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Abstrak :
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.

Abstrak :
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.