cover
Filter by Year
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
129
Articles
Correlation between Mitral Valve Area and Right Ventricle Function based on TAPSE (Tricuspid Annular Plane Systolic Excursion) Parameter in Mitral Stenosis Patient

Zulfa, Hashina, Maharani, Erika, Mumpuni, Hasanah

ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Original Source | Check in Google Scholar |

Abstract

Background: Mitral stenosis is the most common mitral valve disease found in Indonesia. Mechanical obstruction of blood flow from left atrium to left ventricle is compensated by pressure elevation in the left atrium and pulmonary circulation. It leads to right ventricle dysfunction which can be scored using TAPSE (Tricuspid Annular Plane Systolic Excursion) Parameter.Aim: The goal of this study is to assess the relationship between mitral valve area and right ventricle function based on TAPSE parameter in mitral stenosis patient.Methods: This study was conducted in Dr. Sardjito Hospital from May until July 2017. This was a part of mitral stenosis registry study. The parameter used was planimetry mitral valve area and TAPSE from echocardiography. The relationship between mitral valve area and TAPSE score we reanalyzed using Spearman correlation test in SPSS software.Results: The total sample included in this study was 132 people, consisted of thirty-eight (28.79%) males and ninety-four (71.21%) females. The range of the subjects??age was 18 68 year oldand the mean was 43.31±11.13 year old. The body mass index median was 21.24 (14.24??35.38) kg/m2. The subjects were dominated by severe degree mitral stenosis patients, those were ninety-three (70.45%) people, followed by moderate degree patients, those were thirty-two (24.24%) people, and mild degree patients, those were seven (5.30%) people. Twenty-eight (21.21%) people had isolated mitral stenosis. The mitral valve area median was 0.8 (0.27??1.90) cm2. The TAPSE score range was 6??30 mm and the mean was 17.48±4.58 mm. The result from Spearman correlation test showed that the relationship strength between mitral valve area and TAPSE score were very weak (r=0.167) with significant p-value (p=0.028).Conclusion: There is a statistically significant positive relationship with very weak strength between mitral valve area and TAPSE score as a right ventricle function parameter in mitral stenosis patients (r = 0.167, p = 0.028).

Correlation between Tp-Te Interval and Myocardial Blush Grade Value in Anterior ST Elevation Myocardial Infarction Patient

Kaneko, Rio Probo, Maharani, Erika, Taufiq, Nahar

ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Original Source | Check in Google Scholar |

Abstract

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.

Correlation between Triglyceride/HDL Ratio with Severity of Coronary Artery Lesion in Non-Diabetic Stable Angina Pectoris Patients

Sudjana, Pramon Aditya, Achmad, Chaerul, Yahya, Achmad Fauzi, Martha, Januar W., Akbar, M. Rizki

ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Original Source | Check in Google Scholar |

Abstract

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.

3 Dimensional Printing in Cardiology: Innovation for Modern Education and Clinical Implementation

Gharini, Putrika Prastuti Ratna, Herianto, Herianto, Arfian, Nur, Satria, Ferdinandus Bayu, Amin, Nur

ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Original Source | Check in Google Scholar |

Abstract

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

Association Between Neutrophil to Lymphocyte Ratio and Left Ventricle Global Longitudinal Strain in Acute Myocardial Infarction

Nursidiq, Alfa Alfin, Purwaningtyas, Niniek, Wasyanto, Trisulo

ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Original Source | Check in Google Scholar |

Abstract

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.

Pericardial and Pleural Effusion in Patient with Relapse Stage IV Breast Cancer: Same Pathology, Different Etiology?

Rosalinda, Vienna, Hartopo, Anggoro Budi, Anggrahini, Dyah Wulan, Irawan, Bambang

ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Original Source | Check in Google Scholar |

Abstract

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.

Addition of Risk Factors of Coronary Heart Disease in Diagnostic Value of Treadmill Score for Detecting Complexity of Coronary Arterial Lesions

Nasution, Mariyetty K.S., Siregar, Abdullah A., Hasan, Harris, Mukhtar, Zulfikri, Raynaldo, Abdul H., Akbar, Nizam

ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Original Source | Check in Google Scholar |

Abstract

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.

Atrial Arrhythmia in Atrial Septal Defect Patient: A Case Report and Review of Literature

Paranita, Indah, Dinarti, Lucia Kris, Irawan, Bambang

ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Original Source | Check in Google Scholar |

Abstract

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.

Plennary Lecture

Lecture, Plennary

ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (S) (2018): Supplement, Abstracts of Jogja Cardiology Update 2018 (JCU 2018)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Original Source | Check in Google Scholar |

Abstract

Plennary Lecture JCU 2018

Abstracts of Case Report Posters Day 1

Case Report Day 1, Posters

ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (S) (2018): Supplement, Abstracts of Jogja Cardiology Update 2018 (JCU 2018)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Original Source | Check in Google Scholar |

Abstract

Abstracts of Case Report Posters Day 1 (JCU 2018)