Hasil Pencarian  ::  Simpan CSV :: Kembali

"[ABSTRAKLatar belakang. Pada stenosis mitral sering timbul komplikasi hipertensi pulmoner dan disfungsi ventikel kanan. Belum ada penelitian yang menghubungkan antara resistensi vaskular paru sebelum operasi dengan fungsi jantung kanan saat pasca operasi serta perubahannya pasca operasi stenosis mitral rematik.Metode. Studi ini merupakan studi kohort prospektif pada 31 pasien stenosis mitral rematik yang menjalani operasi katup mitral di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita sejak April 2014 sampai Maret 2015. Pasien menjalani pemeriksaan ekokardiografi sebelum operasi, sebelum pulang perawatan pasca operasi serta saat follow up mid term di poliklinik. Dilakukan analisa statistik untuk melihat hubungan antara resistensi vaskular paru (RVP) pra operasi dengan strain longitudinal ventrikel kanan saat follow up mid term serta perubahan strain longitudinal ventrikel kanan pasca operasi (delta strain).Hasil. Tidak terdapat korelasi antara RVP pra operasi dengan strain longitudinal speckle tracking ventrikel kanan saat follow up mid term pasca operasi (r 0,199 p 0,264) serta dengan perubahan strain longitudinal ventrikel kanan pasca operasi atau delta strain (r 0,174 p 0,350).Kesimpulan. Resistensi vaskular paru pra operasi tidak berhubungan dengan strain longitudinal speckle tracking ventrikel kanan saat follow up mid term pasca operasi serta dengan perubahan strain longitudinal ventrikel kanan pasca operasi atau delta strain.

---

ABSTRACTBackground. In MS right ventikel (RV) dysfunction and pulmonary hypertension often occur as complication. There is no research that connects the pulmonary vascular resistance before surgery with RV function and its changes in the case of rheumatic mitral stenosis who underwent mitral valve surgery.Methods. This study is a prospective cohort study which involves 31 patients with rheumatic mitral stenosis who underwent surgery at National Cardiovaskular Center Harapan Kita Hospital from April 2014 to March 2015. Patients underwent echocardiography before surgery, after surgery pre-hospital discharge and mid-term follow-up at clinic. Statistical analysis was performed to see the relationship between preoperative pulmonary vascular resistance (PVR) with RV function at mid term follow up, which is assessed using echocardiographic parameters right ventricular longitudinal speckle strain, and also with right ventricle longitudinal speckle strain postoperative changes (delta strain).Results. There is no correlation between pre operative PVR with RV longitudinal speckle strain at mid term follow-up (r 0,199 p 0,264), and post operative changes or delta strain (r 0.174 p 0.350).Conclusion. RVP before surgery is not associated with right ventricle longitudinal speckle strain at follow up mid term and post operative changes or delta strain., Background. Acute rheumatic fever and rheumatic heart disease is still regarded as animportant public health problem especially in developing countries. Mitral stenosis (MS) is asequale of rheumatic fever which are most commonly found. In MS right ventikel (RV)dysfunction and pulmonary hypertension often occur as complication. The right ventricle hasa smaller muscle mass so it is more sensitive to changes in pressure loads. There is noresearch that connects the pulmonary vaskular resistance before surgery with RV functionand also changes in the case of rheumatic mitral stenosis who underwent mitral valvesurgery.Methods. This study is a prospective cohort study which involves 31 patients with rheumaticmitral stenosis who underwent surgery at National Cardiovaskular Center Harapan Kita Hospital from April 2014 to March 2015. Patients underwent echocardiography before surgery, after surgery pre-hospital discharge and mid-term follow-up at clinic. Statisticalanalysis was performed to see changes in RV function with longitudinal speckle strain, aftersurgery pre-hospital discharge and mid-term follow-up at clinic. Analysis also performed tosee the relationship between preoperative pulmonary vascular resistance (PVR) with RVfunction at mid term follow up, which is assessed using echocardiographic parameters rightventricular longitudinal speckle strain, and also with right ventricle longitudinal specklestrain postoperative changes (delta strain). Results. Right ventricular function after surgery seen with longitudinal speckle strainimproved from -12.94 ± 3.63 preoperatively into -13.06 ± 3.63 after surgery pre hospitaldischarge, and -15.25 ± 3.75 at follow-up evaluation (p 0.007). There is no correlationbetween pre operative PVR with longitudinal speckle strain at mid term follow-up (r 0,199 p0,264), and RV longitudinal speckle strain post operative changes or delta strain (r 0.174 p0.350). Conclusion. After mitral valve surgery, right ventricle longitudinal speckle strain improves.RVP before surgery is not associated with right ventricle longitudinal speckle strain at follow up mid term and right ventricle longitudinal speckle strain post operative changes or deltastrain. ]"

"Lima puluh persen penderita gagal jantung merupakan gagal jantung dengan fraksi ejeksi yang normal (HFPEF). Morbiditas dan mortalitas HFPEF belumlah jelas. Latihan olahraga telah menjadi rekomendasi pertama dalam beberapa panduan klinis, namun belum pada HFPEF. Strain longitudinal apikal 4 ruangan dapat digunakan sebagai nilai prognostik. Perbaikan fungsi longitudinal intrinsik ventrikel kiri menggunakan strain longitudinal apikal empat ruangan akibat latihan olahraga belumlah diketahui. Kuasi eksperimental menggunakan 30 sampel konsekutif HFPEF, dilakukan program latihan olahraga tersupervisi. Program latihan olahraga dilakukan selama satu bulan. Dilakukan pemeriksaan ekokardiografi, 6MWT, kuesioner MLWHF dan WHO. Terdapat perbedaan yang signifikan dalam 6MWT, nilai skoring MLWHF dan WHO5 sebelum dan sesudah latihan olahraga. Didapatkan nilai strain longitudinal sebesar -16,20% (-10,7% sampai dengan -17,81%). Strain longitudinal apikal 4 ruangan mengalami perbaikan pada minggu ke 2 dan ke 4 latihan olahraga (sebelum latihan olahraga LS = -16,20 [-10,70 to -17,81]; minggu ke dua latihan olah raga LS = -18,00±2,69 dan minggu ke 4 latihan olahraga LS = -21,86±1,79) dan terdapat perbedaan yang signifikan (p < 0,001). Terdapat perbaikan fungsi intrinsik longitudinal ventrikel kiri sebelum dengan sesudah diberikan program latihan olahraga pada penderita gagal jantung dengan fraksi ejeksi yang normal.

---

Fifty percent of patients with heart failure are heart failure with preserved ejection fraction (HFPEF). Morbidity and mortality of HFPEF is unclear. Exercise has become the first recommendation in several clinical guidelines, but not yet in HFPEF. Apical 4 chamber longitudinal strain can be used as a prognostic value. But the improvement of longitudinal intrinsic left ventricular function using apical 4 chamber longitudinal strain due to exercise training is not yet known. Quasi- experimental study using thirty consecutive sample of HFPEF. Exercise training program was conducted for a month. Echocardiography, 6MWT, MLWHF and WHO questionnaire was performed before and after exercise. There was significant differences in the 6MWT, the value of MLWHF and WHO5 score before and after exercise. Longitudinal strain values obtained by -16.20 % (-10.7% to -17.81%). Four chamber longitudinal strain was improved at weeks 2 and 4 of exercise (before exercise LS = -16.20[-10.70 to -17.81]; the second week of exercise training LS = -18.00±2,69 and week 4 exercise LS = -21.86 ± 1.79) and there were significant differences (p < 0.001). There was an improvement in the longitudinal intrinsic left ventricular function before and after exercise training in patients with heart failure with preserved ejection fraction."

"Tujuan penelitian ini adalah untuk mencari variabel prognostik terhadap kematian penderita yang dilakukan beda katup mitral. Penelitian bersifat retrospektif terhadap semua penderita yang dilakukan bedah katup mitral dengan atau tanpa bedah ikutan trikuspid di Rumah Sakit Jantung Harapan Kita, Jakarta amtara bulan September 1985 sampai tanggal 31 Desember 1988 (n=162). Sembilan puluh orang dengan stenosis mitral (MS) dominan, 72 orang dengan insufisiensi mitral (MI), terdiri dari 56 orang laki-laki dan 106 orang wanita, berumur antara 7-64 (rata-rata 30,1 + 12,9) tahun. Bedah perbaikan katup dilakukan pada 87 orang, sedang oenggantian katup pada 75 orang. Seratus empat puluh sembilan orang dapat diamati (92%) dengan mengirim surat, telepon, pengamatan 16 bulan (antara 0-40 bulan), dengan jumlah pengamatan kumulatif 2607,4 bulan. Enam belas variabel prabedah dan 4 variabel intrabedah telah diuji untuk mendapatkan variabel prognostik terhadap kematian (bedah serta tertunda). Angka ketahanan hidup dihitung menurut Kaplan-Meier. Analisis univariat dengan uji logrank. Angka kematian bedah dan angka kematian tertunda seluruh penderita masing-masing 6,8% dan 2,8 per 100 oang-tahun, untuk penderita MS masing-masing 8,9% dan 1,5 per 100 orang-tahun, sedang untuk penderita MI 4,2% dan 4,6 per 100 rang-tahun. Satu-satunya variabel prognostik independen penderita MS adalah jenis operasi (perbaikan atau penggantian katup). Angka ketahanan hidup 3 tahun penderita MS dengan bedah perbaikan katup adalah 94,8 +- 2,9%, sedang untuk penderita MS dengan bedah penggantian katup 78,0 +- 5,7% (p=0,0174). Tetapi penderita MS dengan bedah penggantian katup mempunyai umur lebih tua, kelas fungsional lebih buruk, lebih banyak yang dalam irama fibrilasi atrium, rasio kardiotoraks lebih besar dan indeks curah jantung lebih rendah dan bermakna bila dibandingkan dengan bedah perbaikan katup. Untuk penderita MI, hanya variabel fraksi ejeksi (EF) yang merupakan variabel prognostik independen. Angka ketahanan hidup 3 tahun penderita MI dengan EF < 50% adalah 74,2 +- 7,2% sedang untuk penderita MI dengan EF > 50% adalah 97,5 +- 2,4% (p=0,0229). sebagai kesimpulan operasi katup mitral mungkin akan lebih bermanfaat bila dilakukan dalam keadaan yang dini. Suatu penelitian jangka panjang mengenai variabel prognostik terhadap kematian dan/atau kualitas hidup penderita bedah katup mitral masih sangat relevan dimasa yang akan datang untuk mendapatkan masukan yang lebih akurat.

---

The purpose of this study was to find prognostic variables for mortality in patients undergoing mitral valve surgery. This was a retrospective study of all patients undergoing mitral valve surgery with or without tricuspid concomitant surgery at Harapan Kita Heart Hospital, Jakarta between September 1985 and December 31, 1988 (n=162). Ninety patients with dominant mitral stenosis (MS), 72 patients with mitral insufficiency (MI), consisting of 56 men and 106 women, aged between 7-64 (mean 30.1 + 12.9) years. Valve repair surgery was performed on 87 patients, while valve replacement was performed on 75 patients. One hundred and forty-nine patients could be observed (92%) by sending letters, telephone, 16-month observation (between 0-40 months), with a cumulative observation of 2607.4 months. Sixteen preoperative variables and 4 intraoperative variables were tested to obtain prognostic variables for death (surgical and delayed). Survival rates were calculated according to Kaplan-Meier. Univariate analysis with logrank test. Surgical mortality and delayed mortality rates for all patients were 6.8% and 2.8 per 100 person-years, respectively, for MS patients 8.9% and 1.5 per 100 person-years, while for MI patients 4.2% and 4.6 per 100 person-years. The only independent prognostic variable for MS patients was the type of surgery (valve repair or replacement). The 3-year survival rate for MS patients with valve repair surgery was 94.8 +- 2.9%, while for MS patients with valve replacement surgery it was 78.0 +- 5.7% (p = 0.0174). However, MS patients with valve replacement surgery were older, had worse functional class, more were in atrial fibrillation rhythm, had a higher cardiothoracic ratio and a lower cardiac output index and was significant when compared with valve repair surgery. For MI patients, only the ejection fraction (EF) variable is an independent prognostic variable. The 3-year survival rate for MI patients with EF < 50% is 74.2 +- 7.2% while for MI patients with EF > 50% is 97.5 +- 2.4% (p = 0.0229). In conclusion, mitral valve surgery may be more beneficial if performed in an early state. A long-term study of prognostic variables on mortality and/or quality of life in mitral valve surgery patients is still very relevant in the future to obtain more accurate input."

"[ABSTRAKLatar Belakang. Perburukan fungsi ginjal berkaitan dengan luaran klinis yang lebih buruk pada pasien gagal jantung dekompensasi akut. Karakteristik klinis pada saat pasien masuk ke unit gawat darurat (UGD) dapat menolong untuk identifikasi pasien yang berisiko terhadap kejadian perburukan fungsi ginjal. Tujuan penelitian ini adalah membuat sistem skor untuk mempermudah identifikasi pasien yang berisiko terhadap perburukan fungsi ginjal pada gagal jantung dekompensasi akut.Metode. Studi kohort retrospektif dilakukan terhadap 614 pasien yang menjalani perawatan karenan gagal jantung dekompensasi akut. Perburukan fungsi ginjal didefinisikan sebagai peningkatan nilai kreatinin serum ≥ 0.3 mg/dL kapanpun selama perawatan atau ≥ 25% dari awal masuk perawatan.Hasil. Perburukan fungsi ginjal terjadi pada hampir 26% pasien. Prediktor independen terhadap kejadian perburukan fungsi ginjal yang didapat melalui analisis dengan logistik regresi backward selection adalah usia > 75 tahun (p < 0.0001); perempuan (p = 0.034); riwayat hipertensi (p = 0.001); anemia (p = 0.005); dan serum Creatinin saat masuk di UGD > 2.5 mg/dL (p = 0.013). Sistem skor dibuat dari model akhir tersebut. Dilakukan validasi internal dengan metode bootstrap didapatkan hasil optimisme yang baik (0.01088808).Kesimpulan. Sistem skor baru dapat memprediksi kejadian perburukan fungsi ginjal pada pasien gagal jantung dekompensasi akut yang menjalani rawat inap.

---

ABSTRACTBackground. Worsening renal function (WRF) is associated with worse outcomes among patients who are hospitalized with acute decompensated heart failure (ADHF). Clinical characteristics at admission may help identify patients at increased risk of WRF. The aim of this study was to create in admission scoring system to simplify identification patients at risk of WRF in ADHF setting.Methods. A retrospective data of 614 patients admitted with ADHF was analyzed. By the definition WRF occurred when serum Creatinin increased at anytime during hospitalization by ≥ 0.3 mg/dL or by ≥ 25% from admission.Results. Worsening renal function developed in near 26% patients. The independent predictors of WRF analyzed with backward selection logistic regression were: age > 75 years old (p < 0.0001), female (p = 0.034); history of hypertension (p = 0.001); anemia (p = 0.005); and in admission serum Creatinin (p = 0.013). A scoring system was generated from this final model. An internal validation with bootstrap method showed good optimism (0.01088808).Conclusion. A new scoring system could predict in-hospital worsening renal function among patients hospitalized with acute decompensated heart failure., Background. Worsening renal function (WRF) is associated with worse outcomesamong patients who are hospitalized with acute decompensated heart failure(ADHF). Clinical characteristics at admission may help identify patients at incresedrisk of WRF. The aim of this study was to create in admission scoring system tosimplify identification patients at risk of WRF in ADHF setting.Methods. A retrospective data of 614 patients admitted with ADHF was analyzed.By the definition WRF occurred when serum Creatinin increased at anytime duringhospitalization by ≥ 0.3 mg/dL or by ≥ 25% from admission.Results. Worsening renal function developed in near 26% patients. Theindependent predictors of WRF analyzed with backward selection logisticregression were: age > 75 years old (p < 0.0001), female (p = 0.034); history ofhypertension (p = 0.001); anemia (p = 0.005); and in admission serum Creatinin (p= 0.013). A scoring system was generated from this final model. An internalvalidation with bootstrap method showed good optimism (0.01088808).Conclusion. A new scoring system could predict in-hospital worsening renal function among patients hospitalized with acute decompensated heart failure.]"

"The major cause of mortalities in Indonesia shifs to Non Communicable risk faktors that related to physiological factors (intermediate risk factors) i.e. hypertension, obesity, and central obesity, diabetes...."

"[Latar belakang : Fibrilasi atrium merupakan aritmia yang paling sering terjadipasca bedah pintas arteri koroner. Peningkatan stress oksidatif, inflamasi, aktivitasneurohormonal memiliki peran terhadap kejadian fibrilasi atrium pasca bedahpintas arteri koroner. Berbagai strategi farmakologis seperti antiaritmia,antiinflamasi, dan antioksidan sudah dipelajari untuk menurun risiko kejadianfibrilasi atrium pasca bedah pintas arteri koroner namun kejadian fibrilasi atriummasih tinggi. Allopurinol memiliki efek antioksidan, namun belum ada uji klinisyang mempelajari efek allopurinol terhadap kejadian fibrilasi atrium. Penelitianini bertujuan untuk menilai efek allopurinol terhadap kejadian fibrilasi atriumpasca bedah pintas arteri koronerMetode : Uji klinis randomisasi tersamar ganda dilakukan di Rumah SakitPembuluh Darah Harapan Kita (RSJPDHK) pada periode April ? Mei 2015.Pasien BPAK on-pump elektif yang diseleksi secara consecutive samplingkemudian dibagi menjadi dua kelompok yaitu kelompok allopurinol dankelompok plasebo dengan randomisasi blok. Subyek diberikan allopurinol 600 mg/ plasebo dosis tunggal sejak 1 hari sebelum operasi sampai hari ke-5 pascaoperasi. Dilakukan pengamatan kejadian fibrilasi atrium pasca operasi sampaipasien pulang dari perawatan.Hasil : Sebanyak 90 subyek diikutsertakan dalam penelitian, 45 subyek padamasing-masing kelompok. Kejadiaan fibrilasi atrium lebih rendah secarabermakna pada kelompok allopurinol (12 (26,7%) vs 22 (48,9%) p 0,030). Kesimpulan : Pemberian allopurinol perioperatif menurunkan kejadian fibrilasi atrium pasca bedah pintas arteri koroner.;Background : Atrial fibrillation is the most common arrhythmias after coronaryartery bypass surgery. Increased oxidative stress, inflammation, neurohormonalactivity has a role on the incidence of atrial fibrillation after coronary arterybypass surgery. Various pharmacological strategies such as antiarrhythmias, antiinflammatory,and antioxidant have been studied to decrease atrial fibrillationincident after coronary artery bypass surgery, but the incidence of atrialfibrillation is still high. Allopurinol has antioxidant effects, but there was noclinical trials that studied the effect of allopurinol on atrial fibrillation incidence.The aim of this study to assess allopurinol effect on the atrial fibrillation incidenceafter coronary artery bypass surgery. Methods: A double-blind randomized clinical trial conducted at the NationalCardiovascular Center Harapan Kita in Jakarta from April to May 2015. Electiveon-pump CABG patients were selected by consecutive sampling then divided intotwo groups: allopurinol and placebo groups with block randomization. Subjectsgiven allopurinol 600 mg / placebo single dose since 1 day before surgery untilthe 5th day post-surgery. The incidence of atrial fibrillation was observedpostoperatively.Results: A total of 90 subjects were included in the study, 45 subjects in eachgroup. Occurrence of atrial fibrillation was significantly lower in the allopurinolgroup (12 (26.7%) vs 22 (48.9%) p 0,030). Conclusion: Perioperative allopurinol reduced the incidence of atrial fibrillation after coronary artery bypass surgery., Background : Atrial fibrillation is the most common arrhythmias after coronaryartery bypass surgery. Increased oxidative stress, inflammation, neurohormonalactivity has a role on the incidence of atrial fibrillation after coronary arterybypass surgery. Various pharmacological strategies such as antiarrhythmias, antiinflammatory,and antioxidant have been studied to decrease atrial fibrillationincident after coronary artery bypass surgery, but the incidence of atrialfibrillation is still high. Allopurinol has antioxidant effects, but there was noclinical trials that studied the effect of allopurinol on atrial fibrillation incidence.The aim of this study to assess allopurinol effect on the atrial fibrillation incidenceafter coronary artery bypass surgery. Methods: A double-blind randomized clinical trial conducted at the NationalCardiovascular Center Harapan Kita in Jakarta from April to May 2015. Electiveon-pump CABG patients were selected by consecutive sampling then divided intotwo groups: allopurinol and placebo groups with block randomization. Subjectsgiven allopurinol 600 mg / placebo single dose since 1 day before surgery untilthe 5th day post-surgery. The incidence of atrial fibrillation was observedpostoperatively.Results: A total of 90 subjects were included in the study, 45 subjects in eachgroup. Occurrence of atrial fibrillation was significantly lower in the allopurinolgroup (12 (26.7%) vs 22 (48.9%) p 0,030). Conclusion: Perioperative allopurinol reduced the incidence of atrial fibrillation after coronary artery bypass surgery.]"

"[ABSTRAKLatar belakang : Kekakuan arteri berkaitan dengan peningkatan risiko kejadian kardiovaskular. Variabilitas tekanan darah dengan menggunakan ambulatory blood pressure monitoring telah terbukti sebagai prediktor prognosis kardiovaskular dan dapat menggambarkan kekakuan arteri. Penelitian ini bertujuan untuk menyelidiki hubungan variasi tekanan darah dengan menggunakan home blood pressure monitoring dengan pemeriksaan pulse wave velocity sebagai penilaian kekakuan arteri.Metode : Penelitian potong-lintang dilakukan terhadap 57 subyek hipertensi yang belum terobati berusia 30-50 tahun. Subyek menjalani pemeriksaan PWV dan dilakukan monitoring tekanan darah menggunakan HBPM sebanyak 3 hari (setiap pagi dan malam, masing-masing dua kali pengukuran). Dilakukan juga penilaian terhadap variabel perancu (obesitas, diabetes, dislipidemia, penurunan fungsi ginjal).Hasil : Sebanyak 21% subyek obesitas, 8,7% mengidap diabetes melitus, 60% mengalami dislipedemia, 14% merokok, tidak ada yang mengalami perburukan fungsi ginjal. Tidak ada hubungan antara obesitas, dislipidemia, merokok, jenis kelamin, merokok dengan kekakuan arteri. Diabetes melitus memliki hubungan yang signifikan dengan kekakuan arteri (p=0,01). Ada perbedaan antar pengukuran tekanan sistolik berdasarkan pengelompokan hari dan waktu, sebaliknya tidak ada perbedaan antar pengukuran tekanan diastolik. Terdapat korelasi antara kekakuan arteri dengan rata-rata tekanan darah diastolik (p=0,028), rata-rata tekanan darah diastolik pagi (p=0,015), koefisien variasi diastolik (p=0,030), koefisien variasi diastolik pagi (p=0,015).Kesimpulan : Tidak terdapat hubungan variabilitas tekanan darah sistolik terhadap kekakuan arteri namun terdapat kecenderungan hubungan yang positif. Terdapat hubungan berbanding terbalik yang signifikan antara variabilitas tekanan darah diastolik dengan kekakuan arteri.

---

ABSTRACTBackground : Arterial stiffness is related to higher risk of cardiovascular events. Blood pressure variability using ambulatory blood pressure monitoring has proven as a cardiovascular prognosis predictor and also serves as predictor of arterial stiffness. The study aims to prove the correlation between blood pressure variability measurement using home blood pressure monitoring and arterial stiffness measurement using pulse wave velocityMethods : A cross-sectional study was conducted to 57 subjects with native hypertension between 30-50 years old. Subjects underwent PWV measurement and was monitored for their blood pressure using HBPM for three consecutive days (morning and night BP each repeated two times). Subjects also screened for related confoundings i.e., diabetes, obesity, dyslipidemia, renal function disturbance. Results : As many as 21% subjects is obese, 8.7% had diabetes melitus, 60% had dyslipidemia, 14% is smoker. There is no subjects with renal function disturbance. There is no correlation between obesity, dyslipidemia, smoking habit, and sex to arterial stiffness, whereas diabetes melitus has a strong correlation to arterial stiffness (p=0,01). There was a significant difference between sytolic blood pressure measurement at each group of blood pressure based on day and time, but no difference found between diastolic blood pressure. There is significant correlation between arterial stiffness and mean diastolic pressure, mean morning diastolic pressure, variance coefficient of diastolic pressure, variance coefficient of morning blood pressure.Conclusion : We conclude that HBPM is reliable in measuring blood pressure variability. There is no significant relation of systolic blood pressure variability to arterial stiffness, but there is a tendency of positive correlation. While there is a significant negative correlation between diastolic pressure to arterial stiffness., Background : Arterial stiffness is related to higher risk of cardiovascular events.Blood pressure variability using ambulatory blood pressure monitoring has proven asa cardiovascular prognosis predictor and also serves as predictor of arterial stiffness.The study aims to prove the correlation between blood pressure variabilitymeasurement using home blood pressure monitoring and arterial stiffnessmeasurement using pulse wave velocity Methods : A cross-sectional study was conducted to 57 subjects with nativehypertension between 30-50 years old. Subjects underwent PWV measurement andwas monitored for their blood pressure using HBPM for three consecutive days(morning and night BP each repeated two times). Subjects also screened for relatedconfoundings i.e., diabetes, obesity, dyslipidemia, renal function disturbance. Results : As many as 21% subjects is obese, 8.7% had diabetes melitus, 60% haddyslipidemia, 14% is smoker. There is no subjects with renal function disturbance.There is no correlation between obesity, dyslipidemia, smoking habit, and sex toarterial stiffness, whereas diabetes melitus has a strong correlation to arterial stiffness(p=0,01). There was a significant difference between sytolic blood pressuremeasurement at each group of blood pressure based on day and time, but nodifference found between diastolic blood pressure. There is significant correlationbetween arterial stiffness and mean diastolic pressure, mean morning diastolicpressure, variance coefficient of diastolic pressure, variance coefficient of morningblood pressure.Conclusion : We conclude that HBPM is reliable in measuring blood pressurevariability. There is no significant relation of systolic blood pressure variability toarterial stiffness, but there is a tendency of positive correlation. While there is a significant negative correlation between diastolic pressure to arterial stiffness. ]"

"[ABSTRAKLatar Belakang : Endotelial glikokaliks merupakan bagian penting dalam barrier vaskular. Keadaan inflamasi, hiperglikemia, iskemia, dan hipervolemia dapat menyebabkan kerusakan glikokaliks. Kerusakan glikokaliks menyebabkan cairan terekstravasasi ke interstisial. Pada pasien pasca BPAK terjadi peningkatan syndecan-1 dalam plasma yang merupakan penanda terjadinya kerusakan endotelial glikokaliks. Hipervolemia pasca BPAK juga dapat memperburuk kerusakan glikokaliks dan hipervolemia sendiri berhubungan dengan kejadian komplikasi mayor pasca operasi. Pemilihan jenis cairan yang tepat diperlukan pada kondisi ini.Tujuan : Mengetahui apakah terdapat perbedaan efek pemberian koloid dan kristaloid terhadap endotelial glikokaliks pada pasien pasca bedah pintas arteri koroner.Metode Penelitian : Penelitian ini merupakan studi intervensi acak pada pasien pasca BPAK dengan pengambilan sampel secara konsekutif. Pasien yang tidak responsif terhadap pemberiaan cairan, memiliki fungsi pompa jantung pre oparasi yang turun, memiliki kelainan fungsi ginjal, atau menggunakan IABP saat operasi akan dieksklusi dari penelitian. Responsivitas terhadap cairan dinilai dengan pemeriksaan Doppler karotis. Pasien kemudian akan diberikan cairan koloid atau kristaloid secara acak. Sampel darah diambil pre dan pasca pemberian cairan. Kadar syndecan-1 diperiksa dengan metode ELISA.Hasil : Subyek penelitian sebanyak 54 orang dengan 27 orang mendapat cairan koloid dan 27 orang mendapat cairan kristaloid. Hasil pemeriksaan syndecan-1 pre pemberian cairan adalah 1,97 (0,29-14,03) ng/ml pada kelompok yang mendapat Gelofusine dan 2,14 (0,68-11,80) ng/ml pada kelompok Ringer?s lactate (p = 0,736). Syndecan-1 pasca pemberian cairan adalah 1,78 (0,23-10,98) ng/ml pada kelompok Gelofusine dan 2,08 (0,72-12,23) ng/ml pada kelompok Ringer?s lactate (p=0,276). Selisih antara syndecan-1 pre dan pasca pemberian cairan adalah 0,23 (-1,3 - 3,55) ng/ml pada kelompok Gelofusine dan 0,14 (-2,12 - 1,80) ng/ml pada kelompok Ringer?s lactate (p = 0,043). Syndecan-1 turun pada 23 pasien (85,5%) kelompok Gelofusine dan 15 pasien (55,6%) kelompok Ringer?s lactate (p = 0,017). Analisis bivariat pada beberapa faktor yang diduga mempengaruhi perubahan syndecan-1 menunjukkan bahwa jenis cairan merupakan satu-satunya faktor yang berpengaruh.Kesimpulan : Penelitian ini membuktikan bahwa terdapat perbedaan efek antara pemberian koloid (Gelofusine) dan kristaloid (Ringer?s lactate) terhadap endotelial glikokaliks pada pasien pasca BPAK. Pemberian koloid dapat lebih memperbaiki kerusakan endotelial glikokaliks yang terjadi pasca BPAK.

---

ABSTRACTBackground : Endothelial glycocalyx is an important part of vascular barrier. Inflammation, hyperglycemia, ischemia, and hypervolemia contribute to shedding of the glycocalyx. Damage to the glycocalyx can make fluid extravasation to interstitial. Increasing syndecan-1 value in plasma as marker of shedding the endothelial glycocalyx can occured in the post CABG patients. Hypervolemia is a worsening factor of the shedding in glycocalyx and hypervolemia contribute to major complication after operation. It is important to choose the appropriate fluid for this patient.Objective : The aim of this study is to examine the difference effect of colloid and crystalloid administration on endothelial glycocalyx in post CABG patients.Methods : This is a randomized trial which recruits post CABG patients cosecutively. Non fluid responsive, reduced left ventricle ejection fraction, reduced renal function, or used of IABP during operation are excluded. Fluid responsiveness will be measured by carotis Doppler. Patients then given colloid or crytalloid randomly. Blood sample were taken before and after fluid loading. Syndecan-1 value examined using ELISA method.Result : The total of 54 subjects with 27 patients received colloid and 27 patients received crystalloid. Syndecan-1 pre loading are 1,97 (0,29-14,03) ng/ml in Gelofusine group vs 2,14 (0,68-11,80) ng/ml in Ringer?s lactate group (p = 0,736). Syndecan-1 post loading are 1,78 (0,23-10,98) ng/ml in Gelofusine group vs 2,08 (0,72-12,23) ng/ml in Ringer?s lactate group (p=0,276). The difference of syndecan-1 value in pre and post fluid loading are 0,23 (-1,3 - 3,55) ng/ml in Gelofusine group and 0,14 (-2,12 - 1,80) ng/ml in Ringer?s lactate group (p = 0,043). Lowering syndecan-1 occured in 23 patients (85,2%) in Gelofusine group and 15 (55,6%) in Ringer?s lactate group (p= 0,017). Bivariat analysis showed that kind of fluid is the only factor can influence the difference of syndecan-1. Conclusion : There is contrasting effect of colloid and crystalloid administration on endothelial glycocalyx in post CABG patients. Colloid can reduce shedding of the endothelial glycocalyx after CABG., Background : Endothelial glycocalyx is an important part of vascular barrier. Inflammation, hyperglycemia, ischemia, and hypervolemia contribute to shedding of the glycocalyx. Damage to the glycocalyx can make fluid extravasation to interstitial. Increasing syndecan-1 value in plasma as marker of shedding the endothelial glycocalyx can occured in the post CABG patients. Hypervolemia is a worsening factor of the shedding in glycocalyx and hypervolemia contribute to major complication after operation. It is important to choose the appropriate fluid for this patient.Objective : The aim of this study is to examine the difference effect of colloid and crystalloid administration on endothelial glycocalyx in post CABG patients.Methods : This is a randomized trial which recruits post CABG patients cosecutively. Non fluid responsive, reduced left ventricle ejection fraction, reduced renal function, or used of IABP during operation are excluded. Fluid responsiveness will be measured by carotis Doppler. Patients then given colloid or crytalloid randomly. Blood sample were taken before and after fluid loading. Syndecan-1 value examined using ELISA method.Result : The total of 54 subjects with 27 patients received colloid and 27 patients received crystalloid. Syndecan-1 pre loading are 1,97 (0,29-14,03) ng/ml in Gelofusine group vs 2,14 (0,68-11,80) ng/ml in Ringer’s lactate group (p = 0,736). Syndecan-1 post loading are 1,78 (0,23-10,98) ng/ml in Gelofusine group vs 2,08 (0,72-12,23) ng/ml in Ringer’s lactate group (p=0,276). The difference of syndecan-1 value in pre and post fluid loading are 0,23 (-1,3 - 3,55) ng/ml in Gelofusine group and 0,14 (-2,12 - 1,80) ng/ml in Ringer’s lactate group (p = 0,043). Lowering syndecan-1 occured in 23 patients (85,2%) in Gelofusine group and 15 (55,6%) in Ringer’s lactate group (p= 0,017). Bivariat analysis showed that kind of fluid is the only factor can influence the difference of syndecan-1. Conclusion : There is contrasting effect of colloid and crystalloid administration on endothelial glycocalyx in post CABG patients. Colloid can reduce shedding of the endothelial glycocalyx after CABG.]"

"Penyakit jantung koroner (PJK) telah menjadi penyebab utama mortalitas di seluruh dunia, termasuk di Indonesia. Prevalensi PJK semakin lama semakin meningkat di negara berkembang. Hal tersebut terutama dipengaruhi oleh peningkatan risiko mayor PJK. Modifikasi faktor risiko tersebut memerlukan peran pengetahuan, sikap, dan perilaku mengenai penyakit jantung koroner. Kelompok remaja dan dewasa menjadi sasaran yang tepat untuk pencegahan PJK. Penelitian ini bertujuan untuk mengetahui sejauh mana pengetahuan, sikap, dan perilaku penyakit jantung koroner pada kelompok remaja dan dewasa di Jakarta Pusat sebagai bentuk upaya pencegahan penyakit. Penelitian menggunakan desain potong lintang. Sampel penelitian terdiri dari kelompok remaja dan dewasa di daerah Rawasari, Jakarta Pusat. Jumlah sampel penelitian 102 orang, yaitu 51 kelompok remaja dan 51 kelompok dewasa yang diambil melalui kuesioner. Dari data yang telah dikumpulkan, didapatkan 43,1% remaja dan 25,5% dewasa memiliki tingkat pengetahuan kurang, sebanyak 3,9% remaja memiliki sikap yang kurang, serta 3,9% remaja dan dewasa memiliki perilaku yang kurang. Selain itu, didapatkan pula bahwa pengetahuan dan sikap tidak memiliki hubungan bermakna dengan perilaku pada kelompok remaja dan dewasa. Walaupun tidak terdapat hubungan yang bermakna antara pengetahuan, sikap, dan perilaku, perbaikan pengetahuan, sikap, dan perilaku sangat dibutuhkan karena masih banyak kelompok remaja dan dewasa yang belum memiliki pengetahuan, sikap, dan perilaku baik.

---

Coronary heart disease is amongst mortality in the world, including Indonesia. The prevalence of coronary heart disease is increasing in Indonesia. It is caused by increasing risk factors, especially the major risk factor. Knowledge, attitude, and practice have important parts to minimize the risk factor of coronary heart disease. Adolescent and adult group are the important group to prevent the disease. This research aims to know the knowledge, attitude, and practice about coronary heart disease in adolescent and adult groups at Central Jakarta for preventing the disease.

This research use cross sectional design and the sample is 102 people, including 51 adults and 51 adolescents group in Rawasari, Central Jakarta. The results show that 43.1% adolescents and 25.5% adults have poor knowledge, 3.9% adolescents have poor attitude and 3.9% adolescents and adults have poor practice. There is no relation between knowledge, attitude, and practice both in adolescent and adult group in this research (p > 0.05). However, it is needed to improve knowledge, attitude, and practice in adult and adolescent group because of poor knowledge, attitude, and practice . "