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Ayuthia Putri Sedyawan
Perbandingan efek lisinopril dan amlodipin terhadap kekakuan pembuluh arteri pada pasien hipertensi yang belum pernah diobati = aortic stiffness in native hypertension amlodipin versus lisinopril administration ashalina study
"[ABSTRAK
Latar belakang. Hipertensi adalah faktor risiko kardiovaskular yang penting. Kekakuan arteri meningkat seiring dengan peningkatan usia, hipertensi, diabetes mellitus, aterosklerosis, dan lainnya. Kekakuan arteri dapat diukur secara non-invasif dengan menggunakan alat carotid-femoral pulse wave velocity (CF-PWV), dimana alat ini mengukur kecepatan gelombang nadi yang berjalan dari arteri karotis komunis ke arteri femoralis. Obat antihipertensi telah diketahui memiliki kemampuan terhadap kekakuan arteri, namun berbeda efektifitasnya.
Tujuan. Melihat perbandingan efek pemberian penghambat enzim pengubah angiotensin dan penyekat kanal kalsium terhadap kekakuan arteri pada pasien hipertensi yang belum pernah diobati sebelumnya.
Metode. Uji klinis acak dengan tersamar ganda, dilakukan di RS Pusat Jantung dan Pembuluh Darah Harapan Kita (Maret-Mei 2015) terhadap 54 subyek usia 30-50 tahun. Subyek dibagi menjadi dua grup, grup lisinopril (n=27) dan amlodipin (n=27). Tekanan darah dan CF-PWV diukur sebelum dan setelah intervensi.
Hasil. Terdapat penurunan tekanan darah dan sesudah terapi untuk kedua grup. Delta penurunan CF-PWV untuk kedua intervensi menujukkan hasil yang signifikan (P value <0.001). Lisinopril memiliki penurunan delta CF-PWV yang lebih signifikan dibandingkan amlodipin. (P value <0.001 IK 95% 0.2 - 0.5).
Kesimpulan. Penelitian ini membuktikan adanya perbedaan bermakna terhadap CF-PWV pada grup yang diberikan lisinopril dan amlodipin, dimana lisinopril memiliki delta penurunan PWV yang lebih signifikan.
ABSTRACT
Background. Hypertension is a well-recognized cardiovascular risk factors. Arterial stiffness increases with age, hypertension, diabetes mellitus, atherosclerosis, etc. Arterial stiffness can be assessed noninvasively by carotid-femoral pulse wave velocity (CF-PWV) measurement, that is, the velocity of the pulse wave to travel a given distance between carotid and femoral artery. Antihypertensive drugs have been implicated in arterial stiffness diminishment but vary in effectiveness.
Objective. To examine the difference in arterial stiffness reduction in young native hypertensive subjects that was given ace-inhibitor or calcium channel blocker.
Methods. A double blind randomized clinical trial was conducted in National Cardiovascular Centre Harapan Kita to 54 subjects (30-50 years old), from March to May 2015. Subjects were divided into lisinopril 5mg (n=27) and amlodipine 5mg (n=27) groups. Blood pressure and CF-PWV were measured before and 4 weeks post therapy.
Results. Blood pressure reduction was found before and after treatment for both groups. CF-PWV for lisinopril and amlodipine showed significant reduction (p-value <0.001). Lisinopril had more significant decrease in CF-PWV (P value <0.001 CI 95% 0.2 - 0.5).
Conclusion. There was a statistically significant difference in CF-PWV reduction between lisinopril and amlodipin administration to patients with native hypertension, with lisinopril having the larger effect., Background. Hypertension is a well-recognized cardiovascular risk factors.
Arterial stiffness increases with age
subjects with diabetes mellitus,
and hypertension
and is also enhanced in
atherosclerosis,
and end-stage renal disease.
Arterial stiffness can be assessed noninvasively with the use of carotid-femoral
pulse wave velocity (CF-PWV) measurement, that is, the velocity of the pulse
wave to travel a given distance between carotid and femoral artery.
Antihypertensive drugs have been implicated in arterial stiffness diminishment
but vary in their degree of effect. The calcium channel blocker having its
“destiffening” effect have been widely known to reduce arterial stiffness.
However, the renin-angiotensin system inhibitors proved to be superior to all
other antihypertensive drugs in reducing arterial stiffness.
Objective. The aim of this study was to examine the difference in arterial stiffness
reduction in native hypertensive subjects that was given ace-inhibitor or calcium
channel blocker for four weeks, by measuring the CF-PWV.
Methods. A double blind randomized clinical trial was conducted in National
Cardiovascular Centre Harapan Kita (NCCHK) to 54 subjects with native
hypertension between the age of 30-50 years old, from March to May 2015.
Subjects were divided into two groups: lisinopril 5mg (n=27) and amlodipine 5mg
(n=27). Blood pressure and CF-PWV were measured before and after 4 weeks of
therapy. Statistical analysis was done using bivariat and multivariat analisis to
determine the significance of arterial stiffness reduction.
Results. There was a reduction in blood pressure (systole, diastole, mean arterial
pressure) before and after the treatment for both groups. However although it was
clinicaly significant, statistically it was not (P value >0.05). Nonetheless, CFPWV
for
lisinopril
and
amlodipin
showed
significant
reduction
with
both
p-value
were
<0.001 (2.09±0.280, CI 95% 1.80-2.2 and 1.77±0.340, CI 95% 1.6-1.9).
When both drugs were compared using multivariate analysis, lisinopril was
proved to have a more significant decrease in CF-PWV (P value <0.001 CI 95%
0.2 - 0.5).
Conclusion. This study proved that there was a statistically significant difference
in CF-PWV reduction between lisinopril and amlodipin administration to patients with native hypertension, with lisinopril having the larger effect. ]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Ima Ansari Kusuma
Perbedaan efek pemberian koloid dan kristaloid terhadap endotelial glikokaliks pada pasien pasca bedah pintas arteri koroner = Contrasting effect of colloid and crystalloid administration on endothelial glycocalyx in post coronary artery bypass graft patients
"[ABSTRAK
Latar 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.
ABSTRACT
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., 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.]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Sebastian Andy
Hubungan pengukuran variabilitas tekanan darah dengan menggunakan Home Blood Pressure Monitoring terhadap Pulse Wave Velocity sebagai penilaian kekakuan arteri = Association between blood pressure variability measurement using Home Blood Pressure Monitoring and arterial stiffness measurement using Pulse Wave Velocity
"[ABSTRAK
Latar 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.
ABSTRACT
Background : 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 velocity
Methods : 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 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 velocity
Methods : 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. ]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Zul Efendi
Efek allopurinol terhadap kejadian fibrilasi atrium pasca bedah pintas arteri koroner = Allopurinol effect on the incidence of atrial fibrillation following coronary artery bypass surgery
"[Latar belakang : Fibrilasi atrium merupakan aritmia yang paling sering terjadi
pasca bedah pintas arteri koroner. Peningkatan stress oksidatif, inflamasi, aktivitas
neurohormonal memiliki peran terhadap kejadian fibrilasi atrium pasca bedah
pintas arteri koroner. Berbagai strategi farmakologis seperti antiaritmia,
antiinflamasi, dan antioksidan sudah dipelajari untuk menurun risiko kejadian
fibrilasi atrium pasca bedah pintas arteri koroner namun kejadian fibrilasi atrium
masih tinggi. Allopurinol memiliki efek antioksidan, namun belum ada uji klinis
yang mempelajari efek allopurinol terhadap kejadian fibrilasi atrium. Penelitian
ini bertujuan untuk menilai efek allopurinol terhadap kejadian fibrilasi atrium
pasca bedah pintas arteri koroner
Metode : Uji klinis randomisasi tersamar ganda dilakukan di Rumah Sakit
Pembuluh Darah Harapan Kita (RSJPDHK) pada periode April ? Mei 2015.
Pasien BPAK on-pump elektif yang diseleksi secara consecutive sampling
kemudian dibagi menjadi dua kelompok yaitu kelompok allopurinol dan
kelompok plasebo dengan randomisasi blok. Subyek diberikan allopurinol 600 mg
/ plasebo dosis tunggal sejak 1 hari sebelum operasi sampai hari ke-5 pasca
operasi. Dilakukan pengamatan kejadian fibrilasi atrium pasca operasi sampai
pasien pulang dari perawatan.
Hasil : Sebanyak 90 subyek diikutsertakan dalam penelitian, 45 subyek pada
masing-masing kelompok. Kejadiaan fibrilasi atrium lebih rendah secara
bermakna 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 coronary
artery bypass surgery. Increased oxidative stress, inflammation, neurohormonal
activity has a role on the incidence of atrial fibrillation after coronary artery
bypass surgery. Various pharmacological strategies such as antiarrhythmias, antiinflammatory,
and antioxidant have been studied to decrease atrial fibrillation
incident after coronary artery bypass surgery, but the incidence of atrial
fibrillation is still high. Allopurinol has antioxidant effects, but there was no
clinical trials that studied the effect of allopurinol on atrial fibrillation incidence.
The aim of this study to assess allopurinol effect on the atrial fibrillation incidence
after coronary artery bypass surgery.
Methods: A double-blind randomized clinical trial conducted at the National
Cardiovascular Center Harapan Kita in Jakarta from April to May 2015. Elective
on-pump CABG patients were selected by consecutive sampling then divided into
two groups: allopurinol and placebo groups with block randomization. Subjects
given allopurinol 600 mg / placebo single dose since 1 day before surgery until
the 5th day post-surgery. The incidence of atrial fibrillation was observed
postoperatively.
Results: A total of 90 subjects were included in the study, 45 subjects in each
group. Occurrence of atrial fibrillation was significantly lower in the allopurinol
group (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 coronary
artery bypass surgery. Increased oxidative stress, inflammation, neurohormonal
activity has a role on the incidence of atrial fibrillation after coronary artery
bypass surgery. Various pharmacological strategies such as antiarrhythmias, antiinflammatory,
and antioxidant have been studied to decrease atrial fibrillation
incident after coronary artery bypass surgery, but the incidence of atrial
fibrillation is still high. Allopurinol has antioxidant effects, but there was no
clinical trials that studied the effect of allopurinol on atrial fibrillation incidence.
The aim of this study to assess allopurinol effect on the atrial fibrillation incidence
after coronary artery bypass surgery.
Methods: A double-blind randomized clinical trial conducted at the National
Cardiovascular Center Harapan Kita in Jakarta from April to May 2015. Elective
on-pump CABG patients were selected by consecutive sampling then divided into
two groups: allopurinol and placebo groups with block randomization. Subjects
given allopurinol 600 mg / placebo single dose since 1 day before surgery until
the 5th day post-surgery. The incidence of atrial fibrillation was observed
postoperatively.
Results: A total of 90 subjects were included in the study, 45 subjects in each
group. Occurrence of atrial fibrillation was significantly lower in the allopurinol
group (12 (26.7%) vs 22 (48.9%) p 0,030).
Conclusion: Perioperative allopurinol reduced the incidence of atrial fibrillation after coronary artery bypass surgery.]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Budhi Setianto Purwowiyoto
Perbaikan fungsi intrinsik longitudinal ventrikel kiri sebelum dan sesudah latihan olahraga pada pasien gagal jantung dengan fraksi ejeksi yang normal = The improvement of longitudinal intrisic function of left ventricle before and after exercise training in heart failure with preserved ejection fraction patient
"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."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Vebiona Kartini Prima Putri
Sistem skor kardio-renal sebagai prediktor perburukan fungsi ginjal pada pasien gagal jantung dekompensasi akut yang menjalani rawat inap = Cardiorenal scoring system as a predictor of worsening renal function among patients hospitalized with acute decompensated heart failure
"[ABSTRAK
Latar 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.
ABSTRACT
Background. 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 outcomes
among patients who are hospitalized with acute decompensated heart failure
(ADHF). Clinical characteristics at admission may help identify patients at incresed
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.]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Pengenalan dini dan tata laksana penyakit jantung bawaan pada neonatus
Jakarta: Balai Penerbit Fakultas Kedokteran Universitas Indonesia, 1994
616.12 UNI p
Buku Teks SO  Universitas Indonesia Library
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Grasella Angelika Putri
Pengetahuan sikap dan perilaku mengenai penyakit jantung koroner pada kelompok remaja dan dewasa di Jakarta Pusat tahun 2012 = Knowledge attitude and practice about coronary heart disease in adolescent and adult groups at Central Jakarta in 2012
"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 . "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Skripsi Membership  Universitas Indonesia Library
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Widdy Winarta
Pengetahuan sikap dan perilaku mengenai penyakit jantung koroner pada kelompok dewasa dan remaja di Jakarta Selatan tahun 2012 = Knowledge attitude and practice of adult and adolescent regarding coronary heart disease at South Jakarta in 2012
"Penyakit jantung koroner merupakan penyakit berbahaya dengan berbagai faktor risiko. Penelitian ini pun bertujuan untuk meneliti tingkat pengetahuan, sikap dan perilaku kelompok remaja dan dewasa di Jakarta Selatan agar nantinya dapat dijadikan acuan dalam upaya pencegahan penyakit jantung koroner. Penelitian ini merupakan sebuah studi cross sectional analitik yang dilakukan pada kelompok remaja dan dewasa di Jakarta Selatan dengan jumlah total sampel 104 orang yang terdiri atas 52 orang remaja dan 52 orang dewasa. Data penelitian diambil dengan menggunakan kuesioner yang telah diuji reliabilitas dan validitasnya sebelum pengambilan data dilakukan. Hasil dari penelitian memperlihatkan rerata usia kelompok remaja dan dewasa adalah 16,85 dan 45(±8,197). Selain itu terdapat 27 laki-laki dan 25 perempuan pada kelompok remaja serta 24 laki-laki dan 28 perempuan pada kelompok dewasa. Dari hasil penelitian, didapatkan data bahwa persentase remaja dengan pengetahuan dan perilaku baik hanya 36,5%. Pada kelompok dewasa, didapatkan pengetahuan baik sebesar 34,6% dan perilaku baik sebesar 67,3%. Selain itu, pada kedua kelompok didapatkan hasil bahwa tidak terdapat hubungan antara pengetahuan, sikap dan perilaku. Dengan demikian, upaya perbaikan perlu dilakukan dengan fokus utama pada pengetahuan dewasa dan remaja serta perilaku remaja.
Coronary heart disease is a serious health problems which has many risk factors related to it. This research aims to study the level of knowledge, attitude and practice of adults and adolescents towards coronary heart disease in South Jakarta for future implementation of its result on prevention of coronary heart disease. A cross-sectional study was performed on 104 people of South Jakarta which encompass 52 adolescents and 52 adults. The questionnaire which has been tested for its reliability and validity were used for data collection. Mean scores of the adolescents and adults age were 16.85 and 45(±8.197) respectively. There were 27 men, 25 women; and 24 men, 28 women respectively in adolescents and adults group that participated in this research. Main problem that was obtained from this research is a low level of good knowledge and attitude of the adolescent group which is only 36.5%. Besides that, a problem was also seen in adults group which level of good knowledge and practice is 34.6% and 67.3% respectively. In both groups, relationship between knowledge, attitude and practice is not significant. In conclusion, improvements in knowledge and practice of adults and adolescents is necessary because low percentage was seen in each group."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Skripsi Membership  Universitas Indonesia Library
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Muhammad Iqbal Maulana
Pengetahuan sikap dan perilaku mengenai penyakit jantung koroner pada dewasa dan remaja di Jakarta Timur tahun 2012 = Knowledge attitude and practice of adolescent and adult regarding coronary heart disease at East Jakarta in 2012
"Penyakit jantung koroner adalah penyakit dengan risiko multifaktorial. Penelitian ini memiliki tujuan untuk mengetahui lebih lanjut tentang tingkat pengetahuan, sikap dan perilaku kelompok dewasa dan remaja di Jakarta Timur agar kedepannya dapat dijadikan pedoman untuk upaya pencegahan penyakit jantung koroner. Penelitian ini menggunakan metode cross sectional analitik yang dilakukan pada kelompok dewasa dan remaja di Jakarta Timur dengan jumlah total sampel sebanyak 110 orang yang terdiri atas 55 orang remaja dan 55 orang dewasa. Sampel penelitian adalah 24 laki-laki dan 31 perempuan pada kelompok remaja serta 26 laki-laki dan 29 perempuan pada kelompok dewasa Data penelitian diambil dengan menggunakan kuesioner yang telah diuji validitas dan reliabilitasnya sebelum dilakukan pengambilan data. Hasil dari penelitian ini memperlihatkan rerata usia kelompok dewasa dan remaja adalah 39,69 dan 17,02 tahun. Pada kelompok dewasa dengan pengetahuan kurang hanya sebanyak 32,7%. Hasil yang diperoleh pada kelompok remaja jauh dibawah dewasa yaitu sebanyak 46,2% memiliki pengetahuan kurang. Pada penelitian ini, didapatkan bahwa pada kelompok dewasa, pengetahuan dan sikap tidak berhubungan dengan perilaku dengan nilai p masing-masing adala 0,346 dan 0,927. Pada kelompok remaja, pengetahuan dan sikap juga tidak berhubungan dengan perilaku dengan nilai p masing-masing adalah 0,997 dan 1,000. Dengan demikian, perlu adanya upaya perbaikan dengan fokus utama pada pengetahuan dewasa dan remaja serta perilaku remaja.
Coronary heart disease is major health problems nowadays which has multifactorial risk related to it. Thus this research goal to study the level of knowledge, attitude and practice of adolescents and adults towards coronary heart disease in East Jakarta for future implementation of its result on prevention of coronary heart disease. A questionnaire-based survey which has been tested for its reliability and validity was carried out with 55 adolescents and 55 adults, selected randomly from population in East Jakarta as research subject. There were 26 men and 29 women in the adults group while in adolescents group there were 24 men and 31 women which participated in this research. The mean scores of the adults age were 39,69 while for the adolescents group were 17,02. The results showed that 46,2% adolescent group with poor knowledge. While in adults groups showed better result with 32,7% with poor knowledge. In adults group, the level of knowledge and attitude is not correlated to the level of practice. Same result were also seen in adolescents group where the level of knowledge and attitude did not correlate to the level of practice. In conclusion, improving knowledge and practice of adults and adolescents is necessary because low percentage was seen in each group."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Skripsi Membership  Universitas Indonesia Library
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