Majalah Kardiologi Indonesia最新文献

{"title":"The Impact of Tricuspid Annular Plane Systolic Excursion (TAPSE) After Mitral Valve Surgery on Long Term Mortality","authors":"Sabrina Erriyanti, A. Soesanto, I. Sakidjan, A. Atmosudigdo, Oktavia Lilyasari, R. Ariani, S. Siagian","doi":"10.30701/ijc.1196","DOIUrl":"https://doi.org/10.30701/ijc.1196","url":null,"abstract":"<jats:p />","PeriodicalId":32916,"journal":{"name":"Majalah Kardiologi Indonesia","volume":"177 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41291941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Persistent Symptom and Echocardiographic Findings in Survivors of COVID-19 Infection with Mild Symptoms","authors":"P. Almazini, A. Soesanto, A. Kuncoro, R. Ariani, E. Rudiktyo, R. Sukmawan","doi":"10.30701/ijc.1160","DOIUrl":"https://doi.org/10.30701/ijc.1160","url":null,"abstract":"<jats:p />","PeriodicalId":32916,"journal":{"name":"Majalah Kardiologi Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48513334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Positive Ischemic Response on Treadmill Test Implies Otherwise: One Overlooked Pitfall on TMT","authors":"D. Rifanda, M. A. L. Parama, Teuku Muhammad Haykal Putra, W. A. Widodo","doi":"10.30701/ijc.1197","DOIUrl":"https://doi.org/10.30701/ijc.1197","url":null,"abstract":"When Positive Ischemic Response on Treadmill Test Implies Otherwise: One Overlooked Pitfall on TMT \u0000  \u0000Background: \u0000Particular ischemic process that portrayed in Electrocardiogram (ECG) changes bear similar depiction to different conditions, one of them is hypokalemia. On the other hand, Treadmill Test (TMT) has been used for decades for risk stratifying and diagnosing coronary artery disease as a non-invasive, safe and affordable screening test. However, using ECG changes as interpretation, TMT could have incidence of false positive results reported in various conditions, one of which is hypokalemia. The aim is to report a case of positive ischemic response resemblance in TMT of patient with severe hypokalemia. \u0000  \u0000Case Illustration: \u0000A-43-years-old female with history of unstable angina pectoris with risk factors of diabetes mellitus and hypertension underwent several examinations. Computed Tomography Coronary Angiography (CTCA) showed a 60% stenosis lesion in Left Anterior Descending (LAD) coronary artery. Within 3 minutes of TMT the ECG showed ST-segment depression in lead II, III, aVF, V1-V6 and prominent elevation in lead aVR. Fear of left main coronary artery occlusion, the test was terminated and the patient was immediately planned for urgent Percutaneous Coronary Intervention (PCI). The result indicated non-significant coronary lesion. Potassium concentration of 1.87 mmol per liter and troponin levels were normal. Unbeknownst before, the patient had multiple episodes of vomiting for a whole day and felt dehydrated prior to the TMT. Patient then treated for potassium implementation and discharged uneventfully. \u0000  \u0000Conclusion: \u0000Hypokalemia could induce widespread ST-Segment depression or ST-Segment elevation in right limb lead. Peculiarly in context of stress testing or accompanied with chest pain, it is difficult to differentiate ECG changes in hypokalemia with true myocardial ischemia. Hypokalemia should be considered when TMT result is not concordance with true myocardial ischemia. \u0000 ","PeriodicalId":32916,"journal":{"name":"Majalah Kardiologi Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43920989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-Reactive Protein to Albumin Ratio Predict In-Hospital and Long-term Outcome of ST-Segment-Elevation Myocardial Infarction Patients with SARS-CoV2 Infection Underwent Fibrinolytic Therapy.","authors":"G. Jagannatha, Rina Artha, Wayan Agus Surya Pradnyana, S. Kamardi, Anastasya Maria Kosasih","doi":"10.30701/ijc.1305","DOIUrl":"https://doi.org/10.30701/ijc.1305","url":null,"abstract":"Background: The choice of reperfusion therapy in STEMI patients with COVID-19 is unclear. CRP to Albumin ratio (CAR) found to be a predictor of thrombus burden. This study was to determine the relationship and predictive value of CAR to in-hospital and long-term outcome of STEMI patients with COVID-19 treated with fibrinolytic. \u0000Methods: 297 COVID-19 patients with STEMI underwent fibrinolytic were enrolled. In-hospital outcomes were in-hospital mortality due to cardiovascular death which was divided into mortality <48 hours and >48 hours, fibrinolytic failure, and cardiogenic shock. The presence of reinfarction post fibrinolytic and mortality after the patient discharged was assessed as the long-term outcome. \u0000Results: During follow-up, 19.8% experienced in-hospital mortality and 16.1% had reinfarction. In the in-hospital outcome, patients with in-hospital death, failed fibrinolytic and cardiogenic shock had higher CAR (6.7+2.4 vs 4.7+1.9; 6.3+1.9 vs 2.1+1.6; 5.5+2.1vs1.8+1.5) with all p-value <0.05. CAR with an optimal cut-off >4.46 can be a predictor of fibrinolytic failure with sensitivity of 86.7% and specificity of 93.6% (PR19.82; 95%CI 10.32-38.06) and predictor of in-hospital death <48 hours with sensitivity of 84.6% and specificity of 82.7% (PR5.02; 95%CI 3.20-7.90). In the long-term outcome, patients who experienced reinfarction and out-hospital death had higher CAR (5.1+1.2vs2.5+2.4; 5.2+1.3vs2.6+2.4) than those who did not experience the event respectively with all p-value <0.05. CAR with an optimal cut-off >3.67 can be predictor of reinfarction with sensitivity of 87.5% and specificity of 73.5% (PR12.250; 95%CI 5.38-27.87). The Cox regression model showing CAR >3.67 was also associated with higher reinfarction event (p=0.001). \u0000Conclusion: CAR has the potential to be a predictor of in-hospital and long-term outcomes for STEMI patients with COVID-19 which can help determine which patients need more invasive strategy to prevent mortality and morbidity.","PeriodicalId":32916,"journal":{"name":"Majalah Kardiologi Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43787467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Acute Coronary Syndrome Indonesia : Insight from One ACS Multicenter Registry","authors":"D. Juzar, A. Muzakkir, Y. Ilhami, N. Taufiq, T. Astiawati, I. M. J. R A, M. Pramudyo, Andria Priyana, Afdhalun Hakim, S. Anjarwani, Jusup Endang, B. Widyantoro","doi":"10.30701/ijc.1406","DOIUrl":"https://doi.org/10.30701/ijc.1406","url":null,"abstract":"Background \u0000Acute coronary syndrome (ACS) is a life-threatening disorder which contributes to high morbidity and mortality in the world. Registry of ACS offers a great guidance for improvement and research. We collated a multicentre registry to gain information about demographic, management, and outcomes of ACS in Indonesia. \u0000Methods \u0000IndONEsia Acute Coronary Syndrome Registry (One ACS Registry) was a prospective nationwide multicenter registry with 14 hospitals participating in submitting data of ACS  via standardized electronic case report form (eCRF). Between July 2018 and June 2019, 7634 patients with ACS were registered. This registry recorded baseline characteristics; onset, awareness, and transfer time; physical examination and additional test; diagnosis; in-hospital medications and intervention; complications; and in-hospital outcomes. \u0000Results \u0000Nearly half of patients (48.8%) were diagnosed with STE-ACS. Most prevalent risk factors were male gender, smoking, hypertension. Patients with NSTE-ACS tended to have more concomitant diseases including diabetes mellitus, dyslipidemia, prior AMI, HF, PCI, and CABG. Majority of ACS patients in our registry (89.4%) were funded by national health coverage. Antiplatelet, anticoagulant, antihypertensive, and statins were prescribed as 24-hours therapy and discharge therapy; however presription of potent P2Y12 inhibitor was low. More STE-ACS patients underwent reperfusion therapy than non-reperfusion (65.2% vs. 34.8%), and primary PCI was the most common method (45.7%). Only 21.8% STE-ACS patients underwent reperfusion strategy within 0-3 hours of onset. Invasive strategy performed in 17.6% of NSTE-ACS patients, and only 6.7% performed early (within <24 hours). Patients underwent early invasive strategy had a shorter median LoS than late invasive strategy (P<0.001). A shorter median LoS also found in intermediate and low risk patients.  Mortality rate in our ACS patients was 8.9%; STE-ACS patients showed higher mortality than NSTE-ACS (11.7 vs. 6.2%). \u0000Conclusion \u0000Our registry showed a comparable proportion between STE- and NSTE-ACS patients, with male gender predominant in middle age. Both STE- and NSTE-ACS sharing the same risk factors. We need an improvement in referral time, especially in patients with STE-ACS. Evidence from our registry showed that there are two issues that need to be addressed in order to improve ACS outcomes: optimal and adequate medical treatment and invasive strategy.","PeriodicalId":32916,"journal":{"name":"Majalah Kardiologi Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47829897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Degree AV Block in Infants","authors":"A. Cahyono","doi":"10.30701/ijc.1244","DOIUrl":"https://doi.org/10.30701/ijc.1244","url":null,"abstract":"Background: Atrioventricular (AV) block in children may pose a challenge for phycisians. However, it can be detected with careful physical examination. \u0000Case illustration: A 4 month old infant presented with bradycardia that did not improve during observation period. Her electrocardiography (ECG) showed complete atrioventricular block and her echocardiography showed secundum atrial septal defect (ASD)  and patent ductus arteriosus (PDA). Her father’s ECG showed first degree AV block. She was recovered well after pacemaker implantation and PDA ligation.   \u0000Conclusion: An infant who suffered from complete AV block was successfully treated with pacemaker.","PeriodicalId":32916,"journal":{"name":"Majalah Kardiologi Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48524169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Decongestion in Acute Heart Failure: Time for a New Approach?","authors":"M. Pramudyo","doi":"10.30701/ijc.1381","DOIUrl":"https://doi.org/10.30701/ijc.1381","url":null,"abstract":"As the primary cause of hospitalization in acute heart failure (AHF) patients, congestion was responsible for a higher risk of mortality, rehospitalization, and renal dysfunction in AHF patients. Although loop diuretic was routinely used as the mainstay of AHF therapy, it is still ineffective to obtain the euvolemic state in most hospitalized AHF patients. Therefore, a higher loop diuretic dose was often required to increase the decongestion effect. However, consequently, it can cause several detrimental complications, including renal dysfunction, neurohormonal activation, hyponatremia, hypokalaemia, and reduced blood pressure, which eventually result in poor prognosis. Hence, the new approach may be proposed to optimize decongestion in acute phase, including the use of arginine vasopressin V2 receptor antagonist – Tolvaptan. As an additive therapy to loop diuretic in AHF patients, it can be considered due to its several beneficial effects, including greater decongestion effect, lowered worsening renal function incidence, counteract neurohormonal activation, neutralized hyponatraemic state, no alteration of potassium metabolism, stabilize the blood pressure, and reduced requirement of a higher dose of loop diuretic to achieve an equal or even greater decongestion effect compared to a high dose of loop diuretic alone. Tolvaptan provided favourable outcomes in several specific populations and was considered safe with several mild adverse effects. Several guidelines across countries have approved the use of Tolvaptan in AHF patients with or without hyponatremia. The initial dose of Tolvaptan was 7.5 to 15 mg and can be titrated up to 30 mg. However, further studies were still required to determine the timing dose and optimal dose of Tolvaptan in general and elderly populations with AHF, respectively.","PeriodicalId":32916,"journal":{"name":"Majalah Kardiologi Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42140557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Validation and Comparison of Zwolle, TIMI, and GRACE Risk Scores for STEMI Patients Undergoing Primary Percutaneous Coronary Intervention in The Indonesian Population.","authors":"An Aldia Asrial, Anggit Pudjiastuti","doi":"10.30701/ijc.1324","DOIUrl":"https://doi.org/10.30701/ijc.1324","url":null,"abstract":"Background \u0000Zwolle, TIMI, and GRACE risk scores have been proven to predict mayor adverse cardiovascular events (MACE) in STEMI patients undergoing primary percutaneous coronary intervention (PCI). However, they were developed over a long time ago which many advances have been made in the cardiovascular field today. The scores were also developed in the non-Asian majority population and their accuracy for Indonesian population remains unknown. We aimed to validate and compare these scores for Indonesian population. \u0000Methods \u0000An analytical observational study was conducted on 193 patients undergoing primary PCI. The Zwolle, GRACE, and TIMI risk scores were calculated for each patient. Then, the risk score validation was carried out with the calibration test using Hosmer Lemeshow test and discrimination test using the AUC ROC. Furthermore, the comparisons between the risk scores were carried out using the DeLong test. \u0000Results \u0000The three scores have good results in the Hosmer Lemeshow calibration test (p > 0.05). The discrimination test also indicated good results with AUC ROC Zwolle, TIMI and GRACE risk scores respectively 0.776; 0.782; 0.831 (p<0.05). There was no significant difference in the prediction accuracy of the three risk scores in the DeLong test. \u0000  \u0000  \u0000Conclusions \u0000The Zwolle, TIMI, and GRACE risk scores had good validity for predicting major adverse cardiovascular events in STEMI patients undergoing primary PCI. There was no significant difference in the prediction accuracy of the three risk scores. \u0000Keywords: Risk score, major adverse cardiovascular events, primary percutaneous coronary interventions","PeriodicalId":32916,"journal":{"name":"Majalah Kardiologi Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42136977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile of Acute Coronary Syndrome Patients in Kupang","authors":"Aditya Angela Adam, Leonora Johana Tiluata, Lowry Yunita, Magma Purnawan Putra, Niva Wilujeng, Leonita Vivian Homalessy, Daniel Christian Fernandez Hutabarat","doi":"10.30701/ijc.1194","DOIUrl":"https://doi.org/10.30701/ijc.1194","url":null,"abstract":"<jats:p />","PeriodicalId":32916,"journal":{"name":"Majalah Kardiologi Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43796411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of T Peak – T End Interval Reduction on Electrocardiogram as a Marker of Successful Reperfusion in Patients with ST Elevation Myocardial Infarction undergoing Fibrinolytic Therapy","authors":"Muhammad Desfrianda","doi":"10.30701/ijc.1195","DOIUrl":"https://doi.org/10.30701/ijc.1195","url":null,"abstract":"Background: Immediate reperfusion is the key of ST Elevation Myocardial Infarction (STEMI) Management. Despite the superiority of primary percutaneous coronary intervention (PCI), fibrinolytic therapy is still the preferred choice in many settings because of their availability and easy resources. Assessment of successful fibrinolytic determines the next strategy, ST-segment resolution (STR) correlates well with TIMI flow, reflects myocardial perfusion, and has a better prognostic value. T Peak – T End (Tpe) interval is proposed to be a valuable tool for reperfusion marker as it measures the transmural dispersion of repolarization (TDR) which can be an additional myocardial perfusion assessment. This study aims to see whether the Tpe interval reduction can be a marker of the successful reperfusion in patients with STEMI treated with fibrinolytic.   \u0000Methods : This cross-sectional study involved STEMI patients underwent fibrinolytic therapy. Tpe interval was measured at admission and 90 minutes after fibrinolytic, then the changes in the form of difference (ms) and resolution (%) were assessed and compared between successful and failed reperfusion groups according to STR. \u0000Results: Among total of 86 patients, there were 53 patients (61.2%) with successful reperfusion. Tpe interval reduction was greater in the successful reperfusion group. The value of Tpe difference in predicting STR ³ 50% had a sensitivity of 66% and specificity of 75.8% with an area under curve (AUC) of 0.726 and a cut-off point of 20 ms. While the AUC of Tpe resolution 0.726 with a cut-off point of 16.2%, had a sensitivity of 66% and a specificity of 72.7%. \u0000Conclusion: The Tpe interval reduction can be a valuable additional marker of successful reperfusion in patients with STEMI treated with fibrinolytic. \u0000  \u0000  \u0000 ","PeriodicalId":32916,"journal":{"name":"Majalah Kardiologi Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48595475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}