Indonesian Journal of Cardiology
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Systematic Review and Meta-analyses
Get PDFAbstracts of the 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 202
Impact of acute kidney injury in patients with acute decompensated heart failure: Cardiorenal syndrome
Get PDFCardiorenal syndrome (CRS) is a complex interdependent relationship between the heart and kidneys, prevalent in hospitalized patients with acute decompensated heart failure (ADHF). The main aim of this study is to evaluation of cardiac and renal function, treatment factors, and outcomes in view of mortality and persistent renal dysfunction in acute decompensated heart failure (cardio renal syndrome type 1) patients. We studied 100 patients hospitalised with ADHF and acute kidney injury (AKI). Patients were evaluated clinically, biochemically, ultrasonographically, and echocardiographically to assess demographics, etiologic and risk factors, cardiac and renal function, and outcomes in view of mortality and persistent renal dysfunction. The study monitored the patients until discharge and follow up with three months to one year. Record information about functional improvement, worsening symptoms, and mortality. The majority of the patients were males (72%), with dyspnea being the most common symptom (92%) followed by decreased urinary output (82%). The mean age of the patients was 62.60 years. Low level of Mean arterial pressure (MAP) 18.97 (95% CI 4.59 to 78.37, P 0.0001), estimated glomerular filtration rate (eGFR) 0.92(95% CI 0.87 to 0.99; P 0.02), maximum creatinine 3.08 (95% CI 1.67 to 5.67, P 0.0001), maximum level of urea 1.02(95% CI, P 0.001), lower Left ventricular ejection fraction (LVEF) 1.05 (95% CI 0.15 to 0.84, P 0.04) were independently predictors of in-hospital mortality. CRS-1 is associated with increased risk of mortality (25%), residual renal dysfunction (16%) at one year follow up. Persistent renal dysfunction, renal replacement therapy possibly improves for the treating persistent renal dysfunction, and recurrent HHF (more than 2 admissions) post hospitalisation index within twelve months were predictors of mortality (25%) at one-year.This article has a related Erratum
Research
Get PDFAbstracts of the 11th Annual Scientific Meeting of the Indonesian Heart Rhythm Society (InaHRS) 2024: Researc
Original Research
Get PDFAbstracts of the 33rd Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 202
Triglyceride Glucose Index as a Predictor of 30-Day Readmission and 6 Months Mortality After Hospitalization in Acute Decompensated Heart Failure
Get PDFBackground: Acute decompensated heart failure (ADHF) is a cardiovascular disease with high mortality and readmission rates. Currently, insulin resistance has been reported to predict prognosis of ADHF patients. Triglyceride glucose index (TyG) has now been proposed as an independent predictor of cardiovascular risk and a simple marker of insulin resistance. However, the association between TyG and 30-days readmission and 6 months mortality after hospitalization remains unclear.
Objective: To investigate TyG as a predictor of 30-day readmission and 6 months mortality after hospitalization in ADHF patients.
Methods: The study was conducted in a retrospective cohort. Data were taken from medical records based on the admission of patients who met the inclusion criteria from January 2018 – November 2021. The clinical outcomes were 30-days readmission and 6 months mortality. The data were analyzed by multivariate analysis and the survival rate of the subjects.
Results: This study included 467 subjects, with 158 subjects have clinical outcomes. The readmission rate is 29% (135 subjects), and 6 month mortality after hospitalization is 5% (23 subjects). Multivariate analysis showed that the factors associated with 30-days readmission were hypertension (p 0.03, HR 1.547, CI 95% 1.044 – 2.291), systolic blood pressure > 140 mmHg on admission (p< 0.001, HR 0.441, CI 95% 0.296 – 0.658), triglyceride ³ 150 mg/dL (p 0.012, HR 1.812, CI 95% 1.139 – 2.881), and TyG index (p <0.001, OR 4.594, CI 95% 2.717 – 7.767). Independent factors for 6 months mortality were only no diuretic medication (p 0.02, HR 6.015, CI 95% 1.975 – 18.320).
Conclusion: Triglyceride glucose index can predict 30-days readmission, but does not associated with 6-months mortality in ADHF patients.This article has a related Erratum
Hubungan Peak Left Atrial Longitudinal Strain dengan Derajat Keparahan Penyakit Jantung Katup Mitral di RSUP Haji Adam Malik Medan
No full textIntroduction: Mitral stenosis and regurgitation, are common throughout the world. Peak Left Atrial Strain (PALS) is a parameter for assessing left atrial deformation in the evaluation of atrial function and a predictor of long-term outcome of various heart diseases. In this study, we assessed the relationship between PALS and the severity of mitral stenosis and mitral regurgitation
Methods: This is a cross-sectional study on 119 subjects with mitral stenosis and 103 mitral regurgitation who met the inclusion criteria at Haji Adam Malik General Hospital. PALS measurements were taken. Data were analyzed univariate, bivariate, correlate to assess the relationship between PALS and the severity of mitral valve disease
Results: 119 patients with severe mitral stenosis. In mitral stenosis, the mean PALS is 8.2 (4.9-22.8). PALS was significantly higher in patients with sinus rhythm than in the group with AF (10.29 ± 3.89 vs 8.63 ± 7.8%; P = 0.002). PALS had a significant correlation with MVA, pressure gradient, and PHT (r = 0.676, P = <0.001; r=-0.594, P= 0.001 and r=-0.594, P= 0.001). Whereas in mitral regurgitation, it has an average PALS of 15.2 (7.8-19.2). PALS was also significantly higher in patients with sinus rhythm than in the group with AF (16.36 ± 2.43 vs 11.64 ± 2.89%, P = 0.001). PALS has a correlation with VC, PISA, EROA and RVol (r = -0.533, P=0.001; r=-0.618; r=-0.563, P=0.001; r= -0.528, P=0.001).
Conclusion: PALS has a significant correlation with the assessment of the severity of mitral stenosis and regurgitation.This articles has a related Erratum. Latar Belakang: Penyakit jantung katup yaitu stenosis mitral dan regurgitasi mitral sering ditemui di seluruh dunia. Peak Left Atrial Strain (PALS) merupakan parameter penilaian deformasi atrium kiri dalam evaluasi fungsi atrium dan prediktor hasil jangka panjang dari berbagai penyakit jantung. Penelitian ini bertujuan untuk mengetahui hubungan antara PALS dengan keparahan stenosis mitral dan regurgitasi mitral.
Metode: Penelitian ini merupakan studi analitik dengan desain cross sectional pada subyek 119 dengan stenosis mitral dan 103 regurgitasi mitral yang memenuhi kriteria inklusi di RSUP H. Adam Malik. Dilakukan pengukuran PALS. Data dianalisa secara univariat dan bivariat serta uji korelasi untuk menilai hubungan PALS dengan derajat keparahan penyakit jantung katup mitral.
Hasil: Sebanyak 119 pasien memiliki stenosis mitral derajat berat. Pada stenosis mitral, rata-rata PALS adalah 8,2 (4,9-22,8)%. PALS secara signifikan lebih tinggi pada pasien dengan irama sinus dibandingkan pada kelompok dengan AF (10,29±3,89 vs 8,63±7,8%; P= 0,002). PALS memiliki korelasi yang signifikan dengan MVA, tekanan gradient, dan PHT (r = 0,676, P = <0,001; r=-0,594, P= 0,001 dan r=-0,594, P= 0,001). Sedangkan pada regurgitasi mitral, memiliki rata-rata PALS yaitu 15.2 (7.8-19.2). PALS juga secara signifikan lebih tinggi pada pasien dengan irama sinus dibandingkan pada kelompok dengan AF (16,36±2,43 vs 11,64±2,89%, P=0,001). PALS memiliki korelasi dengan VC, PISA, EROA dan RVol (r=-0,533, P=0,001; r=-0,618; r=-0,563, P=0,001; r= -0,528, P=0,001).
Kesimpulan: PALS memiliki korelasi yang signifikan terhadap penilaian derajat keparahan stenosis mitral dan regurgitasi mitral
Systematic Review and Meta-analyses
No full textSystematic Review and Meta-analyses - Abstracts of the 6th Indonesian Intensive & Acute Cardiovascular Care Meeting (InaACC) 202
Case Reports
Get PDFCase Reports - Abstracts of the 6th Indonesian Intensive & Acute Cardiovascular Care Meeting (InaACC) 202
Validasi Skor PEACH sebagai Prediktor Mortalitas Selama Rawatan Paska Operasi Penyakit Jantung Bawaan Pada Dewasa di Rumah Sakit Umum Pusat Haji Adam Malik Medan
No full textIntroduction: Congenital heart disease (CHD) is an abnormality in the structure and function of the heart that is acquired while still intrauterine where the incidence of CHD worldwide is estimated at around 8 cases per 1,000 live births. Even though the development of the medical science is currently advanced, there are still CHD patients who are lately diagnosed and found when the patient is an adult so it requires surgical interventions. The PEACH score is a score that can predict postoperative in-hospital mortality in adults CHD patients. This study aims to validate the PEACH score.
Methods: This is a retrospective cohort study of 52 adult patients with CHD who underwent surgery at Haji Adam Malik General Hospital from January 2019 to April 2023. Validation was analyzed using a calibration and discrimination test to the PEACH score in predicting postoperative in-hospital mortality.
Result: The incidence of in-hospital mortality was 8 (15.4%) patients. There is a relationship between the PEACH score group and the incidence of mortality (p=0.006). The results of the calibration test using the Hosmer and Lameshow analysis and the discrimination test using the Receiver Operating Characteristic analysis showed good validation (p=0.85; AUC=0.83).
Conclusion: The PEACH score is valid for predicting postoperative in-hospital mortality in adult congenital heart disease at Haji Adam Malik General Hospital.This article has a related Erratum. Latar Belakang: Penyakit jantung bawaan (PJB) merupakan kelainan baik pada struktur maupun fungsi jantung yang didapat sejak masih berada dalam kandungan dimana angka kejadian PJB di seluruh dunia diperkirakan sekitar 8 kasus setiap 1.000 kelahiran hidup. Meskipun perkembangan dunia kedokteran saat ini cukup pesat, masih terdapat pasien PJB yang terlambat didiagnosis dan ditemukan pada saat pasien sudah beranjak dewasa serta membutuhkan penanganan secara operasi. Skor PEACH merupakan skor yang dapat memprediksi mortalitas selama rawatan paska operasi PJB pada dewasa. Penelitian ini bertujuan untuk memvalidasi skor PEACH dalam memprediksi mortalitas selama rawatan paska operasi PJB pada dewasa.
Metode: Penelitian ini merupakan penelitian kohort retrospektif terhadap 52 pasien dewasa dengan PJB yang menjalani operasi di RSUP HAM sejak Januari 2019 sampai April 2023. Dilakukan validasi dengan uji kalibrasi dan diskriminasi terhadap skor PEACH dalam memprediksi mortalitas selama rawatan di rumah sakit.
Hasil: Jumlah mortalitas selama rawatan adalah 8 (15.4%) pasien. Terdapat hubungan antara kelompok skor PEACH dengan kejadian mortalitas (p=0.006). Hasil uji kalibrasi dengan analisis Hosmer and Lameshow dan uji diskriminasi dengan analisis Receiver Operating Characteristic menunjukkan validasi yang cukup baik (p=0.85; AUC=0.83).
Kesimpulan: Skor PEACH valid dalam memprediksi mortalitas selama rawatan paska operasi penyakit jantung bawaan pada dewasa di RSUP Haji Adam Malik Meda
Transcatheter Closure for Ventricular Septal Defect (VSD): Unveiling Key Predictors in Pediatric Interventions
Get PDFBackground: Transcatheter closure of specific types of VSD has been widely performed, especially in developing countries, with encouraging follow-up results. Nevertheless, adverse outcomes and failure of closure may occur, which requires sufficient attention. Although transcatheter closure is still the preferable and safest procedure, the risk of failure can lead to the surgical VSD closure procedure.
Methods: A retrospective cohort study was done in patients who underwent transcatheter VSD closure in the presence of AVP with or without AR at Integrated Cardiac Service Prof. Dr. I G N G Ngoerah General Hospital between July 2009 to June 2022. Failure to close was defined as a device failing to be implanted. Patient demographic and clinical data were collected.
Results: Thirty-eight subjects were enrolled, 10 failed to close, where 8 out of 10 of the failure group were with aortic regurgitation, and 7 of the said group were SADC type. There were 16 males and 22 females. Among 38 subjects, 23 have perimembranous outlet VSD, and 15 have subarterial doubly committed VSD. Aortic regurgitation was found in 25 of 38 subjects. Transcatheter closure was done either by a retrograde technique using the Amplatzer Duct Occluder-II or an antegrade technique using the NIT occlude and MFO in 11, 3, and 24 subjects, respectively. The failure happened in 10 patients, 3 of them had minor complications, and 7 had no complications. There are 2 patients out of 10 with membranous septal aneurysms that failed to close. The final analysis identified VSD type SADC (RR 3.578; 95%CI 1.093 to 11.711; p = 0.030) as an independent factor associated with predictors of transcatheter closure failure in pediatric patients with VSD.
Conclusion: Failure to close in transcatheter closure is higher in the SADC type compared to the PMO type. Transcatheter closure appears to be feasible but still challenging in our center.Thsi article has a related Erratum