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Abstrak :
Contents : What is echocardiography? -- Views of the heart -- Optimising the picture -- The left ventricle -- Diastolic function and dyssynchrony -- The right ventricle -- The atria -- Myocardial infarction -- The cardiomyopathies -- Right ventricular pathologies -- Principles of valve disease -- Assessing the aortic valve -- The mitral valve -- The right heart valves -- Infective endocarditis -- Prosthetic valves -- Pericardial disease -- Cardiac masses -- The aorta -- Congenital septal abnormalities -- 3D echocardiography -- The comprehensive examination -- The focused examination -- Reporting an echo study.

Abstrak :
"The Washington Manual of Echocardiography contains essential and relevant information for trainees. It has been prepared by cardiology fellows, with the trainees' perspective in mind, and supervised and edited by faculty from the Washington University School of Medicine. The Washington Manual of Echocardiography provides quick insight into the interpretation of echocardiographic images, understanding the basic echocardiographic and Doppler physiology, and assisting with the technical aspects of transducing an echocardiographic exam. The Washington Manual of Echocardiogrpahy is geared toward cardiology fellows, emergency department physicians, and internal medicine residents interested in cardiology. This book is comprehensive enough to carry trainees through the echo rotation as well as concise and accessible at 3 a.m., when trainees are trying to appropriately diagnose important pathologies. It provides easily digestible knowledge and pearls from experienced echocardiologists and sonographers. Features Include: Easy-to-navigate sections on valvular heart disease, cardiomyopathies, congenital anomalies and trans-esophageal echocardiography, Image-heavy pocket book to enhance visual learning, Early emphasis on pearls and techniques on how to transduce an exam and get the optimal images. Succinct yet comprehensive information on key areas of echocardiography and Doppler techniques"--Provided by publisher.

Abstrak :
Latar Belakang: Angka mortalitas pasien Coronavirus Disease 2019 (COVID-19) di Indonesia cukup tinggi, salah satu organ yang terlibat dalam memengaruhi tingginya mortalitas ini adalah jantung. Evaluasi ekokardiografi dapat membantu mengidentifikasi secara dini gangguan jantung yang berhubungan dengan mortalitas pasien. Saat ini data kelainan jantung dengan pemeriksaan ekokardiografi pada pasien COVID-19 derajat berat-kritis di Indonesia.Tujuan: Penelitian ini bertujuan untuk mencari hubungan antara kelainan ekokardiografi dengan mortalitas pada pasien COVID-19 derajat berat dan kritis.Metode: Data pasien COVID-19 derajat berat dan kritis di RSCM diambil berdasarkan rekam medis lalu dilakukan analisis data dengan menampilkan tabel deskriptif, analisis bivariat dengan chi-square dan multivariat dengan regresi logistik.Hasil: Dari total 83 pasien, sebanyak 48 pasien (57,8%) meninggal. Kelainan fungsional yang paling banyak ditemukan pada ekokardiografi adalah mPAP yaitu sebanyak 51 pasien (68%) dan gangguan struktural terbanyak adalah remodelling konsentrik ventrikel kiri yaitu 48 pasien (58%). Hasil analisis chi-square terhadap variabel ekokardiografi memperlihatkan bahwa Tricuspid Annular Plane Systolic Excursion (TAPSE) dengan RR 7,29 (IK95%; 0,98 - 54,36), Right Ventricular Systolic Pressure (RVSP) dengan RR 10,21 (IK95%; 1,41 - 74,04), mean Pulmonary Artery Pressure (mPAP) dengan RR 1,44 (IK95%; 1,02 - 2,04), Pulmonary Acceleration Time (PAT) dengan RR 2,36 (IK95%; 1,14 - 4,86), dan Right Atrial Pressure (RAP) dengan RR 3,40 (IK95%; 1,06 - 10,95), memiliki hubungan signifikan dengan mortalitas. Sedangkan Left Ventricular Ejection Fraction (LVEF), disfungsi diastolik ventrikel kiri (E/e’) dan cardiac output (CO) tidak terdapat hubungan yang signifikan. Analisis multivariat dengan regresi logistik menunjukan bahwa variabel ekokardiografi yang secara independen berhubungan dengan mortalitas adalah RVSP dan RAP.Simpulan: Kelainan ekokardiografi yang berhubungan dengan mortalitas pasien COVID 19 derajat berat dan kritis adalah TAPSE, RVSP, mPAP, PAT dan estimasi RAP. ......Background: The mortality rate of Coronavirus Disease 2019 (COVID-19) patient in Indonesia is high and one of the organ that may contribute mortality is heart problem. Echocardiography can help clinician to identify early functional abnormalities and structural defect of heart that may correlates to mortality and patient’s prognosis. Currently, there are limited data in Indonesia about cardiac abnormalities in severe-critically ill COVID-19 patients that evaluated with echocardiography.Objective: This study aims to determine the relationship between echocardiography abnormalities and mortality in severe and critically ill COVID-19 patients.Methods: Severe and critically ill COVID-19 patients data taken from medical records and then analyzed by presenting descriptive table, bivariate analysis using chi square and multivariate analysis using logistic regression.Results: Out of total 83 patients, 48 ​​patients (57.8%) died. The most common functional abnormality found on echocardiography was mPAP found in 51 patients (68%) and the most common structural defect was left ventricular concentric remodeling in 48 patients (58%). The results of chi-square analysis of echocardiographic variables are Tricuspid Annular Plane Systolic Excursion (TAPSE) RR 7,29 (95%CI; 0,98 - 54,36), Right Ventricular Systolic Pressure (RVSP) RR 10,21 (95% CI; 1,41 - 74,04), mean Pulmonary Artery Pressure (mPAP) RR 1,44 (95%CI; 1,02 - 2,04), Pulmonary Acceleration Time (PAT) RR 2,36 (95%CI; 1,14 - 4,86), dan Right Atrial Pressure (RAP) RR 3,40 (95% CI; 1,06 - 10,95)had a significant relationship with mortality. Meanwhile, left ventricular ejection fraction (LVEF), left ventricular diastolic dysfunction (E/e') and cardiac output (CO) had no significant relationship. Multivariate analysis using logistic regression showed that RVSP and RAP were independent variables that correlates to mortality.Conclusions: Echocardiography abnormalities that associated with mortality in severe-critically ill patients are TAPSE, RVSP, mPAP, PAT and estimated RAP

Abstrak :
Echocardiography in Heart Failure - a volume in the exciting new Practical Echocardiography Series edited by Dr. Catherine M. Otto - provides practical, how-to guidance on effectively applying echocardiography to evaluate heart failure, make therapeutic decisions, and monitor therapy. Definitive, expert instruction from Drs. Martin St. John Sutton and Denise Wiegers is presented in a highly visual, case-based approach that facilitates understanding and equips you to accurately apply this technique while avoiding any potential pitfalls. Access the full text online at www.expertconsult.com al.

Abstrak :
Latar belakang dan tujuan: Penyakit kardiovaskular merupakan komorbid yang sering terjadi dan menjadi penyebab kematian pada pasien penyakit paru obstruktif kronik (PPOK). Penyakit kardiovaskular menjadi salah satu faktor prediksi tahan hidup pasien PPOK. Pemeriksaan echocardiography merupakan pemeriksaan yang akurat dan menyediakan informasi untuk evaluasi fungsi jantung.Tujuan penelitian ini adalah untuk mengetahui fungsi jantung pasien PPOK berdasarkan temuan echocardiography di RSUP Persahabatan Jakarta. Metode: Penelitian ini merupakan penelitian potong lintang terhadap pasien PPOK stabil yang berkunjung ke poli asma-PPOK di RSUP Persahabatan.Penelitian dilakukan dari Januari-Juni 2017. Subjek yang memenuhi kriteria akan dilakukan anamnesis, spirometri dan echocardiography. Hasil: Sebanyak 70 pasien ikut serta dalam penelitian ini dan dilakukan echocardiography. Usia rerata subjek adalah 65,68 ± 7,65. Subjek terbanyak adalah laki-laki (95,7%). Pada penelitian ini ditemukan 5,7% subjek memiliki gagal jantung kiri, 11,4% memiliki gagal jantung kanan, 30% hipertensi pulmoner, 8,6% mengalami dilatasi ventrikel kanan dan 11,4% mengalami pembesaran ventrikel kiri. Analisis statistik menemukan hubungan bermakna antara tricuspid annular plane excursion(TAPSE) dengan eksaserbasi pada PPOK(p<0,05). Terdapat hubungan yang bermakna antara indeks massa tubuh (IMT) dengan kontraksi ventrikel kanan, hipertensi pulmoner dan dilatasi ventrikel kanan. Tidak ditemukan hubungan yang bermakna antara derajat keparahan PPOK dengan dimensi, tekanan dan kontraksi jantung. Kesimpulan: Prevalens gangguan fungsi jantung tinggi pada pasien PPOK dan memiliki hubungan dengan eksaserbasi pada PPOK. Pasien dengan fungsi paru rendah memiliki kecenderungan untuk memilki gangguan di jantung.

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Background/Aim: Cardiovascular disease is a frequent comorbidity and cause of death in chronic obstructive pulmonary disease (COPD). Cardiovascular disease is one of predictive of survival in COPD. Echocardiography provides accurate and rapid information to evaluate cardiac function. The aim of this study is to elucidate the cardiac function based on echocardiography findings in stable COPD patients in the Persahabatan Hospital Jakarta. Methods: This study is a cross sectionalstudy among stable COPD patients who visit asthma-COPD clinics in Persahabatan Hospitals from January to June 2017. Interview, spirometry dan echocardiography perform to all subject who meet the ctiteria. Results: A total 70 subject with COPD perform echocardiography with mean ages 65,68 ± 7,65. Most of subject were men (95,7%). In this study found 5,7% subjects with left ventricle failure, 11,4% with right ventricle failure, 30% with pulmonary hypertension, 8,6% with right ventricle dilatation and 11,4% left ventricle hypertrophy. Statistic analysis have found significant association between tricuspid annular plane systolic excursion (TAPSE) and exacerbation in COPD patient (p<0,05). In this study found significant relationship between body mass index (BMI) and right ventricle contraction, pulmonary hypertension and right ventricle dilatation. There were no significant relationship between COPD severity and cardiac dimension, pressure and contraction. Conclusion: Prevalence of cardiac function abnormality were high in COPD patient and have relationship with exacerbation of COPD. Patient with lower lung function tender to have cardiac problem.

Abstrak :
ABSTRAK
A 27-year-old primiparous woman with 28 weeks gestational age was admitted to our hospital with worsening shortness of breath. She was diagnosed with Ebstein?s anomaly three years ago, but preferred to be left untreated. The patient was not cyanotic and her vital signs were stable. Her ECG showed incomplete RBBB and prolonged PR-interval. Blood tests revealed mild anemia. Observation of two-dimensional echo with color flow Doppler study showed Ebstein?s anomaly with PFO as additional defects, EF of 57%, LV and LA dilatation, RV atrialization, severe TR, and moderate PH with RVSP of 44.3 mmHg. The patient then underwent elective sectio caesaria at 30 weeks of gestational age; both the mother and her baby were alive and were in good conditions. Problem: there was an increasing breathlessness in this patient so that there was an increasing need to take a decision for her pregnancy. Ebstein?s anomaly is a complicated congenital anomaly. Medical treatment may be followed for many years in patients with mild forms of Ebstein?s anomaly. Surgery should be considered if there is objective evidence of debasement such as significant enlargement of heart size, reduction of systolic function in echocardiography.

Abstrak :
Penelition ini bertuiuan untuk menilai derajat Hipertensi Pulmonal (HP) secora kwantitatif dengan pemeriksaan "Pulsed Doppler Echocardiography" (PDE). Penelition dilakukan terhadap 60 penderita HP, semua menialani kateterisasi jantung. Kelompok kelola terdiri dari 15 orang normal. Parameter PDE dilakukan pengukuran "right ventricel pre ejection period" (RPEP), "acceleration time" (ACT), "right Ventricel ejection time" (RVEP) serta rosio RPEP/ACT, RPEP/RVET don AcT/RVET. BerdosarKan panjang fase AcT. penderita dibagi dalom 2 kelompok, yaitu kelompok ACT < 80 ms (kelompok A) dan ACT = 80-120 ms (kelompok B). Berdasarkan "mean pulmonary artery pressure" (MPA) dari kateterisasi jantung, penderita dikelompokkan menjadi kelompok 20-40 mmHg (HP-1), 41-60 mmHg (HP-2) don >60 mmHg C HP-3 ), berturut-turut sesuai dengan deraiat ringan, sedang dan berat. Berdasarkan "pulmonary arterial resintance" ( PAR ) penderita HP karena pirau intrakardial dibagi 2, yaitu kelompok < 5HRU (PAR-1) dan > 5 HRU (PAR-2). Nilai Parameter PDE dari tiap kelompok dibandingkan dengan nilai MPA dan PAR dari hasil pemeriksaan kateterisasi jantung. penderita dibagi 2 golongan, yaitu HP hiperkinetiK don HP pasif, selonjutnya parameter PDE kedua golongon tersebut dibandingkan. Didapatkon korelasi kuat antara AmPA masing-masing dengan RPEP ( MPA = 5.14 + 0.44 RPEP, r = 0.76, SEE = 9.34, X0.01), ACT ( MPA = 84.69 + 0.55 ACT, r =-0.78, SEE=8.99, p<0.01), dan RPEP/ACT (MPA= 18.93 + 15.90 RPEP/ACT, r=0.87, SEE= 7.07, P<0.01). Juga didapatkan korelasi kuat antara PAR dengan RPEP (PAR = -7.93 + 0.12 RPEP, r = 0.82, SEE = 2-055, P<0-01), ACT ( PAR = 17.44 - 0.15 ACT, r = -0.84, SEE = 1.89, P<0.01) dan RPEP/ACT (PAR= -1.16 + 4-24 RPEP/Ac75 r = 11.90, SEE=1.56, P<0-01). Rasio RPEP/ACT dapat membedakon kelcmpoK HP-1, HP-2 don HP-3 secara bermakna (HP-13 1.03-+0.27, dibanding HP-2, 2-02 (0.36, P<0.05 ; HP-2 dibanding HP-3, 2.82±0.423 p<0.05). Rasio RPEP/ACT 1.61 atau kurang sesuai dengan HP ringan, rasio 2.22 atau lebih sesuai dengan HP berat, rasio antara 1.61 - 2.22 sesuai dengan HP sedang. Parameter tersebut juga dapat menentukan tingginya PAR. Parameter PDE golongan HP hiperkinetik tidak berbeda bermakna dibanding HP pasif. Penelitian ini menyimpulkan bahwa RPEP, ACT don RPEP/ACT merupakan Parameter PDE yang dapat dipokai untuk menilai secora kwanitatif don kwanitatif dero,iat HP. Rasio RPEP/ACT merupakan satu-satunya parameter sensitif yang dapat digunakan untuk menentukan HP ringan, sedang dan berat. Golongan HP hiperkinetik dan HP pasif mempunyai parameter PDE soma.

Abstrak :
Deteksi dini gagal jantung (GJ) penting untuk mengurangi angka kesakitan, kematian dan rawat ulang, terutama pada era pandemi COVID-19. Kecerdasan buatan berdasarkan data ekokardiografi berpotensi mempermudah identifikasi GJ, tetapi tingkat kesahihan belum diketahui. Oleh karena itu, dikembangkan model Learning Intelligent for Effective Sonography (LIFES) dengan metode deep learning menggunakan algoritme visual geometry group (VGG)-16 untuk menilai validitas model kecerdasan buatan dalam deteksi GJ dan membedakan jenis GJ dengan atau tanpa penurunan fraksi ejeksi ventrikel kiri (FEVKi) di berbagai alat ekokardiografi. Penelitian uji diagnostik ini menggunakan desain potong lintang yang dibagi dua fase yaitu fase pertama populasi pasien normal dan GJ dengan atau tanpa FEVKi menurun di RS Pusat Jantung Nasional Harapan Kita dan fase kedua di 10 RS jejaring pada bulan Januari 2020–Maret 2022. Pada fase pertama dilakukan analisis 141 rekaman video ekokardiografi dan fase kedua dianalisis 685 video meliputi tampilan apical 4 chamber (A4C), apical 2 chamber (A2C), dan parasternal long axis (PLAX). Dataset setiap fase dibagi untuk melatih (tahap training) dan menguji (tahap testing) model LIFES dalam membedakan dua kelas diagnosis (GJ dan individu normal) dan tiga kelas diagnosis (GJ dengan FEVKi menurun, GJ dengan FEVKi terjaga, dan individu normal). Pada fase 1 performa terbaik model LIFES dalam membedakan dua kelas ditunjukkan pada tampilan A2C dengan skor F1 0,94 dan area under the curve (AUC) 0,93. Klasifikasi tiga kelas terbaik ditunjukkan pada tampilan A2C dengan F1 0,78 dan AUC 0,83 sampai 0,92. Pada fase 2 klasifikasi dua kelas terbaik ditunjukkan oleh tampilan PLAX dengan skor F1 mencapai 0,93 dan AUC 0,91. Klasifikasi tiga kelas terbaik ditunjukkan pada tampilan PLAX dengan F1 0,82 dan AUC berkisar dari 0,91 hingga 0,94. Waktu pemrosesan model LIFES sekitar 0,15 sampai 0,19 detik untuk memprediksi satu sampel. Disimpulkan model LIFES berfungsi baik untuk deteksi dini GJ sesuai konsensus ahli, sekaligus dapat membedakan jenis GJ dengan atau tanpa FEVKi menurun pada berbagai mesin ekokardiografi. ......Early detection of heart failure (HF) is important to reduce morbidity, mortality, and re-hospitalization, especially in the era of the COVID-19 pandemic. Artificial intelligence based on echocardiographic data has the potential to facilitate the identification of HF, but the level of validity is unknown. Therefore, Learning Intelligent for Effective Sonography (LIFES) model was developed with a deep learning method using the visual geometry group (VGG)-16 algorithm to assess the validity of the artificial intelligence model in the detection of HF and distinguish the type of HF with reduced ejection fraction (HFrEF) or preserved in left ventricular ejection fraction (HFpEF) in various echocardiographic devices. This diagnostic test study used a cross-sectional design, which was divided into two phases, namely the population of normal and HFrEF or HFpEF patients at the Harapan Kita National Heart Center Hospital and ten network hospitals from January 2020 to March 2022. In the first phase, 141 echocardiographic video recordings were analyzed and in the second phase, 685 videos were analyzed, including apical-4 chamber (A4C), apical-2 chamber (A2C), and parasternal-longaxis (PLAX) displays. The dataset for each phase was divided between training and testing the LIFES model in distinguishing two-diagnostic classes (HF and normal individuals) and three-diagnostic classes (HFrEF, HFpEF, and normal individuals). In phase 1, the best performance of the LIFES model in distinguishing the two classes is shown on the A2C display with an F1 score of 0.94 and an area under the curve (AUC) 0.93. The best three-class classifications are shown on the A2C display with an F1 of 0.78 and an AUC of 0.83 to 0.92. In phase 2, the best twoclass classifications are shown by the PLAX display with F1 scores reaching 0.93 and AUC 0.91. he best three-class classifications are shown on the PLAX display, with an F1 of 0.82 and an AUC ranging from 0.91 to 0.94. The processing time of the LIFES model is about 0.15 to 0.19 seconds to predict a single sample. It is concluded that the LIFES model works well for the early detection of HF, according to expert consensus while at the same time being able to distinguish the type of HF (HFrEF or HFpEF) on various echocardiographic machines.

Abstrak :
This book is a practical guide to the use of TEE (transoesophageal echocardiography) in the diagnosis of congenital heart disease (CHD). Beginning with an introduction to TEE for CHD, the following chapters describe procedures to be used for different cardiac conditions. 3D TEE allowing multi-dimensional perspectives is also covered.

Abstrak :
Pendahuluan: Hipertensi pulmoner merupakan penyakit yang bersifat progresif dengan angka kematian yang tinggi. Penyebab hipertensi pulmoner tergolong dalam lima kelompok salah satunya adalah penyakit paru (kelompok 3). Tuberkulosis resistan obat (TB-RO) merupakan penyakit kronik paru dengan manifestasi kerusakan parenkim dan pembuluh darah paru. Peningkatan tekanan pembuluh darah pulmoner dicurigai menjadi penyebab komplikasi pada pasien TB-RO. Tujuan: untuk mengetahui proporsi hipertensi pulmoner dengan metode probabilitas echocardiography pada pasien tuberkulosis resistan obat. Metode: Penelitian ini merupakan penelitian potong lintang pada pasien tuberkulosis resistan obat yang berobat di poliklinik TB MDR RSUP Persahabatan kemudian dilakukan pemeriksaan echocardiography di poliklinik Jantung RSUP Persahabatan. Pengambilan sampel dilakukan secara consecutive sampling dalam kurun waktu Agustus sampai dengan Oktober 2020. Hasil: Pada penelitian ini yang memenuhi kriteria inklusi sebesar 65 pasien TB-RO. Jenis kelamin subjek dominan laki-laki sebanyak 50,7%, usia terbanyak adalah kelompok 18-40 tahun sebanyak 80% dan regimen pengobatan terbanyak adalah pada kelompok MDR sebanyak 93,8%. Pemeriksaan echocardiography digunakan untuk menilai probabilitas hipertensi pulmoner dengan proporsi hipertensi pulmoner pada kelompok probabilitas rendah sebesar 95,3% dan probabilitas sedang sebesar 4,7%. Hasil pemeriksaan fisis distensi vena jugular, gambaran foto toraks berupa rasio lebar hilus dibandingkan lebar dinding dada dan gelombang P pulmonal pada EKG memiliki hubungan yang bermakna dengan probabilitas hipertensi pulmoner dengan nilai p<0,05. Kesimpulan: Nilai proporsi hipertensi pulmoner dengan metode probabilitas pada pasien TB- RO sebesar 95,3% pada kelompok probabilitas rendah dan 4,7% pada kelompok probabilitas sedang. Metode penapisan yang dapat digunakan pada pemeriksaan fisis dan penunjang antara lain distensi vena jugular, rasio lebar hilus dengan lebar dinding dada pada foto toraks dan gelombang P pulmonal pada EKG. ......Introduction: Pulmonary hypertension is a progressive disease with a high mortality rate. The causes of pulmonary hypertension are classified into five groups, one of which is lung disease (group 3). Drug-resistant tuberculosis (DR-TB) is a chronic lung disease manifested by damage to the lung parenchyma and pulmonary blood vessels. Increased pulmonary vascular pressure is suspected to be the cause of complications in DR-TB patients. Aims: to determine the porportion of probability of pulmonary hypertension using echocardiography probability in drug-resistant tuberculosis patients. Methods: This study was a cross-sectional study of drug-resistant tuberculosis patients who were treated at the MDR TB polyclinic at Persahabatan Hospital and then carried out an echocardiography examination at the Cardiology Polyclinic at the Persahabatan Hospital. Sampling method was using consecutive sampling from August to October 2020. Results: In this study, 65 DR-TB patients met the inclusion criteria. Male subject was dominant at 50.7%, the age group was 18-40 years in total 80% and the most treatment regimen was in the MDR group as much as 93.8%. Echocardiography examination was used to assess the probability of pulmonary hypertension with the proportion of the low probability group was 95.3% and the moderate probability group was 4.7%. The physical examination of jugular vein distention, chest X-ray imaging to measure the ratio of hilar to chest wall width and pulmonary P wave on the ECG have a significant correlation with the probability of pulmonary hypertension with p value<0.05. Conclusions: The proportion value of pulmonary hypertension using probability method in TB- RO patients are 95.3% in the low probability group and 4.7% in the moderate probability group. The screening method that can be used are physical examination, radiology and laboratory findings, including jugular vein distention, the ratio of hilar to chest wall width in the chest X- ray and pulmonary p wave on the ECG.