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Hervin Ramadhani
Korelasi kadar ST2 terlarut (sST2) dengan miokardial longitudinal strain speckle tracking dua dimensi untuk menilai disfungsi ventrikel kiri subklinis pada subjek stenosis aorta berat = Asscociation of the biomarkers soluble ST2 and subclinical left ventricular systolic dysfunction assessed by myocardial global longitudinal strain in patients severe aortic stenosis
"ABSTRAK
Latar belakang.
Pada pasien SA fraksi ejeksi ventrikel kiri dapat normal bahkan supra normal untuk
jangka waktu yang lama walaupun proses remodeling ventrikel kiri sudah mulai terjadi..
Ekokardiografi speckle tracking dua dimensi (EST) mempunyai kelebihan untuk
digunakan dalam menilai penurunan fungsi kontraktilitas miokard subklinis, dimana
keadaan tersebut dapat mempengaruhi prognosis pasien SA. sST2 merupakan biomarker
yang relatif baru, dapat meningkat pada regangan otot jantung (myocardial stretch),
fibrosis, inflamasi, dan injuri miokard, apakah berhubungan dengan disfungsi dini
ventrikel kiri masih belum diketahui.
Tujuan. Mengetahui korelasi sST2 terhadap nilai GLS EST pada pasien SA berat dengan
FEVK normal
Metode. Merupakan studi potong lintang. Evaluasi dilakukan pada 29 pasien stenosis
aorta berat dengan fraksi ejeksi normal yang datang ke poliklinik RS Jantung Harapan
Kita periode Februari 2015 sampai November 2015. Dilakukan pengambilan figur
ekokardiografi untuk menilai severitas SA dan untuk perhitungan nilai global longitudinal
strain speckle tracking kemudian dilakukan pengambilan sampel darah di laboratorium
RS Jantung Harapan Kita untuk menilai sST2.
Hasil Penelitian. Dua puluh sembilan subjek ikut dalam penelitian ini dengan rerata usia
adalah 59.7±12.1 tahun. Fungsi intrinsik ventrikel kiri pasien SA berat pada penelitian ini
mengalami penurunan dengan nilai rerata GLS -11±4.5%. Hasil uji korelasi menunjukan
terdapat korelasi positif dengan kekuatan korelasi sedang yang bermakna (r=0.429,
p=0.02). Analisis multivariat tetap menunjukkan adanya hubungan antara kadar sST2
dengan nilai GLS EST (r=0,282 p=0.036).
Kesimpulan. Terdapat korelasi sST2 dengan global longitudinal strain speckle tracking
pada pasien SA berat dengan fraksi ejeksi normal.ABSTRACT
Background. In severe aortic stenosis (AS), cardiac performance measured at the
ventricular chamber is typically normal or supranormal, whereas Global Longitudinal
Strain providing comprehensive information on LV myocardial contractility and is
superior in detecting subtle deteriorations. Impaired LV GLS is associated mortality risk
and reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,
and myocardial injury. Whether sST2 is increased in relation to the subclinical LV
dysfunction assessed by GLS in AS is unknown.
Objectives. To study correlation beetwen sST2 and GLS in patients with AS severe
Methods. This is a correlation study with cross sectional design. The subject was aortic
stenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at our
outpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. A
comprehensive transthoracic echocardiography was performed to evaluate severity of
aortic stenosis. and echocardiographic figure recordings were stored in digital for off-line
subsequent GLS analysis. sST2 measurements were drawn after echocardiography.
Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1
years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.
A
Pearson
correlate
revealed
significant
positive
correlation
between
sST2
and
GLS
(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor still
showed a positive correlation between sST2 and GLS (r=0,282 p=0.036).
Conclusion. This cross sectional study demonstrated a moderate correlation between
sST2 with left ventricle global longitudinal strain speckle tracking in patients with severe
aortic stenosis with preserved EF.
;Background. In severe aortic stenosis (AS), cardiac performance measured at the
ventricular chamber is typically normal or supranormal, whereas Global Longitudinal
Strain providing comprehensive information on LV myocardial contractility and is
superior in detecting subtle deteriorations. Impaired LV GLS is associated mortality risk
and reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,
and myocardial injury. Whether sST2 is increased in relation to the subclinical LV
dysfunction assessed by GLS in AS is unknown.
Objectives. To study correlation beetwen sST2 and GLS in patients with AS severe
Methods. This is a correlation study with cross sectional design. The subject was aortic
stenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at our
outpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. A
comprehensive transthoracic echocardiography was performed to evaluate severity of
aortic stenosis. and echocardiographic figure recordings were stored in digital for off-line
subsequent GLS analysis. sST2 measurements were drawn after echocardiography.
Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1
years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.
A
Pearson
correlate
revealed
significant
positive
correlation
between
sST2
and
GLS
(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor still
showed a positive correlation between sST2 and GLS (r=0,282 p=0.036).
Conclusion. This cross sectional study demonstrated a moderate correlation between
sST2 with left ventricle global longitudinal strain speckle tracking in patients with severe
aortic stenosis with preserved EF.
;Background. In severe aortic stenosis (AS), cardiac performance measured at the
ventricular chamber is typically normal or supranormal, whereas Global Longitudinal
Strain providing comprehensive information on LV myocardial contractility and is
superior in detecting subtle deteriorations. Impaired LV GLS is associated mortality risk
and reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,
and myocardial injury. Whether sST2 is increased in relation to the subclinical LV
dysfunction assessed by GLS in AS is unknown.
Objectives. To study correlation beetwen sST2 and GLS in patients with AS severe
Methods. This is a correlation study with cross sectional design. The subject was aortic
stenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at our
outpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. A
comprehensive transthoracic echocardiography was performed to evaluate severity of
aortic stenosis. and echocardiographic figure recordings were stored in digital for off-line
subsequent GLS analysis. sST2 measurements were drawn after echocardiography.
Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1
years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.
A
Pearson
correlate
revealed
significant
positive
correlation
between
sST2
and
GLS
(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor still
showed a positive correlation between sST2 and GLS (r=0,282 p=0.036).
Conclusion. This cross sectional study demonstrated a moderate correlation between
sST2 with left ventricle global longitudinal strain speckle tracking in patients with severe
aortic stenosis with preserved EF.
;Background. In severe aortic stenosis (AS), cardiac performance measured at the
ventricular chamber is typically normal or supranormal, whereas Global Longitudinal
Strain providing comprehensive information on LV myocardial contractility and is
superior in detecting subtle deteriorations. Impaired LV GLS is associated mortality risk
and reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,
and myocardial injury. Whether sST2 is increased in relation to the subclinical LV
dysfunction assessed by GLS in AS is unknown.
Objectives. To study correlation beetwen sST2 and GLS in patients with AS severe
Methods. This is a correlation study with cross sectional design. The subject was aortic
stenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at our
outpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. A
comprehensive transthoracic echocardiography was performed to evaluate severity of
aortic stenosis. and echocardiographic figure recordings were stored in digital for off-line
subsequent GLS analysis. sST2 measurements were drawn after echocardiography.
Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1
years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.
A
Pearson
correlate
revealed
significant
positive
correlation
between
sST2
and
GLS
(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor still
showed a positive correlation between sST2 and GLS (r=0,282 p=0.036).
Conclusion. This cross sectional study demonstrated a moderate correlation between
sST2 with left ventricle global longitudinal strain speckle tracking in patients with severe
aortic stenosis with preserved EF.
;Background. In severe aortic stenosis (AS), cardiac performance measured at the
ventricular chamber is typically normal or supranormal, whereas Global Longitudinal
Strain providing comprehensive information on LV myocardial contractility and is
superior in detecting subtle deteriorations. Impaired LV GLS is associated mortality risk
and reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,
and myocardial injury. Whether sST2 is increased in relation to the subclinical LV
dysfunction assessed by GLS in AS is unknown.
Objectives. To study correlation beetwen sST2 and GLS in patients with AS severe
Methods. This is a correlation study with cross sectional design. The subject was aortic
stenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at our
outpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. A
comprehensive transthoracic echocardiography was performed to evaluate severity of
aortic stenosis. and echocardiographic figure recordings were stored in digital for off-line
subsequent GLS analysis. sST2 measurements were drawn after echocardiography.
Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1
years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.
A
Pearson
correlate
revealed
significant
positive
correlation
between
sST2
and
GLS
(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor still
showed a positive correlation between sST2 and GLS (r=0,282 p=0.036).
Conclusion. This cross sectional study demonstrated a moderate correlation between
sST2 with left ventricle global longitudinal strain speckle tracking in patients with severe
aortic stenosis with preserved EF.
"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Risca Rini Aryanti
Hubungan Rasio PAO2/FIO2 dan Kadar D-Dimer terhadap Kadar ST2 Terlarut dan Spirometri pada Pasien dengan Penyakit Kardiovaskular Pasca Covid-19 Varian Omicron = Relationship of PaO2/FiO2 Ratio and D-Dimer Levels to sST2 Levels and Spirometry Profile in Patients with Post COVID-19 Variant Omicron with Cardiovascular Disease
"Latar Belakang: COVID-19 di Indonesia menyebabkan kematian hingga lebih dari 150.000 orang. Salah satu populasi yang mengalami dampak dengan risiko kematian yang tinggi adalah populasi penyakit kardiovaskular. Severitas COVID-19 sering dikaitkan dengan rendahnya rasio PaO2/FiO2 dan tingginya kadar D-dimer. COVID-19 varian Omicron diketahui memiliki angka penyebaran yang lebih tinggi dengan severitas infeksi yang lebih rendah dibandingkan varian sebelumnya. Namun dampak jangka panjang pada pasien COVID-19 varian Omicron, khususnya pada populasi pasien dengan penyakit kardiovaskular masih menjadi pertanyaan. Penelitian ini ingin mengetahui dampak pasca COVID-19 varian Omicron dengan melihat kadar ST2 terlarut dan adanya gangguan paru yang dinilai dengan pemeriksaan spirometri.
Tujuan: Penelitian ini dilakukan untuk mengetahui hubungan Rasio PaO2/FiO2 dan Kadar D-dimer pada saat admisi terhadap kadar ST2 terlarut dan gambaran spirometri pada pasien pasca COVID-19 varian Omicron dengan penyakit kardiovaskular. Metode: Penelitian berupa studi potong lintang terhadap pasien COVID-19 varian Omicron dengan riwayat komorbid penyakit kardiovaskular yang dirawat di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita. Diagnosis COVID-19 varian Omicron dilakukan dengan menggunakan metode WGS/SGTF. Pasien dengan kriteria inklusi menjalani pemeriksaan spirometri dan pengukuran kadar ST2 terlarut pada 6 bulan pasca perawatan.
Hasil dan Pembahasan: Penelitian ini menunjukkan rasio PaO2/FiO2 dengan median 454 dan kadar D-dimer 790ng/mL. Mayoritas pasien menunjukkan gambaran gangguan resktriktif. Kadar ST2 terlarut pasca perawatan memiliki median 2716,8pg/mL. Tidak ditemukan adanya hubungan yang signifikan antara rasio PaO2/FiO2 dan kadar D-Dimer terhadap kadar ST2 terlarut maupun gambaran spirometri pada 6 bulan pasca COVID-19. Hal ini dapat dikaitkan dengan severitas COVID-19 yang lebih rendah sehingga tidak terdapat hubungan bermakna terhadap parameter admisi serta hubungan pengukuran 6 bulan pasca COVID-19 dengan kemungkinan adanya perbaikan fibrosis.
Kesimpulan: Tidak ada hubungan yang signifikan antara rasio PaO2/FiO2 dan kadar D- Dimer terhadap kadar ST2 terlarut ataupun gambaran spirometri pada 6 bulan pasca COVID-19 varian Omicron.
Introduction: COVID-19 in Indonesia has caused more than 150,000 deaths. One of the affected populations with a high risk of death is the cardiovascular disease population. The severity of COVID-19 is associated with a low of PaO2/FiO2 ratio and the increased levels of D-dimer. Omicron variant is known to have higher transmission with less severe infection than the previous variant. However, research related to long term effect post COVID-19 with Omicron variant in cardiovascular population is not yet known.
Aim: This study was conducted to determine the relationship of PaO2/FiO2 ratio and D- dimer levels at admission to sST2 levels and spirometry profile in post COVID-19 variant Omicron patient with cardiovascular disease.
Method: Research in the form of a cross-sectional study was conducted on Omicron variant COVID-19 patients with a history of comorbid cardiovascular disease who were treated at the Harapan Kita Heart and Blood Vessel Hospital (RSJPDHK). The diagnosis of COVID-19 is carried out using the WGS/SGTF method. Patients undergo spirometry examination and measurement of sST2 levels at 6 month after hospitalization.
Results and Discussion: This study shows a PaO2/FiO2 ratio with a median of 454 with D-dimer levels 790 ng/mL. The majority of patients have a restrictive patterns. The median sST2 value in Omicron variant COVID-19 patients at 2716.8 pg/mL. There was no significant relationship between the ratio of PaO2/FiO2 and D-Dimer levels to sST2 levels and spirometry profile at 6 months after COVID-19 infection. This can be associated with lower COVID-19 severity so that there is no significant association with inflammatory parameters such as PaO2/FiO2 ratio and D-dimer levels, as well as the relationship between measurements 6 months post COVID-19 and the possibility of fibrosis improvement.
Conclusion: There was no significant relationship between the ratio of PaO2/FiO2 and D-Dimer levels to sST2 levels and spirometry abnormality at 6 months post COVID-19 variant Omicron."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Zakky Hazami
Hubungan antara Faktor Klinis dan Laboratoris Saat Admisi dengan Kadar SST2 sebagai Penanda Fibrosis Jantung 12 Minggu Pasca Infeksi COVID-19 pada Pasien dengan Komorbid Kardiovaskular = Association between Clinical and Laboratory Factors on Admission with ST2 Levels as a Marker Of Cardiac Fibrosis 12 Weeks After COVID-19 Infection in Patient with Cardiovascular Comorbid
"Latar Belakang : Infeksi COVID-19 telah diketahui masih dapat menyebabkan gejala sampai 90 hari dan bahkan lebih, meski infeksi akutnya telah berlalu. Hal ini disebabkan karena adanya fenomena sindroma pasca COVID-19. Mekanisme kejadian tersebut sampai saat ini masih belum diketahui pasti. Hal tersebut diduga kuat akibat adanya fibrosis di beberapa organ, terutama jantung dan paru. Sementara itu, beberapa studi telah menyebutkan bahwa sST2 merupakan penanda fibrosis jantung. Meskipun demikian, sampai saat ini belum ada penelitian yang mencoba mengetahui faktor-faktor apa saja yang memiliki hubungan dengan kejadian fibrosis pasca infeksi COVID-19. Kadar sST2 pada pasien komorbid kardiovaskular tanpa COVID-19 dan populasi orang sehat, khususnya di Indonesia juga belum diketahui.
Tujuan : Mengetahui perbandingan kadar sST2 pada pasien komorbid kardiovaskular 12 minggu pasca infeksi COVID-19 dengan pasien komorbid kardiovaskular tanpa COVID-19 dan populasi orang sehat, serta hubungannya dengan faktor-faktor admisi.
Metode : Penelitian ini merupakan studi observasional potong lintang. Kadar sST2 pada pasien 12 minggu pasca infeksi COVID-19 dibandingkan dengan komorbid kardiovaskular akan dibandingkan dengan kelompok kontrol, yaitu kontrol 1 yang merupakan pasien komorbid kardiovaskular tanpa COVID-19 dan kontrol 2 yang merupakan populasi orang sehat. Kelompok kontrol dipilih menggunakan metode matching. Hubungan faktor klinis dan laboratoris saat dengan kadar sST2 pada pasien 12 minggu pasca infeksi COVID-19 dianalisis menggunakan analisis multivariat.
Hasil : Terdapat 162 subjek yang menyelesaikan rangkaian penelitian yang terdiri atas 100 subjek dengan penyintas COVID-19 disertai komorbiditas kardiovaskular (kelompok kasus), 31 subjek dengan komorbiditas kardiovaskular tanpa COVID-19 (kelompok kontrol 1), dan 31 subjek sehat tanpa riwayat COVID-19 dan komorbiditas kardiovaskular (kelompok kontrol 2). Ketiga kelompok memiliki karakteristik yang sama. Terdapat perbedaan signifikan rerata nilai sST2 antara kelompok kasus dibandingkan kontrol 1 dan kontrol 2 (2786 ± 73 vs 2666 ± 162 pg/l, p <0.001 dan 2786 ± 73 vs 2517.15 ± 321 pg/l, p < 0.001), serta kontrol 1 dibandingkan kontrol 2 (2666 ± 162 pg/l vs 2517.15 ± 321 pg/l, p < 0.001). Analisis multivariat menunjukkan PaO2 (p < 0.001) dan nilai CT (p = 0.04) memiliki hubungan dengan kadar sST2 pada pasien 12 minggu pasca infeksi COVID-19.
Kesimpulan : Terdapat perbedaan signifikan antara kadar sST2 sebagai penanda fibrosis jantung pada ketiga kelompok subjek penelitian, dengan kadar sST2 lebih tinggi pada subjek dengan penyintas COVID-19 disertai komorbiditas kardiovaskular. Terdapat hubungan PaO2 dan nilai CT saat admisi dengan kadar sST2.
Background : Recent findings showed that symptoms associated with COVID-19 infection may persist up to 90 days even after the acute disease period has passed. This condition is now termed as post COVID-19 syndrome. Several pathophysiologic mechanisms of this event had been proposed, all of which still needed further elaboration. One of the proposed mechanisms involves fibrotic processes in several organs, especially heart and the lungs. SST2 has been suggested as a novel biomarker for cardiac fibrosis. However data are still needed to further elucidate the factors which are associated with the incidence of fibrosis post COVID-19 infection. Furthermore, data regarding sST2 levels in patients with cardiovascular comorbidities and in healthy subjects are still limited.
Objective : Knowing the differences on sST2 levels between subjects with cardiovascular comorbidities 12 weeks post COVID-19 infection, those without history of COVID-19 but with cardiovascular comorbidities, and healthy population, as well as knowing its relationship with admission factors.
Methods : This study is a cross-sectional observational study on patients 3 months after COVID-19 infection presented with cardiovascular comorbidities. Age and sex-matched control groups were used as comparison. The results were compared with a group without history of COVID-19 and healthy populations. Relationship between admission factors was assessed using multivariate analysis
Results : 162 subjects completed the study series, consisting of 100 subjects with COVID-19 survivors with cardiovascular comorbidities (case group), 31 subjects with cardiovascular comorbidities without COVID-19 (control group 1), and 31 healthy subjects without a history of COVID-19 and cardiovascular comorbidities (control group 2). All three groups had similar characteristics. There was a significant difference in the mean sST2 value between the case groups compared to control 1 and control 2 (2786 ± 73 vs 2666 ± 162 pg/l, p < 0.001 and 2786 ± 73 vs 2517.15 ± 321 pg/l, p < 0.001 respectively), and control 1 compared to control 2 (2666 ± 162 pg/l vs 2517.15 ± 321 pg/l, p < 0.001). Multivariate analysis revealed PaO2 (p < 0.001 and CT values (p = 0.04) as admission factor associated with increased sST2 3 months after initial COVID-19 infection.
Conclusion : SST2 levels were found to be significantly different between the three groups, with the highest level on the case group (subjects with history of COVID-19 and cardiovascular comorbidities). Factors upon admissions which include Arterial oxygen partial pressure (PaO2) (p < 0.001) and CT value (p = 0.04) were found to be associated with increased sST2 levels."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library