mutation are also presence.

Non-ST-Elevation Acute Myocardial Infarction and Sustained Slow Ventricular Tachycardia due to Coronary Slow Flow Phenomenon: a Case Report Baiq Gerisa Rahmi Faharani; Anggoro Budi Hartopo; Nahar Taufiq
ACI (Acta Cardiologia Indonesiana) Vol 5, No 2 (2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Coronary slow flow is a phenomenon that is found in coronary angiography.It is a rare case and identified by the corrected TIMI frame count. The presence of a slow flow in the coronary arteries is associated with life-threatening arrhythmias, sudden death, andacute coronary syndrome. We aim to report a coronary slow flow phenomenon present with non-ST-elevation acute myocardial infarction and sustained slow ventricular tachycardia in 66-year-old male patient. Brief heparinisation and continued by oral acetosal, ticagrelor, bisoprolol and atorvastatin therapy successfully diminish the symptom.

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