Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang: Angka morbiditas dan mortalitas meningkat pada pasien fibrilasi atrium (FA) yang mengalami gagal jantung akut. Pada pasien irama sinus, left atrial volume index (LAVI) dan heart rate variability (HRV) merupakan prediktor kuat terjadinya komplikasi kardiovaskular. Penelitian LAVI dan HRV pada pasien FA hingga saat ini belum konklusif.Tujuan: Mengetahui hubungan LAVI dan HRV dengan kejadian gagal jantung akut pada pasien FAMetode: Studi kohort retrospektif dengan populasi terjangkau pasien dewasa FA di Rumah Sakit dr. Cipto Mangunkusumo (RSCM) 1 Januari 2020 hingga 31 Desember 2021 yang berasal dari registri Optimal INR measures for Indonesians (OPTIMA). Data sekunder LAVI diukur dengan ekokardiografi dan parameter HRV terdiri dari standar deviation of NN intervals (SDNN), root mean square of successive differences (RMSSD), rasio low frequency dan high frequency (LF/HF) diukur menggunakan alat HRV portabel. Pasien diikuti hingga 30 Januari 2023, luaran dinilai dengan melihat catatan medik atau melalui telepon.Hasil: Dilakukan analisis pada 144 sampel. Proporsi kejadian gagal jantung akut sebesar 15,3%. Tidak terdapat hubungan antara SDNN dengan kejadian gagal jantung akut (RR 1,75; IK95% 0,260 – 11,779, p=0,565). Tidak terdapat hubungan antara LF/HF dengan kejadian gagal jantung akut (RR 2,865; IK 95% 0,765 – 10,732, p=0,118). Terdapat hubungan antara LAVI dengan kejadian gagal jantung akut (adjusted RR 2,501; IK 95% 1,003 – 6,236, p=0,049). Diabetes melitus dan hipertensi merupakan faktor perancu pada penelitian ini.Kesimpulan: Peningkatan LAVI berhubungan dengan kejadian gagal jantung akut pada pasien FA. HRV tidak berhubungan dengan kejadian gagal jantung akut pada pasien FA.

---

Background Morbidity and mortality rates increase in patients with atrial fibrillation (AF) who experience acute heart failure. In patients with sinus rhythm, left atrial volume index (LAVI) and heart rate variability (HRV) are strong predictors of cardiovascular complications. Research on LAVI and HRV in AF patients has so far not been conclusive.

Objectives: To determine the relationship between LAVI and HRV and the incidence of acute heart failure in AF patients.

Methods: A retrospective cohort study was conducted with an accessible population of adult AF patients at RSCM from January 1, 2020, to December 31, 2021, originating from the Optimal measures INR for Indonesians (OPTIMA) registry. LAVI was measured by echocardiography, and HRV parameters consist of the standard deviation of NN intervals (SDNN), the root mean square of successive differences (RMSSD), and the ratio of low frequency and high frequency (LF/HF) measured using a portable ECG device. Patients were followed until January 30, 2023, and outcomes were assessed by looking at medical records or by telephone.

Result: A total of 144 subjects were analysed. The proportion of acute heart failure is 15.3%. There was no relationship between SDNN and the incidence of acute heart failure (RR 1.75; 95% CI 0.260–11.779, p=0.565). There was no relationship between LF/HF and the incidence of acute heart failure (RR 2.865; 95% CI 0.765–10.732, p=0.118). There is a relationship between LAVI and the incidence of acute heart failure (adjusted RR 2.501; 95% CI 1.003–6.236, p = 0.049). DM and hypertension were confounding factors in this study.

Conclusion: The elevation of LAVI is associated with the incidence of acute heart failure in AF patients. HRV is not associated with the incidence of acute heart failure in AF patients."

"Latar belakang : Pasien gagal jantung kronik memerlukan evaluasi pemeriksaan ekokardiografi. Berbagai metode pemeriksaan digunakan dalam pemeriksaan ekokardiografi, diantaranya pemeriksaan LAEF, LAVI, dan LVEF yang terkait dengan penelitian ini. Metode pemeriksaan LAEF dan LAVI memiliki peran dalam menilai remodelling atrium kiri, sedang LVEF terkait dengan fungsi sistolik ventrikel kiri.Tujuan : Penelitian ini bertujuan menilai korelasi nilai LAEF dan LAVI dengan nilai LVEF pada < 40% dan ≥ 40%.Metode : Studi potong lintang pada 150 pasien gagal jantung kronik yang dilakukan pemeriksaan ekokardiografi trans-torakal di eko-lab PJT RSCM.Pemeriksaan ekokardiografi metode LAEF dengan metode area length (2 dimensi) pada minimal 2 view eko, sedangkan LAVI dengan metode 2 dimensi. Pemeriksaan LVEF dengan metode Simpson.Hasil : Pada penelitian didapatkan 150 subjek dengan nilai median LAVI 30,9mL/m2 (RIK 22,08-40,80), nilai median LVEF 55,75 % (RIK 40,75-61,85), nilai LAEF median 31,8 % (RIK 23,98-38,30). Korelasi nilai LAEF dengan nilai LVEF pada LVEF < 40% dengan hasil korelasi positif sedang bermakna (r = 0,614; p <0,001), pada LVEF ≥ 40% dengan hasil korelasi positif sedang bermakna (r =0,580 ; p < 0,001). Korelasi nilai LAVI dengan nilai LVEF pada LVEF < 40% dengan hasil berkorelasi negatif lemah dan tidak bermakna (r = -0,093; p = 0,722), sedangkan pada LVEF ≥ 40% dengan hasil berkorelasi negatif lemah bermakna (r = -0,299; p < 0,001). Dilakukan sub-analisis pada LVEF 40-50%, didapatkan nilai LAEF dan nilai LVEF berkorelasi positif lemah bermakna (r = 0,492; p <0,001). Lalu sub-analisis pada LVEF ≥ 50%, didapatkan korelasi nilai LAEF dan nilai LVEF positif lemah tidak bermakna (r = 0,205; p = 0,063).Kesimpulan : Terdapat korelasi positif nilai LAEF dengan nilai LVEF pada pasien gagal jantung kronik baik pada HFrEF (LVEF < 40%) dan LVEF ≥ 40%, sehingga nilai LAEF pada cut-off nilai LVEF 40% dapat menjadi salah satu marker menilai proses remodelling atrium kiri. Sedangkan nilai LAVI dengan LVEF pada pasien gagal jantung kronik ditemukan korelasi lemah atau tidak adanya korelasi.

---

Background : Patients with chronic heart failure require echocardiographic evaluation. Various examination methods were used in echocardiographic examinations, including LAEF, LAVI, and LVEF examinations related to this study. LAEF and LAVI examination methods have a role in assessing left atrial remodeling, while LVEF is related to left ventricular systolic function.

Objective : This study aims to assess the correlation between LAEF and LAVI values with LVEF values at LVEF < 40% and LVEF 40%.

Methods : A cross-sectional study of 150 patients with chronic heart failure who underwent transthoracic echocardiography at the RSCM PJT eco-lab. Echocardiographic examination using the LAEF method with the area length method (2 dimensions), in at least 2 eco views, while the LAVI using the 2-dimensional method. LVEF examination by the Simpson method.

Results : The study found 150 subjects with a median LAVI value of 30.9 mL/m2 (IQR 22.08-40.80), a median LVEF value of 55.75% (IQR 40.75-61.85), a median LAEF value of 31 ,8% (IQR 23.98-38.30). The correlation between the LAEF value and the LVEF value at LVEF < 40% has a moderately significant positive correlation (r = 0.614; p < 0.001), while at LVEF ≥ 40% has a moderately significant positive correlation (r = 0.580 ; p < 0.001). The correlation between the LAVI value and the LVEF value at LVEF < 40% has a weak and insignificant negative correlation (r = -0.093; p = 0.722), while at LVEF ≥ 40% has a weak negative significant correlation (r = -0.299; p < 0.001). Sub-analysis was performed on LVEF 40-50%, and the LAEF value and LVEF value were positively and significantly correlated (r = 0.492; p < 0.001). Then the sub-analysis at LVEF > 50%, it was found that the correlation between the LAEF value and LVEF value were weak positive and not significant correlated (r = 0.205; p = 0.063).

Conclusion : There is a positive correlation between LAEF values and LVEF values in chronic heart failure patients both at HFrEF (LVEF < 40%) and LVEF ≥ 40%, so that the LAEF value at the cut-off LVEF 40% can be one of the markers to assess the left atrial remodeling process. While the value of LAVI with LVEF in patients with chronic heart failure found a weak correlation or no correlation."

"ABSTRAKLatar Belakang. Stenosis Mitral (SM) tinggi prevalensinya di negara berkembang karena erat terkaitdengan prevalensi penyakit jantung demam rematik (PJR). Pasien SM sedang-berat terdapatpeningkatan regio turbulensi dan shear stress mengakibatkan kerusakan endotel pembuluh darahsehingga meningkatkan resiko tromboemboli. P-selectin merupakan molekul adhesi berperan dalamproses inflamasi dan sebagai faktor protrombotik yang diekspresikan secara cepat. Indeks volumeatrium kiri (IVAK) merupakan parameter superior untuk mengukur fungsi atrium kiri denganekokardiografi.Metode. Penelitian potong lintang melibatkan 20 pasien SM sedang-berat dengan MVA <1.5 cm2yang menjalani Komisuratomi Mitral Transvena Perkutan (KMTP) yang diambil secara konsekutifpada bulan Mei 2013 sampai Oktober 2013 di Pusat Jantung Nasional Harapan Kita Jakarta. Pasiendiambil sampel darah pra dan pasca KMTP untuk diperiksa kadar P-Selectin. Kemudian hasilnyadianalisa secara statistik.Hasil. Dalam studi ini, tidak didapatkan asosiasi antara IVAK dengan ekspresi kadar P-selectin pradan pasca KMTP. Hal ini ditunjukkan dengan nilai pra KMTP β= -0.103 (95% CI -0.251,0.045)p=0.16 dan pasca KMTP β= 0.009 (95% CI -0.155,0.172) p=0.91. Setelah dilakukan regresilinier dengan penyesuaian (adjusted) terhadap variabel perancu yakni usia, jenis kelamin, dan atrialfibrilasi tetap tidak didapatkan asosiasi antara IVAK dengan kadar P-selectin dengan nilai pra KMTPβ= -0.154 (95% CI -0.340,0.032) p=0.09 dan pasca KMTP β= -0.049 (95% CI -0.250,0.152)p=0.61.Kesimpulan. Tidak ada perbedaan nilai P-selectin pra dan pasca KMTP. Nilai IVAK yang sudahjelek tidak berhubungan dengan kadar P-selectin pra dan pasca KMTP pada pasien SM.

---

ABSTRACTBackground. The prevalence of Mitral stenosis (MS) remains significant in developingcountries related to prevalence of Rheumatic Heart Disease (RHD).In moderate-severe MSpatients enormous increase in turbulent region and shear stress causing dysfunction ofvascular endothelial, as consequence it increase the risk of thromboembolic complication. Pselectinis an adhesion molecule that play role in inflammation process, it express rapidly inminutes. Left Atrial Volume Index (LAVI) is superior parameter compare with otherechocardiography two dimension method to assess left atrial function.Methods. Study was designed as cross-sectional study involving 20 MS moderate-severepatients with MVA< 1.5 cm2 who performed successful Percutaneous transvenous BalloonMitral Valvulotomy (PBMV). Samples were taken consecutively from May 2013 to October2013 at the National Cardiovascular Center Harapan Kita Jakarta. Blood samples of Pselectinwere collected pre and post PBMV. The result was statistically analyzed by usingechocardiography data of LAVI prior PBMV to describe any association between expressionof P-selectin and atrial function.Result. In our study, we found no association between LAVI and expression of P-selectinlevel pre and post PBMV MS patient. This data describe in each of value of pre PBMV β= -0.103 (95% CI -0.251,0.045) p=0.16 and post PBMV β= 0.009 (95% CI -0.155,0.172) p=0.91After we performed linear regression with adjusted confounding variable including sex, age,and atrial fibrillation, still we found no association between LAVI and P-selectin level. Thisdata describe in each of value of pre PBMV β= -0.154 (95% CI -0.340,0.032) p=0.09 andpost PBMV β= -0.049 (95% CI -0.250,0.152) p=0.61.Conclusion. We found there is no difference in P-selectin level pre and post PBMV. There isno association between poor LAVI value and expression of P-selectin pre and post PBMV inMS."