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"Aliran darah koroner terjadi terutama pada fase diastolik. Stenosis arteri koronaria menimbulkan iskemia miokard. Iskemia miokard dapat menimbulkan gangguan diastolik. Gangguan diastolik mengakibatkan penurunan aliran darah koroner pada sepertiga awal diastolik, baik pada waktu istirahat maupun selama takikardia. Angina pektoris merupakan gejala iskemia miokard. Tujuan penelitian ini untuk membuktikan bahwa ditemukan gangguan diastolik ventrikel kiri, dan angina pektoris akan lebih berat bila disertai dengan gangguan diastolik ventrikel kiri pada pasien stenosis arteri koronaria. Pada penelitian ini dilakukan pemeriksaan variabeI diastolik ventrikel kiri, dengan ali ran mitral gelombang pulsa doppler ekokardiografi saat istirahat, pada pasien yang terbukti mengalami stenosis arteri koronaria dari pemeriksaan angiografi koroner. Pada penelitian ini, yang memenuhi kelima variabel diastolik dan diklasifikasikan sebagai fungsi diastolik normal adalah 3,3%, relaksasi abnormal 10%, sementara 86,7% menunjukkan perubahan beberapa variabel diastolik.

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Coronary blood flow occurs mainly in the diastolic phase. Arterial stenosis The coronary artery gives rise to myocardial ischemia. Myocardial ischemia can cause diastolic disorders. Diastolic disorders result in decreased blood flow coronary in the first third of diastolic, both at rest and during tachicardia. Angina pectoris is a symptom of myocardial ischemia. The purpose of this study to prove that diastolic disorders of the left ventricle, and angina were found Pectoris will be more severe when accompanied by diastolic disorders of the left ventricle in patients with coronary artery stenosis. In this study, a variabeI examination was carried out diastolic left ventricle, with ali ran mitral pulse wave Doppler echocardiography at rest, in patients who have been shown to have coronary artery stenosis of coronary angiography examination. In this study, a variabeI examination was carried out diastolic left ventricle, with ali ran mitral pulse wave Doppler echocardiography at rest, in patients who have been shown to have coronary artery stenosis of coronary angiography examination. In this study, which meets all five variables diastolic and classified as normal diastolic function is 3.3%, relaxation abnormal 10%, while 86.7% showed changes in several diastolic variables.

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"ABSTRAKPendahuluan Keputusan untuk melakukan tindakan operasi reparasi dan replace katup mitral pada stenosis mitral masih diperdebatkan. Tujuan penelitian ini adalah mencari hubunganantara Wilkin?s score dengan keputusan operasi reparasi dan replace katup mitralpada stenosis mitral, serta mencari titik potong nilai Wilkins? score pada operasireparasi dan replace katup mitralMetodePenelitian adalah deskriptif analitik dengan pendekatan cross sectional secararetrospektif mencakup seluruh pasien dari RS Harapan Kita Jakarta yang dilakukanoperasi stenosis mitral pada Januari 2010 ? September 2015 oleh satu orang dokterbedah Jantung. Hubungan Wilkins? score dengan keputusan operasi serta nilai titikpotong Wilkins? score pada operasi reparasi dan replace menjadi luaran yang akanditeliti.HasilSeratus dua puluh lima subjek dengan usia rata-rata kelompok reparasi 36,78 ± 9,37tahun dan replace 44,49 ± 9,29 tahun. Didapatkan nilai mean Wilkins? score padakelompok reparasi 6,5 (4-12) dan kelompok replace 8 (4-14) dengan nilai signifikansip<0,001. Dengan area under curve 0,786 dan p<0,001, dapat dinilai titik potongWilkins? score berada pada nilai 7. Dengan memerhatikan variabel lain yangmenunjukkan adanya hubungan signifikan pada analisis bivariat yaitu usia,regurgitasi mitral dan Euro score, dilakukan analisis multivariate dengan uji regresilogistic didapatkan area under curve 0,946 dan p<0,001, dapat dinilai titik potongWilkins? score berada pada 5. KesimpulanWilkins? score berhubungan dalam pengambilan keputusan tindakan operasi reparasidan replace katup pada subjek dengan stenosis mitral, dengan titik poin pada putusanoperasi reparasi dan replace yaitu Wilkins? score 7. Jika Wilkins? scoremempertimbangkan faktor usia, regurgitasi mitral dan Euro score titik poin padaputusan operasi reparasi dan replace yaitu Wilkins? score 5.

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ABSTRACTIntroductionDecision on the repair and replacement of mitral valve surgery in mitral stenosispatients is still being debated. The aim for this research is to find the relationshipbetween Wilkins? score and the decision between repair and replacing mitral valve inmitral stenosis cases, and to find the cut off point for Wilkins?score in the mitralvalve repair and replacement procedureMethodsThe research is an analytic descriptive study with restrospective cross sectionaldesign. This research covered all patients of Harapan Kita Hospital for Heart andBlood vessels that had mitral stenosis operations from January of 2010 untilSeptember 2015 that is conducted by one of the surgeon in that hospital. Therelationship between Wilkin?s score and the decision to operate and the cut of pointof the Wilkins? score on the repair and replacement decision is the outcome that weare going to study in this research.ResultsOne hundred and twenty five subjects with the mean age of repair 36,78 ± 9,37 yearsold and replacement age of 44,49 ± 9,29 years old. We found that the mean ofWilkins? score in the reparation group is 6,5 (4-12) and in the replacement group is 8(4-14) with the significance value is p <0,001. With area under the curve of 0,786 andp<0,001 we can see that the the cut off point for Wilkins? score is 7. By seeing othervariables to show the significance between all bivariates variable such as age, mitralregurgitation and Euro score, we conducted multivariate analysis of regression testwe found area under the curve 0,946 with p<0,001. We can assess that the cut offpoint of Wilkins? score is 5 ConclusionWilkins score is related with decision making of valve repair and replacmentprocedure in patients with mitral stenosis with poin between decision is 7. If Wilkinsscore consider other factors such as age, the presence of mitral regurgitation and EuroScore the point that determine the decision to repair and replace mitral valve isWilkins? score 5."

"Latar Belakang: Stenosis vena sentral adalah salah satu permasalahan utama yang dihadapi dalam penggunaan akses hemodialisis FAV. Kondisi ini dapat ditangani dengan tindakan single balloon angioplasty. Namun, tatalaksana ini memiliki angka patensi yang tidak memuaskan akibat respon pembuluh darah terhadap barotrauma. Mengetahui risiko yang mempengaruhi patensi pasca tindakan single baloon angioplasty pada penderita stenosis vena sentral penting untuk memprediksi prognosis pasien. Penelitian ini bertujuan untuk mengetahui faktor yang berpengaruh terhadap patensi 6 dan 12 bulan pasca tindakan single baloon angioplasty pada pasien stenosis vena sentral. Metode: Sebuah penelitian kohort retrospektif multicenter pada Januari 2018 – September 2022 di empat rumah sakit dilakukan untuk menilai faktor yang berpengaruh terhadap patensi 6 dan 12 bulan pasca tindakan single baloon angioplasty pada pasien stenosis vena sentral. Faktor yang diteliti mencakup derajat stenosis, panjang stenosis, jumlah stenosis, lokasi stenosis, residual stenosis, ukuran balon, dan tekanan balon. Hasil: Terdapat total 76 pasien pada penelitian ini. Pada penelitian ditemukan faktor yang berpengaruh pada patensi 6 bulan pasca single balloon angioplasty adalah jenis kelamin laki – laki (78.4% vs 46.2%; p 0.004), panjang stenosis ≥ 2 cm (85.7% vs 56.5%; p 0.042), lokasi stenosis pada vena innominata (75% vs 39.3%; p: 0.002),derajat stenosis ≥ 80% (83.3% vs 42.5%; p : 0.001), dan residual stenosis ≥ 30% (85% vs 53.6%; p 0.013). Tidak ditemukan faktor yang berpengaruh pada patensi 12 bulan pasca single balloon angioplasty. Kesimpulan: Terdapat hubungan antara panjang stenosis, lokasi stenosis, derajat stenosis, dan residual stenosis terhadap patensi single balloon angioplasty

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Background: Central venous stenosis is one of the main problems encountered in AVF hemodialysis access. This condition can be treated with a single balloon angioplasty. However, this treatment has a low patency rates due to the response of the vessels to barotrauma. Knowing the risks that affect patency after single balloon angioplasty in patients with central venous stenosis is important to predict the patient's prognosis. This study aims to determine the factors influencing 6 and 12 months patency after single balloon angioplasty in central venous stenosis patient. Methods: A multicenter retrospective cohort study in January 2018 – September 2022 in four hospitals was conducted to assess factors that affect 6 and 12 months patency after single balloon angioplasty in patients with central venous stenosis. Factors studied included the degree of stenosis, length of stenosis, number of stenosis, location of stenosis, residual stenosis, balloon size, and balloon pressure. Results: There were a total of 76 patients in this study. In this study, it was found that the factors that affected the patency 6 months after single balloon angioplasty were male gender (78.4% vs 46.2%; p 0.004), stenosis length ≥ 2 cm (85.7% vs 56.5%; p 0.042),stenosis at the innominate vein (75% vs 39.3%; p: 0.002), stenosis degree ≥ 80% (83.3% vs 42.5%; p : 0.001), and residual stenosis ≥ 30% (85% vs 53.6%; p 0.013). There were no factors that had an effect on patency 12 months after single balloon angioplasty. Conclusion: There is a relationship between the length of the stenosis, the location of the stenosis, the degree of stenosis, and the residual stenosis on the patency of single balloon angioplasty"

"Latar Belakang : PJK disebabkan adanya stenosis pembuluh koroner akibat adanya proses aterosklerosis. Aterosklerosis berhubungan dengan penebalan tunika intima media arteri karotis komunis. Penebalan tunika intima media terjadi akibat kondisi inflamasi sebagai konsekuensi peningkatan sekresi sitokin proinflamasi.Tujuan : Mengetahui gambaran ketebalan tunika intima media pada pasien PJK stabil dan korelasinya dengan derajat stenosis arteri koroner.Metode : Dilakukan studi potong lintang pada lima puluh enam pasien PJK stabil yang telah menjalani angiografi koroner. Derajat stenosis arteri koroner dinilai dengan skor Gensini > 40 berat dan le; 40 ringan-sedang . Ketebalan tunika intima media arteri karotis komunis dinilai menggunakan alat USG dan dinyatakan tidak normal jika rerata ketebalannya ge;1mm. Dilakukan analisa statistik untuk melihat korelasi antara tebal tunika intima arteri karotis komunis dengan skor Gensini arteri koroner.Hasil : Didapatkan rerata Tebal Tunika Intima-Media Arteri Karotis Komunis TTIM AKK gabungan sebesar 0,95 mm SB 0,18 . Nilai median skor gensini adalah 71 kisaran 0-256 . Uji spearman correlation menunjukan hasil korelasi bermakna antara derajat beratnya skor Gensini dan TTIM AKK dengan p.

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Background Coronary heart disease CHD is caused by stenosis of coronary artery as the effect of atherosclerosis. Atherosclerosis has a correlation with the thicken of intimal media of common carotid artery. The thicken of intimal media of common carotid artery happened because of inflammatory process which is a consequencies of increased proinflammatory cytokines.Objective To determine the correlation between Intimal media thickness IMT with the severity of coronary artery stenosis in patient with stable CHDMethod A cross sectional study was conducted on fifty six stable CHD patient undergoing coronary angiography. Severity of coronary artery stenosis was evaluated using Gensini scoring system 40 severe and le 40 mild moderate. IMT was measured using USG and determined as abnormal if the mean of IMT ge 1mm. Statistical analytic was perform to determine the correlation between CCA IMT with Gensini score of coronary artery.Results Mean value of combined IMT of common carotid artery IMT CCA was 0.95mm SD 0,18. The median value of Gensini score was 71 range 0 256. The Spearman correlation Test showed a significant correlation between Gensini score severity with IMT CCA p."

"ABSTRAK Latar belakang. Pada pasien SA fraksi ejeksi ventrikel kiri dapat normal bahkan supra normal untukjangka waktu yang lama walaupun proses remodeling ventrikel kiri sudah mulai terjadi..Ekokardiografi speckle tracking dua dimensi (EST) mempunyai kelebihan untukdigunakan dalam menilai penurunan fungsi kontraktilitas miokard subklinis, dimanakeadaan tersebut dapat mempengaruhi prognosis pasien SA. sST2 merupakan biomarkeryang relatif baru, dapat meningkat pada regangan otot jantung (myocardial stretch),fibrosis, inflamasi, dan injuri miokard, apakah berhubungan dengan disfungsi diniventrikel kiri masih belum diketahui.Tujuan. Mengetahui korelasi sST2 terhadap nilai GLS EST pada pasien SA berat denganFEVK normalMetode. Merupakan studi potong lintang. Evaluasi dilakukan pada 29 pasien stenosisaorta berat dengan fraksi ejeksi normal yang datang ke poliklinik RS Jantung HarapanKita periode Februari 2015 sampai November 2015. Dilakukan pengambilan figurekokardiografi untuk menilai severitas SA dan untuk perhitungan nilai global longitudinalstrain speckle tracking kemudian dilakukan pengambilan sampel darah di laboratoriumRS Jantung Harapan Kita untuk menilai sST2.Hasil Penelitian. Dua puluh sembilan subjek ikut dalam penelitian ini dengan rerata usiaadalah 59.7±12.1 tahun. Fungsi intrinsik ventrikel kiri pasien SA berat pada penelitian inimengalami penurunan dengan nilai rerata GLS -11±4.5%. Hasil uji korelasi menunjukanterdapat korelasi positif dengan kekuatan korelasi sedang yang bermakna (r=0.429,p=0.02). Analisis multivariat tetap menunjukkan adanya hubungan antara kadar sST2dengan nilai GLS EST (r=0,282 p=0.036). Kesimpulan. Terdapat korelasi sST2 dengan global longitudinal strain speckle trackingpada pasien SA berat dengan fraksi ejeksi normal.ABSTRACT Background. In severe aortic stenosis (AS), cardiac performance measured at theventricular chamber is typically normal or supranormal, whereas Global LongitudinalStrain providing comprehensive information on LV myocardial contractility and issuperior in detecting subtle deteriorations. Impaired LV GLS is associated mortality riskand reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,and myocardial injury. Whether sST2 is increased in relation to the subclinical LVdysfunction assessed by GLS in AS is unknown.Objectives. To study correlation beetwen sST2 and GLS in patients with AS severeMethods. This is a correlation study with cross sectional design. The subject was aorticstenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at ouroutpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. Acomprehensive transthoracic echocardiography was performed to evaluate severity ofaortic stenosis. and echocardiographic figure recordings were stored in digital for off-linesubsequent GLS analysis. sST2 measurements were drawn after echocardiography.Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.APearsoncorrelaterevealedsignificantpositivecorrelationbetweensST2andGLS(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor stillshowed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation betweensST2 with left ventricle global longitudinal strain speckle tracking in patients with severeaortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at theventricular chamber is typically normal or supranormal, whereas Global LongitudinalStrain providing comprehensive information on LV myocardial contractility and issuperior in detecting subtle deteriorations. Impaired LV GLS is associated mortality riskand reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,and myocardial injury. Whether sST2 is increased in relation to the subclinical LVdysfunction assessed by GLS in AS is unknown.Objectives. To study correlation beetwen sST2 and GLS in patients with AS severeMethods. This is a correlation study with cross sectional design. The subject was aorticstenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at ouroutpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. Acomprehensive transthoracic echocardiography was performed to evaluate severity ofaortic stenosis. and echocardiographic figure recordings were stored in digital for off-linesubsequent GLS analysis. sST2 measurements were drawn after echocardiography.Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.APearsoncorrelaterevealedsignificantpositivecorrelationbetweensST2andGLS(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor stillshowed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation betweensST2 with left ventricle global longitudinal strain speckle tracking in patients with severeaortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at theventricular chamber is typically normal or supranormal, whereas Global LongitudinalStrain providing comprehensive information on LV myocardial contractility and issuperior in detecting subtle deteriorations. Impaired LV GLS is associated mortality riskand reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,and myocardial injury. Whether sST2 is increased in relation to the subclinical LVdysfunction assessed by GLS in AS is unknown.Objectives. To study correlation beetwen sST2 and GLS in patients with AS severeMethods. This is a correlation study with cross sectional design. The subject was aorticstenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at ouroutpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. Acomprehensive transthoracic echocardiography was performed to evaluate severity ofaortic stenosis. and echocardiographic figure recordings were stored in digital for off-linesubsequent GLS analysis. sST2 measurements were drawn after echocardiography.Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.APearsoncorrelaterevealedsignificantpositivecorrelationbetweensST2andGLS(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor stillshowed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation betweensST2 with left ventricle global longitudinal strain speckle tracking in patients with severeaortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at theventricular chamber is typically normal or supranormal, whereas Global LongitudinalStrain providing comprehensive information on LV myocardial contractility and issuperior in detecting subtle deteriorations. Impaired LV GLS is associated mortality riskand reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,and myocardial injury. Whether sST2 is increased in relation to the subclinical LVdysfunction assessed by GLS in AS is unknown.Objectives. To study correlation beetwen sST2 and GLS in patients with AS severeMethods. This is a correlation study with cross sectional design. The subject was aorticstenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at ouroutpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. Acomprehensive transthoracic echocardiography was performed to evaluate severity ofaortic stenosis. and echocardiographic figure recordings were stored in digital for off-linesubsequent GLS analysis. sST2 measurements were drawn after echocardiography.Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.APearsoncorrelaterevealedsignificantpositivecorrelationbetweensST2andGLS(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor stillshowed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation betweensST2 with left ventricle global longitudinal strain speckle tracking in patients with severeaortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at theventricular chamber is typically normal or supranormal, whereas Global LongitudinalStrain providing comprehensive information on LV myocardial contractility and issuperior in detecting subtle deteriorations. Impaired LV GLS is associated mortality riskand reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,and myocardial injury. Whether sST2 is increased in relation to the subclinical LVdysfunction assessed by GLS in AS is unknown.Objectives. To study correlation beetwen sST2 and GLS in patients with AS severeMethods. This is a correlation study with cross sectional design. The subject was aorticstenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at ouroutpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. Acomprehensive transthoracic echocardiography was performed to evaluate severity ofaortic stenosis. and echocardiographic figure recordings were stored in digital for off-linesubsequent GLS analysis. sST2 measurements were drawn after echocardiography.Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.APearsoncorrelaterevealedsignificantpositivecorrelationbetweensST2andGLS(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor stillshowed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation betweensST2 with left ventricle global longitudinal strain speckle tracking in patients with severeaortic stenosis with preserved EF. "

"Latar Belakang: Kondisi MS akan menyebabkan terjadinya peningkatan tekanan atrium kiri secara progresif dan menyebabkan remodelling serta dilatasi atrium kiri. Proses ini akan berakhir dengan penurunan komplians dari atrium kiri dan menyebabkan perubahan secara morfologis dan fungsional. Beberapa studi menunjukkan pengukuran Strain atrium kiri pada pasca tindakan balloon mitral valvuloplasty (BMV) menunjukkan perbaikan yang bermakna. Namun belum ada yang menilai hubungan antara perubahan Strain atrium kiri dengan perbaikan kapasitas fungsional pada pasien MS pasca tindakan BMV.Tujuan: Tujuan penelitian ini adalah untuk mengevaluasi hubungan antara perubahan Strain atrium kiri dengan perubahan kapasitas fungsional pada pasien MS pasca tindakan BMV.Metode: Desain penelitian yang digunakan adalah studi dengan one group pre-post design. Penelitian ini menggunakan data pemeriksaan ekokardiografi dan data kapasitas fungsional pasien mitral stenosis yang dilakukan tindakan BMV pada Maret 2019 hingga April 2020. Dilakukan pengukuran strain atrium kiri dengan metode speckle tracking echocardiography. Data sebelum dan sesudah BMV dianalisis untuk mencari hubungan variabel terhadap perubahan kapasitas fungsional.Hasil: Pasca tindakan BMV, terjadi perbaikan signifikan kapasitas fungsional yang ditandai dengan perbaikan median lama latihan (241 (18 – 1080) ke 606 (80 – 1900) detik, p <0.0001) dan perbaikan median nilai VO2max estimasi (18,8 (10,2 – 51,4) ke 33(12,6-83,2) mlO2/kg/menit, p <0.0001). Strain atrium kiri mengalami perubahan signifikan pasca tindakan BMV dari median 8(2-23)% ke 11(4-27)%. Dari uji korelasi didapatkan bahwa pre-MVG (r 0,23, adjusted R2 = 4,9%) berkorelasi terhadap perubahan kapasitas fungsional. Pada analisis bivariat dan multivariat didapatkan bahwa perubahan strain atrium kiri tidak berhubungan dengan perubahan kapasitas fungsional. Nilai pra MVA >1 cm2 (OR 7,37, IK 95% 1,0-54,35; p = 0,05) pra MVG > 10 mmHg (OR 6,6, IK 95% 1,71-25,5; p = 0,006) dan pra mPAP < 25 mmHg (OR 5,96, IK 95% 1,37-25,9; p = 0,017) berkorelasi terhadap perbaikan lama latihan pasca tindakan BMV.Kesimpulan: Perubahan strain atrium kiri tidak berhubungan dengan perubahan kapasitas fungsional pada pasien MS pasca tindakan BMV.

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Background: MS conditions will cause a progressive increase in left atrial pressure, remodelling and left atrial dilatation. This process will end with a decrease of left atrial compliance, causing morphological and functional changes. Several studies have shown that left atrial strain measurements after the BMV procedure showed significant improvement. However, no study has assessed the relationship between changes in left atrial strain and improvements in functional capacity in MS patients after the BMV procedure.

Objectives: This study aimed to evaluate the association between left atrial strain changes and functional capacity changes in MS patients after BMV procedures

Method: This is a one group pre-post design using retrospective data. This study used echocardiographic and functional capacity data of mitral stenosis patients who underwent BMV procedures from March 2019 to April 2020. Left atrial strain was measured using the speckle tracking echocardiography method. Data before and after BMV were analyzed to find the association of variables to changes in functional capacity.

Results: After the BMV procedure, there was a significant improvement in functional capacity as indicated by an improvement in the median length of exercise (241 (18 – 1080) to 606 (80 – 1900) seconds, p <0.0001) and an improvement in the median estimated VO2max value (18.8 (10.2). – 51.4) to 33(12.6-83.2) mlO2/kg/min, p < 0.0001). The left atrial strain underwent a significant change after the BMV procedure from a median of 8(2-23)% to 11(4-27)%. From the correlation test it was found that pre-MVG (r 0.23, adjusted R2 = 4.9%) correlated with changes in functional capacity. In bivariate and multivariate analysis, it was found that changes in left atrial strain were not associated with changes in functional capacity. Pre MVA value >1 cm2 (OR 7.37, CI 95% 1.0-54.35; p = 0.05) pre MVG > 10 mmHg (OR 6.6, CI 95% 1.71-25.5 ; p = 0.006) and pre mPAP < 25 mmHg (OR 5.96, CI 95% 1.37-25.9; p = 0.017) correlated with the improvement in duration of exercise after the BMV action.

Conclusion: Changes in left atrial strain are not associated with changes in functional capacity in MS patients after the BMV procedure."

"ABSTRAKPenyebab PAD yang paling sering adalah atherosclerosis. PAD berhubungan dengan penyakit atherosklerosis lain seperti renal artery stenosis (RAS). Angka harapan hidup menurun pada pasien yang mengalami RAS, terutama yag stenosisnya diatas 60% namun belum sampai ke tahap gagal ginjal kronik. Dengan penatalaksanaan yang holistik diharapkan angka harapan hidup pasien semakin meningkat.Tujuan: Untuk mengetahui prevalensi RAS pada pasien PAD serta melihat hubungan antara Angio Score, riwayat hipertensi dan diabetes melitus terhadap derajat RAS yang terjadi.Metode: Desain yang digunakan adalah desain potong lintang. Penelitian ini dilakukan di RSUPN Dr. Cipto Mangunkusumo selama periode Februari hingga Mei 2019. Penelitian dilakukan di RSUPN Dr. Cipto Mangunkusumo dengan diagnosis lower extremity PAD dan dari pemeriksaan CT Angiografi didapatkan stenosis pada pembuluh darah tungkai, serta tampak arteri renalis pada pemeriksaan CTA yang dilakukan pada pasien tersebut. Pengambilan sampel dilakukan dengan metode total sampling.Hasil: sampel terbanyak berjenis kelamin wanita (50,8%) sedangkan pria sebanyak 32 orang (49,2%). Sebanyak 90,8% pasien yang diteliti menderita diabetes sedangkan 61,5% dari sampel menderita hipertensi. RAS derajat 1 merupakan yang terbanyak ditemukan. Tidak ada hubungan ANGIO Score terhadap usia, jenis kelamin dan diabetes mellitus, namun ada terhadap hipertensi. Terdapat hubungan antara RAS dengan usia dan hipertensi, namun tidak terdapat hubungan terhadap diabetes mellitus dan jenis kelamin. ANGIO Score dan RAS terdapat hubungan yang bermakna (p<0,001).Simpulan: Perbandingan ANGIO Score berdasarkan derajat stenosis mendapatkan hasil uji Kruskall Wallis mendapatkan nilai p<0,001 dan dilanjutkan dengan uji Mann Whitney mendapatkan bahwa perbedaan sudah terjadi saat perbandingan derajat stenosis 0 dengan derajat 1 dan seterusnya (p<0,001). Semakin tinggi nilai ANGIO Score (cut off pada score 9), angka spesifitas semakin tinggi.

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ABSTRACTBackground: The most common cause of PAD is atherosclerosis. PAD is associated with other atherosclerosis diseases such as renal artery stenosis (RAS). Life expectancy decreases in patients who experience RAS, especially those with stenosis above 60% but have not yet reached the stage of chronic renal failure. With holistic management, it is expected that the patient's life expectancy will increase.Objective: To determine the prevalence of RAS in PAD patients and to see the relationship between Angio Score, history of hypertension and diabetes mellitus to the degree of RAS that occurred.Method: The design used is a cross-sectional design. This research was conducted at RSUPN Dr. Cipto Mangunkusumo during the period February to May 2019. The study was conducted at RSUPN Dr. Cipto Mangunkusumo with a diagnosis of lower extremity PAD, which obtained an ABI score of <0.9, severe ischemia until both unilateral and bilateral limb necrosis and CT angiography examination found stenosis in the leg veins, and the appearance of the renal artery on CTA examination performed on patients that is. Sampling is done by the total sampling method.Results: the most samples were female (50.8%) while men were 32 (49.2%). As many as 90.8% of patients studied had diabetes while 61.5% of the samples suffered from hypertension. 1st degree RAS is the most found. There is no relationship between ANGIO Score with age, gender and diabetes mellitus, but there is a hypertension. There is a relationship between RAS and age and hypertension, but there is no relationship to diabetes mellitus and gender. ANGIO Score and RAS have a significant relationship (p <0.001).Conclusion: The comparison of ANGIO Score based on the degree of stenosis obtained the results of the Kruskall Wallis test obtained a p value of <0.001 and continued with the Mann Whitney test found that the difference had occurred when the ratio of stenosis degrees was 0 with degrees 1 and so on (p <0.001). The higher the ANGIO score (cut off at score 9), the higher the specificity."

"[LATAR BELAKANGPenyebab terbanyak Penyakit Arteri Perifer (PAP) pada usia diatas 40 tahun adalah aterosklerosis. Prevalensi penyakit aterosklerosis perifer meningkat pada kasus dengan diabetes melitus, dislipidemia, hipertensi dan perokok. Critical Limb Ischemia (CLI) merupakan manifestasi dari PAP berat, CLI dikaitkan dengan risiko kehilangan tungkai yang sangat tinggi. Pada pasien CLI tanpa adanya revaskularisasi, pasien biasanya akan dilakukan amputasi dalam hitungan minggu atau bulan. Revaskularisasi secara terbuka memiliki morbiditas yang cukup banyak. Seiring kemajuan teknologi, revaskularisasi secara terbuka perlahan-lahan digantikan dengan adanya intervensi endovaskuler dalam dua dekade terakhir. Revaskularisasi endovaskuler di Departemen Ilmu Bedah RSCM baru mulai dilakukan pada tahun 2012 dan di Indonesia saat ini belum ada studi yang menilai hasil dari tindakan revaskularisasi.METODEMetode yang diambil adalah analitik komparatif berpasangan dengan disain penelitian longitudinal pre-post study. Selama Agustus 2013 hingga Agustus 2014 didapatkan 16 pasien yang masuk kriteria inklusi. Dilakukan pengambilan data nilai ABI sebelum dan sesudah revaskularisasi endovaskuler. ABI digunakan sebagai penilaian efektivitas revaskularisasi.HASILHasil didapatkan nilai mean ABI sebelum tindakan 0,7±0,118 dan nilai mean ABI sesudah tindakan 0,844±0,127. Didapatkan peningkatan nilai ABI sesudah tindakan 0,14. Dari hasil uji T berpasangan didapatkan nilai p=0,001. Secara statististik didapatkan peningkatan yang signifikan antara nilai ABI sebelum tindakan dan sesudah tindakan.KESIMPULANDapat ditarik kesimpulan tindakan revaskularisasi endovaskuler terhadap pasien PAP efektif berdasarkan nilai ABI;BACKGROUNDPeripheral Arterial Disease (PAD) above 40 years old mostly cause by atherosclerotic. Peripheral Atherosclerotic prevalence increase with DM, dyslipidemia, hypertension and smoking. CLI had higher amputation risk. Without revascularization CLI patients will do amputation within week or month. Surgical revascularizaton had many morbidity, endovascular revascularization established within 2 decade. Endovascular revascularization in RSCM surgery department established at 2012 and in Indonesia no research to evaluate revascularization effectiveness.METHODSResearch method is dependent category comparative analytic with longitudinal pre-post study. Within August 2013 to August 2014, we collect 16 patients that rolled on inclusion criteria. We collect ABI results before endovascular revascularization and ABI results after endovascular revascularization. ABI were used to evaluated revascularization effectiveness.RESULTSResults are ABI mean before endovascular revascularization 0,7±0,118 and ABI mean after endovascular revascularization 0,844±0,127. There were ABI increased after endovascular revascularization mean 0.14. Statistic analysis with pairing T-test result p=0.001. Based on statistic analysis there were significant increase between ABI before endovascular revascularization and ABI after endovascular revascularization.CONCLUSIONEndovascular revascularization in PAD patients effective base on ABI, BACKGROUNDPeripheral Arterial Disease (PAD) above 40 years old mostly cause by atherosclerotic. Peripheral Atherosclerotic prevalence increase with DM, dyslipidemia, hypertension and smoking. CLI had higher amputation risk. Without revascularization CLI patients will do amputation within week or month. Surgical revascularizaton had many morbidity, endovascular revascularization established within 2 decade. Endovascular revascularization in RSCM surgery department established at 2012 and in Indonesia no research to evaluate revascularization effectiveness.METHODSResearch method is dependent category comparative analytic with longitudinal pre-post study. Within August 2013 to August 2014, we collect 16 patients that rolled on inclusion criteria. We collect ABI results before endovascular revascularization and ABI results after endovascular revascularization. ABI were used to evaluated revascularization effectiveness.RESULTSResults are ABI mean before endovascular revascularization 0,7±0,118 and ABI mean after endovascular revascularization 0,844±0,127. There were ABI increased after endovascular revascularization mean 0.14. Statistic analysis with pairing T-test result p=0.001. Based on statistic analysis there were significant increase between ABI before endovascular revascularization and ABI after endovascular revascularization.CONCLUSIONEndovascular revascularization in PAD patients effective base on ABI]"

"Mitral stenosis merupakan kelainan katup yang paling sering ditemukan di bagian Kardiologi RS. M. Hoesin, Palembang, dan bukti kuat menunjukkan adanya tromboemboli pada mitral stenosis. Banyak studi melihat kontras ekho spontan (KES) yang dianggap sebagai awal kejadian tromboemboli, namun terdapat kontroversi mengenai bagaimana mencapai regresi KES ini. Uji klinik tersamar ganda dilakukan untuk membandingkan aspirin 100 mg dengan acenocoumarol (sintrom) 1 mg yang diberikan selama 4 minggu pada 22 penderita mitral stenosis. Pada akhir penelitian diperoleh regresi 100 % pada KES kelompok acenocoumarol, 40% diantaranya regresi dari KES berat menjadi ringan, sedangkan 60 % mengalami resolusi sempurna. Pada kelompok aspirin tidak satupun KES mengalami regresi. Pada kelompok acenocoumarol, 2 di antara 4 trombus menghilang, sedangkan 2 sisanya ukurannya mengecil, sedangkan pada kelompok aspirin pada akhir minggu keempat, pasien dengan thrombus bertambah dari 3 menjadi 4. Kesimpulan: Pemakaian acenocoumarol 1 mg selama 4 minggu dapat secara efektif dan aman meregresi kontras echo spontan dan thrombus pada mitral stenosis tanpa perubahan hemodinamik yang berarti. (Med J Indones 2002; 11: 202-7)

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Mitral stenosis is one of the most often valvular disease in Division of Cardiology, M. Hoesin hospital, Palembang, and there was strong evidence of thromboembolic phenomenon in mitral stenosis (MS) patients. Many studies evaluated the spontaneous echo contrast (SEC) that was regarded as a precursor of thrombo embolic phenomenon. So far there were controversies regarding how to regress spontaneous echo contrast. A randomized double blind controlled study was done on 22 MS patients with positive SEC, receiving either aspirin 100 mg or acenocoumarol 1 mg and followed up after 4 weeks. There was 100 % regression of SEC in acenocoumarol group that consisted of 40% regression from severe SEC to mild, and 60% complete resolution. In aspirin group there was no resolution of SEC. In acenocoumarol group, 2 of 4 thrombus totally disappeared while the rest was reduced in size. On the other hand, in aspirin group, after 4 weeks, the patients with thrombus was increased from 3 to 4 patients. In conclusion, four week therapy with acenocoumarol 1 mg is effective and save in regressing spontaneous echo contrast and thrombus in mitral stenosis patients without any significant change in hemodynamics. (Med J Indones 2002; 11: 202-7)"

"Latar belakang: Chronic limb threatening ischemia (CLTI) merupakan bentuk terparah peripheral arterial disease. Pasien kaki diabetik dengan CLTI memiliki risiko amputasi mayor dan mortalitas paska revaskularisasi dan dipengaruhi beberapa faktor seperti usia lanjut, gagal ginjal kronik, komorbid penyakit jantung dan hipertensi. Indonesia belum memiliki data amputasi mayor dan mortalitas kaki diabetik dengan CLTI setelah revaskularisasi dan faktor-faktor yang berpengaruh. Penelitian ini bertujuan mengetahui angka amputasi mayor dan mortalitas satu tahun pasca revaskularisasi beserta faktor-faktor yang memengaruhi di Rumah Sakit Cipto Mangunkusumo (RSCM).Metode: Kohort retrospektif pasien kaki diabetik dengan CLTI setelah revaskularisasi di RSCM Januari 2010 – Desember 2020. Pengambilan data rekam medis. Luaran utama amputasi mayor dan mortalitas satu tahun setelah revaskularisasi. Dilakukan analisis bivariat dengan uji Kai Kuadrat, jika persyaratan tidak terpenuhi maka menggunakan Fischer-exact, variabel bermakna diuji lebih lanjut dengan regresi logistik. Hasil: Penelitian melibatkan 150 subjek. Amputasi mayor dan mortalitas satu tahun setelah revaskularisasi sebesar 27,3% dan 24,7%. Tidak didapatkan hubungan yang bermakna antara faktor-faktor yang diteliti dengan amputasi mayor dan mortalitas satu tahun.Kesimpulan: Didapatkan angka amputasi mayor dan mortalitas 1 tahun pasca revaskularisasi. Usia lanjut, gagal ginjal kronik, komorbid penyakit jantung dan hipertensi bukan merupakan faktor yang memengaruhi angka amputasi dan mortalitas satu tahun.

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Background: Chronic limb threatening ischemia (CLTI) is the most severe form of peripheral arterial disease. Diabetic foot patients with CLTI have major amputation and mortality risk after revascularization and affected by factors such as elderly, chronic kidney disease (CKD), cardiac morbidity and hypertension. In Indonesia there are no data regarding diabetic foot major amputation and mortality with CLTI after revacularization and influencing factors. Study aims to determine one year major amputation and mortality and factors that can affect diabetic foot pastients with CLTI after revascularization.

Methods: Retrospective cohort study on diabetic foot patients with CLTI undergoing revascularization at Cipto Mangunkusumo National Hospital from January 2010 to December 2020. The primary outcome was one-year major amputation and mortality after revascularization. Factors included were age, CKD, cardiac comorbidity and hypertension. We conducted bivariate analysis using Chi Square or Fisher-exact test. Variables were further tested using multivariate test.

Result: 150 subjects were enrolled. One-year major amputation and mortality was 27.3% and 24.7%. There are not significant correlations between factors with major amputation and mortality.

Conclusion: Major amputation and mortality rate one year after revascularization at RSCM are gained. Elderly, CKD, cardiac comorbidity and hypertension are not factors affecting one-year major amputation and mortality."