ACI (Acta Cardiologia Indonesiana)
Not a member yet
176 research outputs found
Sort by
Neurohumoral Pathway in Heart Failure
No full textHeart Failure is now considered as one of the leading cause for mortality and morbidity. It is affecting several organs and cause organ damages due to the myocardial failure to pump inadequate oxygenated blood to the body including metabolites, to end organs and peripheral tissues. Heart failure results from multifactorial mechanism including neurohumoral activations including increased activity of the sympathetic nervous system, renin-angiotensin aldosteron system, vasopression and the atrial natriuretic peptide. This neurohumoral pathway has significant contribution to the development of myocardial dysfunction that lead to clinical manifestation of heart failure. Some of the markers in these pathways have now been considered as an independent predictors of prognosis in heart failure patient
Successful Balloon Mitral Valvuloplasty in 21-week Pregnant Patient with Severe Mitral Stenosis: A Case Report and Literature Review
No full textMitral stenosis is the most common manifestation of rheumatic heart disease. Hemodynamic changes during pregnancy increase the burden of the heart in pregnant women with cardiac abnormalities. A 33 years old woman, G3P1A1 is 21 weeks pregnant came to our hospital with a shortness of breath during daily activity, which was worsened since 3 months of pregnancy. The patient has been diagnosed with severe mitral stenosis. The results of echocardiography examination was left atrial dilatation, normal global function and left ventricular with ejection fraction 51%, severe mitral stenosis Wilkin Score 8 with Mitral Valve area 0.53 cm2 and Mitral Valve Gradient 33 mmHg. Subsequently, Balloon Mitral Valvuloplasty was successfully performed. During and after the procedure there was no complication. The fetus was considered in stable condition
Navigating Your Acute Heart Failure Patient in Emergency and Pre-Discharge Phase
No full textHeart failure (HF) leads to frequent hospitalizations. The presence of re-hospitalization risk among patientshospitalized for heart failure is important, especially hemodynamic instability and neurohormonal over activation. ARNI is needed to restore the balance of neurohormonal system in HF. PARADIGM-HF study provide insight on long term benefit of ARNI (i.e. sacubitril/valsartan) in ambulatory setting. How is the evidence of ARNI use for in hospitalization phase of HF? PIONEER and TRANSITION showed that initiation of sacubitril/valsartan shortly after an ADHF event is feasible and well tolerated. In-hospital initiation of sacubitril/valsartan is associated with early and sustained improvements in biomarkers of cardiac wall stress and myocardial injury, indicating pathophysiological benefits in a wide range of HFrEF patients
Mean Platelet Volume as a Predictor of Atherosclerotic Severity in Non ST Elevation Acute Myocardial Infarction
No full textBackground: Acute myocardial infarction (AMI) is the leading cause of death in the world. AMI is classified into ST-elevation myocardial infarction (STEMI) and Non-ST elevation myocardial infarction (NSTEMI). Diagnosis and prediction of severity of atherosclerotic in NSTEMI is a challenge. Despite the risk stratification, 14-20% of patients that undergo coronary angiography have normal or non significant coronary artery disease. The role of platelet and the extent of atherotrombosis in patients with NSTEMI are interesting field of research. Mean platelet volume (MPV) reflects platelet size and reactivity. It can be used as a diagnostic marker and may have predictive value. This study aims to prove the role of MPV as a predictor of the degree of atherosclerotic based on Syntax score in patients with NSTEMI undergoing coronary angiography.Methods: This is a cross sectional study enrolled 86 subjects with NSTEMI. Blood samples were taken at the time of admission to the hospital. An MPV was measured by automated machine. Subsequent coronary angiography was performed using standardized method. Syntax score was determined to reflect the atherosclerotic severity. Statistical analysis was used to assess whether an MPV as a predictor of atherosclerotic severity based on Syntax score.Results: The chi-square analysis showed that high MPV could not be used as a predictor of the atherosclerotic severity based on Syntax score in NSTEMI patients (p value =0.5, prevalence ratio 1.15 (95% CI: 0.755-1.753). From multivariate analysis, only smoking factor had an independent relationship with Syntax score (p value =0.047; Odds ratio 2.531(95% CI: 1.012-6.328).Conclusions: High MPV cannot be used as a predictor of atherosclerotic severity based on Syntax score in NSTEMI patients
Dealing with Sudden Cardiac Death: Who Deserves Device Implantation
No full textSudden cardiac death is one of the leading causes of death in the western industrial nations. Most people are affected by coronary heart disease (coronary heart disease, CHD) or heart muscle (cardiomyopathy). These can lead to life-threatening cardiac arrhythmias. If the heartbeat is too slow due to impulse or conduction disturbances, cardiac pacemakers will be implanted. High-frequency and life-threatening arrhythmias of the ventricles (ventricular tachycardia, flutter or fibrillation) cannot be treated with a pacemaker. In such cases, an implantable cardioverter-defibrillator (ICD) is used, which additionally also provides all functions of a pacemaker. The implantation of a defibrillator is appropriate if a high risk of malignant arrhythmias has been established (primary prevention). If these life-threatening cardiac arrhythmias have occurred before and are not caused by a treatable (reversible) cause, ICD implantation will be used for secondary prevention. The device can stop these life-threatening cardiac arrhythmias by delivering a shock or rapid impulse delivery (antitachycardic pacing) to prevent sudden cardiac death. Another area of application for ICD therapy is advanced heart failure (heart failure), in which both main chambers and / or different wall sections of the left ventricle no longer work synchronously. This form of cardiac insufficiency can be treated by electrical stimulation (cardiac resynchronization therapy, CRT). Since the affected patients are also at increased risk for sudden cardiac death, combination devices are usually implanted, which combine heart failure treatment by resynchronization therapy and the prevention of sudden cardiac death by life-threatening arrhythmia of the heart chambers (CRT-D device). An ICD is implanted subcutaneously or under the pectoral muscle in the area of the left collarbone. Like pacemaker implantation, ICD implantation is a routine, low-complication procedure today
Role of Non-Vitamin K Oral Anticoagulants for Prevention of Stroke in Renal Impaired Atrial Fibrillation Patients
No full textAtrial fibrillation (AF) and chronic kidney disease (CKD) are highly prevalent, particularly with increasing of age and associated comorbidities, such as hypertension, diabetes, heart failure, and vascular disease. The relationship between AF and CKD seems to be bidirectional. CKD predisposes to AF while onset of AF seems to lead to progression of CKD. Stroke prevention is the cornerstone of AF management, and AF patients with CKD are at higher risk of stroke, mortality, cardiac events, and bleeding. Stroke prevention requires use of oral anticoagulants, which are either vitamin K antagonists (e.g. warfarin), or the non-vitamin K antagonist oral anticoagulants (NOAC). While NOAC have been shown to be effective in mild-to-moderate renal dysfunction, there are a paucity of data regarding NOAC in severe and end-stage renal dysfunction. The followingwill discuss the evidence for NOAC in CKD, and summarize the current knowledge regarding the efficacy and safety of NOAC to prevent AF-related stroke and systemic embolism in severe and end-stage renal disease