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P-Index
Chaerul Achmad
Department of Cardiology and Vascular Medicine Faculty of Medicine Universitas Padjadjaran
Articles
3
Documents
Ablasi Konvensional Kepak Atrium Atipikal

Jurnal Kardiologi Indonesia Vol.28 No.3 Mei 2007
Publisher : Indonesian Heart Association

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Abstract

Kepak atrium (KA, atrial flutter) merupakan jenisaritmia tersering kedua setelah firbrilasi atrium dalampraktek klinik. KA saat ini dibedakan berdasarkanketerlibatan ismus kavotrikuspid (IKT) dalam sirkuitreentry-nya. Di antara KA yang melibatkan IKT, KAtipikal dan tipikal terbalik merupakan jenis yang palingsering ditemukan. Semua KA yang tidak melibatkanIKT disebut sebagai KA atipikal. Pada KA atipikalsirkuit reentry kepak dapat berada di atrium kananatau kiri

Hubungan antara QT Variability Index dan Laju Filtrasi Glomerulus pada Penyakit Ginjal Kronik Predialisis

Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penderita penyakit ginjal kronik (PGK) mempunyai risiko yang tinggi untuk mengalami aritmia ventrikel dan kematian mendadak (sudden cardiac death/SCD). Angka kejadian SCD pada penderita PGK meningkat seiring dengan menurunnya laju filtrasi glomerulus (glomerular filtration rate/GFR). Mekanisme patofisiologi yang mendasari SCD pada umumnya aritmia ventrikel yang berhubungan dengan ketidakstabilan repolarisasi miokardium. QT variability index (QTVI), suatu indeks yang menggambarkan ketidakstabilan repolarisasi miokardium, merupakan prediktor yang kuat untuk terjadi aritmia fatal dan SCD. Penelitian ini merupakan studi observasi potong lintang untuk menilai hubungan antara QTVI dan GFR pada penderita PGK predialisis dengan GFR <60 mL/menit. Penelitian ini dilakukan pada penderita PGK yang berobat ke Poliklinik Ginjal Hipertensi Rumah Sakit Dr. Hasan Sadikin Bandung periode Oktober–Desember 2011. Penelitian ini melibatkan 51 subjek. Pemeriksaan elektrokardiografi (EKG) istirahat dilakukan pada semua subjek dan selanjutnya dilakukan penghitungan QTVI. Hampir semua subjek menderita hipertensi atau mendapat antihipertensi (94%). Gambaran EKG dengan hipertrofi ventrikel kiri didapatkan pada 37% subjek dan QTVI rata-rata subjek sebesar 0,16 (SD 0,24). Hubungan antara QTVI dan GFR dianalisis menggunakan Spearman’s rank correlation. QT variability index mempunyai hubungan yang bermakna baik dengan GFR (r=-0,816; p<0,001) maupun dengan estimated glomerular filtration rate (eGFR) (r=-0,460; p<0,001). Simpulan, terdapat hubungan sangat kuat antara QTVI dan GFR pada penderita PGK predialisis, makin rendah GFR makin panjang nilai QTVI. [MKB. 2012;44(4):193–98].Kata kunci: Kematian jantung mendadak, laju filtrasi glomerulus, penyakit ginjal kronik, QT variability indexCorrelation between QT Variability Index and Glomerular Filtration Rate in Predialysis Chronic Kidney DiseaseAbstractChronic kidney disease (CKD) patients are at increased risk for ventricular arrhythmia and sudden cardiac death (SCD). The rate of SCD in CKD patients increased as glomerular filtration rate decreased. Sudden cardiac death is generally mediated by ventricular arrhythmias associated with instability of myocardial repolarization. QT variability index (QTVI) as an index of myocardial repolarization instability is a strong predictor for fatal ventricular arrhythmias and SCD. The aim of this study was to evaluate correlation between QTVI and GFR(< 60 >mL/minute) in predialysis CKD patients. This study was done in Kidney and Hypertension Clinic of Dr. Hasan Sadikin Hospital Bandung, from October to December 2011. A total of 51 subjects were included in this study and had their resting electrocardiography (ECG) recorded and QTVI calculated, 94% had hypertension or received anti hypertension, while only 37% fulfilled the ECG criteria for left ventricular hypertrophy. We determined the correlation between QTVI and GFR using Spearman’s rank, with mean QTVI 0.16 (SD 0.24), we had strong and significant correlation between QTVI and GFR (r=-0.816, p <0.001) and moderate correlation between QTVI and estimated glomerular filtration rate (r=-0.460, p<0.001). In conclusions, there is a strong correlation between QTVI and GFR in predialysis CKD patients, the lower GFR the higher QTVI value. [MKB. 2012;44(4):193–98].Key words: Chronic kidney disease, glomerular filtration rate, QT variability index, sudden cardiac death DOI: http://dx.doi.org/10.15395/mkb.v44n4.214

Hubungan Kadar Apelin dengan Disfungsi Diastol pada Penderita Gagal Jantung dengan Fraksi Ejeksi Normal

Majalah Kedokteran Bandung Vol 47, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Apelin merupakan peptida yang berperan dalam mempertahankan performa jantung pada beban tekanan kronik. Penelitian ini bertujuan menilai hubungan antara kadar apelin dan disfungsi diastol pada penderita gagal jantung dengan fraksi ejeksi normal. Analisis statistik korelasi Spearman-Rank. Penelitian dilakukan di Instalasi Rawat Jalan Jantung dan Divisi Diagnostiik Noninvasif Departmen Kardiologi dan Kedokteran Vaskular Rumah Sakit Dr. Hasan Sadikin Bandung periode Januari–April 2014. Hasil penelitian didapatkan 50 penderita laki-laki sebanyak 24 (48%) dan perempuan 26 (52%), usia rata-rata 58,72 (11,02) tahun, durasi hipertensi 1–30 tahun, median 5 tahun. Indeks massa tubuh rata-rata 24,13 kg/m2. Median tekanan darah sistol 130 (120–180) mmHg, median tekanan darah diastol 90 (70–110)mmHg. Fraksi ejeksi median 65 (49–77%), pengobatan dengan Angiotensin converting enzyme inhibitor (ACEI) sebanyak 48%, calcium channel blocker (CCB) 27%, beta bloker 6%, angiotensin receptor blocker (ARB) 3%, dan diuretik 1%. Pengukuran fungsi diastol, tissue doppler imaging (TDI) rata-rata 10,32, deceleration time rata-rata 228,2 detik, median rasio E/A (early/atrial (late) ventricular filling velocities) 0,77 (0,43–1,53), median isovolumic relaxation time (IVRT) 92 (60–177) detik. Median kadar apelin 1080,5 (993,2–1113) pg/mL. Sebagai simpulan, terdapat korelasi positif antara kadar apelin dan disfungsi diastol yang dihitung dengan TDI (R=0,3445, p=0,014). Apelin dapat digunakan untuk menilai gejala dan prognosis pada penderita gagal jantung dengan fraksi ejeksi normal karena kadarnya meningkat pada beban tekanan disertai fibrosis yang  sedikit dan menurun pada beban tekanan disertai fibrosis yang luas.[MKB. 2015;47(2):91–5]Kata kunci: Apelin, disfungsi diastol, fraksi ejeksi normal, gagal jantung, TDICorrelation between Plasma Apelin Level and Diastolic Dysfunction in Heart Failure Patients with Preserved Ejection Fraction AbstractApelin ia a novel multifunction peptide implicated in cardiovascular performance regulation in chronic pressure overload. Plasma apelin level and its correlation to diastolic dysfunction in patient heart failure with preserved ejection fraction were investigated. Hypertensive patients with heart failure but without coronary artery disease, atrial fibrillation, obese, and diabetes mellitus were enrolled in this study. Each patients underwent plasma apelin measurement and echocardiographic assessment of left ventricular diastolic function. Statistical analysis was conducted using Spearman Rank. Fifty patients,  24 males (48%) and 26 females (52%),  met the inclusion criteria.  The mean age of the participants was 58.72 (11.02) years with a duration of hypertension between 1–30 years, median 5 year. Mean body mass index was 24.13 kg/m2. Systolic blood pressure median was 130 (120–180)mmHg while the diastolic blood pressure median was 90 (70–110)mmHg. Left ventricular ejection fraction median was 65 (49–77)%, treatment with Angiotensin converting enzyme inhibitor (ACEI) was 48%, calcium channel blocker (CCB) was 27%, beta blocker was 6%, angiotensin receptor blocker (ARB) was 3%, and diuretic was 1%. Diastolic function assessment with tissue doppler imaging (TDI) resulted in a mean of 10.32, deceleration time mean of 228.2, E/A (early/atrial (late) filling velocities) ratio median of 0.77 (0.43–1.53),and IVRT (isovolumic relaxation time) median of 92 (59–177). Plasma apelin measurement median was 1080.5 (993.2–11) pg/mL. In conclusion, there is a positive correlation between plasma apelin level and diastolic function (TDI) (R=0.3445, p=0.014). There is no significant correlation between plasma apelin level and diastolic function using other criteria. In conclusion, apelin can be used for assessing symptoms and prognosis of heart failure patients with preserved ejection fraction because apelin level is upregulated when pressure overload occurs with less fibrosis and down-regulated when pressure overload occurs with marked fibrosis. [MKB. 2015;47(2):91–5]Key words: Apelin, diastolic dysfunction, heart failure, preserved ejection fraction DOI: 10.15395/mkb.v47n2.459