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Abstrak :
Dugaan penyakit jantung secara klinis dapat diketahui salah satunya dengan mengamati fungsi otot jantung ventrikel kiri dengan teknik kardiologi nuklir. Dengan metode ini, penyumbatan pembuluh darah koroner ditentukan untuk mengetahui kondisi fungsi otot jantung penyebab iskemik atau infark. Dalam penelitian ini dievaluasi fungsi otot jantung berdasarkan hasil prosentase perfusi, total skor perfusi dan fraksi ejeksi. Subjek yang dipilih adalah 31 pasien yang menjalani pemeriksaan MPI di Rumah Sakit Angkatan Darat Gatot Soebroto Jakarta, menggunakan radiofarmaka 99mTc-sestamibi. Pemeriksaan dilakukan dengan kamera gamma SPECT dual head yang dilengkapi dengan program QPS/QGS. Akuisisi data dilakukan dengan kondisi pasien pada saat stres dan istirahat. Dari hasil evaluasi data menggunakan statistik metode Pearson dan Spearman, diperoleh untuk semua segmen menunjukan korelasi kuat-positif. Berdasarkan data nilai prosentase perfusi pada kondisi stres dan istirahat, diperoleh hasil 8 orang normal dan diperkirakan 11 orang telah mengalami iskemia parsial, 8 orang iskemia total dan 4 orang infark parsial. ...... Suspicion on heart disease can be confirmed by observing the function of the left ventricle heart muscle with nuclear cardiology techniques. In this method, blockage of coronary arteries is determined by finding out the condition of heart muscle function causing ischemia or infarction. In this study, cardiac muscle function was evaluated based on the percentage of perfusion, total score of perfusion and ejection fraction. Subjects of thirty-one patients undergoing the MPI examination on Gatot Soebroto Jakarta Hospital using 99mTc-sestamibi radiopharmaceutical were chosen as samples. The examination was carried out with dual head SPECT equipped with QPS/QGS program. Data acquisitions were performed under patient's stress and rest conditions. Evaluation of the data using statistical methods of Pearson and Spearman was performed to all segments, indicating a strong correlation. As a result 11 subjects suspected for having partial ischemia, 8 subjects for total ischemia, 4 subjects for partial infarction, while the remainder 8 subjects normal.

Abstrak :
A high precision is generally required by doctors in order to read the ECG records presented in the scaled paper. This research is conducted in order to realize a prototype which could help the doctors in the interpretation of ECG records for infarction detection. This research processes the already existing ECG records using wavelet noise elimination technique, which is then analyzed by using High Speed QRS Detection method in order to obtain some parameters of Q-Pathologi- cal wave as well as the elevation value of the ST segment. The final result is the detection of myocardial abnormalities, which is presented visually by using graphical user interface, working well.

Abstrak :
Latar Belakang : Elektrokardiogram tetap merupakan standar emas dalam mengidentifikasi adanya dan lokasi dari infark miokard akut. ST elevasi pada infark miokard akut dapat memprediksi ukuran infark, responnya terhadap terapi reperfusi, dan memperkirakan prognosis dari pasien. Distorsi terminal komplek QRS pada infark miokard akut inferior adalah jika J-point dibandingkan dengan tingginya gelombang R lebih atau sama dengan 0,5 pada dua atau lebih sadapan inferior (sadapan II, III, aVF). Birnbaum dkk. menyatakan bahwa adanya distorsi QRS awal berhubungan dengan tingginya angka kejadian high-degree AV block. Walaupun sebagian besar bersifat transien, high-degree AV block berhubungan dengan peningkatan angka kematian selama perawatan di rumah sakit, meskipun pasien mendapat terapi trombolitik. Bahan dan Cara Kerja : Penelitian ini merupakan penelitian cross-sectional terhadap pasien infark miokard akut inferior yang mendapat terapi trombolitik periode Januari 2000 sampai dengan Desember 2004 yang dirawat di Rumah Sakit Jantung Harapan Kita, yang memenuhi kriteria inklusi dan a ksklusi. Pasien dikelompokkan menjadi 2 bagian yaitu dengan distorsi QRS dan tanpa distorsi QRS. Hubungan antara dua variabel dinilai dengan uji t dan chi-square, serta analisis multivarian dengan logistic regression. Hasil Penelitian : Terdapat 186 subyek penelitian dengan rentang umur 37-72 tahun, lebih banyak pada laki-laki (89%), yang terdiri dari 93 pasien dengan distorsi QRS dan 93 pasien tanpa distorsi QRS. Tidak didapatkan perbedaan data dasar karakteristik Minis dari kedua kelornpok. Dui analisis univarian, kelompok dengan distorsi QRS memiliki jumlah deviasi segmen ST yang lebih tinggi (9,61±3,67 vs 7,76±3,53, p=0,001), dan mengalami kegagalan terapi trombolitik yang lebih besar (74,2% vs 60,2%, p=0,042). Pada analisis multivarian, didapatkan hubungan yang berrnakna antara distorsi QRS dengan high-degree AV block (OR 2,5; 95% CI 1,04-6,01; p=0,04) dan umumnya terjadi saat perawatan di rumah sakit. Kesimpulan : Pasien dengan distorsi terminal komplek QRS pada infark miokard akut inferior yang mendapat terapi trombolitik mempunyai risiko high-degree AV block selama perawatan di rumah sakit yang lebih banyak dibandingkan dengan tanpa distorsi terminal komplek QRS.

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Background : The ECG remains the gold standard for identifying the presence and location of acute myocardial infarction. ST elevation in acute myocardial infarction can predict the size of infarction, response to reperfusion therapy, and prognosis. Distortion of the terminal portion of the QRS in inferior wall acute myocardial infarction based on those with J point I R wave > 0,5 in > 2 leads of the inferior leads II, III, and aVF. Birnbaum et al showed that early QRS distortion is a reliable prediction of the development of advanced AV block among patients receiving thrombolytic therapy for inferior wall acute myocardial infarction. Although transient, development of heart block during inferior infarction is associated with a high in-hospital mortality rate, eventhough they received thrombolytic therapy. Materials and Methods : This study is a cross-sectional study to the patients with inferior wall acute myocardial infarction treated by thrombolytic at NCCHK during January 2000 until December 2004, that fulfill inclusion and exclusion criteria. They were divided into two groups, there are with QRS distortion and without QRS distortion. Correlation between two groups were analyzed by t test, chi-square and multivariate regression analysis. Results : There are 186 patients, ages between 37 until 72 years old, mostly men (89%) which are 93 patients with QRS distortion and 93 patients without QRS distortion. Two groups are comparable. With univariate analysis, the group with QRS distortion have higher ST segmen deviation (9,61±3,67 vs 7,76±3,53, p=0,001) and higher risk of failed thrombolytic (74,2% vs 60,2%, p=0,042). With multivariate regression analysis, there is a significant correlation between QRS distortion and high-degree AV block (OR 2,5; 95% CI 1,04-6,01; p=0,04) and mostly happenned during hospitalization. Conclusion : Patients with distortion of the terminal portion of the QRS in inferior acute myocardial infarction and treated by thrombolytic have a higher risk of high-degree AV block during hospitalization, compared with patients without QRS distortion.