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A Significant Addition of Left Ventricular Fractional Shortening to Ejection Fraction correlated with Global Longitudinal Strain Value in Predicting Major Acute Cardiovascular Event in patients with Acute Coronary Syndrome 在预测急性冠状动脉综合征患者主要急性心血管事件时,射血分数显著增加左心室缩短与整体纵向应变值相关
Pub Date : 2021-03-04 DOI: 10.30701/IJC.1069
B. G. Napitupulu, H. Hasan, N. Akbar, A. P. Ketaren, Zainal Zafri, A. N. Nasution
Background: Global longitudinal strain (GLS) was a proven predictor of systolic function improvement and myocardial remodeling after acute coronary syndrome (ACS) for a residual left ventricular function defined their prognosis. However, not all echocardiography devices are equipped by speckle tracking (STE) as compare to the availability of M-mode modality which capable on assessing fractional shortening (FS) instead. Methods: This study evaluated clinical and echocardiography parameters on myocardial infarction (MI) and non-MI ACS patients.  Clinical outcome was defined as composite major acute cardiovascular event (MACE) on 6 months of follow up. Results: Over 145 patients, GLS>-9.4% was found to be an independent predictor of MACE despite of troponin, age, ejection fraction (EF), prior reperfusion and infarct location [(HR 5.89 (1.82-16.51)]. There is negative correlation between FS and GLS (Spearman r -0,717; p<0,01). By using logistic regression analyses, it was found that the addition of FS<25% to biplane Simpson EF<50% could be useful to rule in the presence of GLS>-9.4% (AUC 0.831). Conclusion: GLS had a prognostic value in patients with ACS. Left ventricular conventional M-mode FS in addition to Simpson EF were well correlated with GLS as well they can be considered as an alternative in predicting the incident of MACE in patient with ACS.   Keywords: global longitudinal strain, prognostic, fractional shortening, acute coronary syndrome
背景:整体纵向应变(GLS)已被证明是急性冠状动脉综合征(ACS)后收缩功能改善和心肌重塑的预测指标,残余左心室功能决定了其预后。然而,与能够评估缩短分数(FS)的M模式模式的可用性相比,并非所有超声心动图设备都配备了散斑跟踪(STE)。方法:本研究评估了心肌梗死(MI)和非MI ACS患者的临床和超声心动图参数。临床结果定义为6个月随访时的复合主要急性心血管事件(MACE)。结果:在145例患者中,尽管肌钙蛋白、年龄、射血分数(EF)、既往再灌注和梗死部位不同,但GLS>-9.4%是MACE的独立预测因子[(HR 5.89(1.82-16.51)]。FS和GLS之间呈负相关(Spearman r-0717;p-9.4%(AUC 0.831)。结论:GLS对ACS患者具有预后价值。除了Simpson EF外,左心室常规M型FS与GLS也有很好的相关性,它们可以被视为预测ACS患者MACE发生率的替代方案。关键词:整体纵向应变,预后,部分缩短,急性冠状动脉综合征
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引用次数: 0
Complete Heart Block In Pregnancy : A Case Report 妊娠期完全性心脏传导阻滞1例报告
Pub Date : 2021-03-04 DOI: 10.30701/IJC.1015
Dhanang Ali Yafi, Cloudia Noviani, R. E. Saputri, A. Purnawarman, Mohd. Andalas, Yusmalinda Yusmalinda
Background: Complete heart block occurs due to various pathological conditions that cause an infiltration, fibrosis, or lose the connection from a part of the cardiac conduction system. Complete heart  block in pregnancy is often caused by congenital anomalies. Around 30% cases, complete heart block remain asymptomatic and not detected until adulthood and may present in pregnancy state and puerperium. When the reversible cause of the AV Block cannot be found, the permanent pacemaker or temporary pacemaker may be indicated when the patients show the symptoms. Case Illusration: A-21 year old female, G2P0A1 preterm pregnancy (27-28 weeks) with bradycardia. From electrocardiograph examination revealed Total AV Block with junctional escape rhytym. Transthoracic echocardiogram shows massive tricuspid regurgitation, early phase of peripartum cardiomyopathy and ejection fraction 36-40%. Caesarean section was peformed due to PPROM. A male baby was born with birth weight of 1100 grams, 32 centimeters of body length and APGAR score of 7/9. The baby was died in NICU on day care 4th, with suspected respiratory problem. Conclusion: Complete heart block in pregnancy is a rare condition. This condition could remain asymptomatic and not detected until pregnancy. Multidisciplinary approach, close monitoring of the symptoms and cardiac functions are needed for patients with CHB.
背景:完全性心脏传导阻滞的发生是由于各种病理情况引起浸润、纤维化或心脏传导系统的一部分失去连接。妊娠期完全性心脏传导阻滞常由先天性异常引起。约30%的完全性心脏传导阻滞患者直到成年后才被发现,并可能在妊娠期和产褥期出现。当无法找到可逆的房室传导阻滞原因时,当患者出现症状时,可能需要使用永久起搏器或临时起搏器。病例说明:A-21岁女性,G2P0A1早产(27-28周)伴心动过缓。心电图检查显示全房室传导阻滞伴交界性逃逸节律。经胸超声心动图显示大量三尖瓣反流,围产期早期心肌病,射血分数36-40%。因PPROM行剖宫产。男婴出生体重1100克,体长32厘米,APGAR评分7/9。该婴儿于4日在新生儿重症监护室死亡,疑似呼吸问题。结论:妊娠期完全性心脏传导阻滞罕见。这种情况可能没有症状,直到怀孕才被发现。多学科联合治疗,密切监测慢性乙型肝炎患者的症状和心功能。
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引用次数: 3
Case Reports 案例报告
Pub Date : 2020-11-26 DOI: 10.30701/ijc.1238
Isic Isic
Indonesian Society of Interventional Cardiology Annual Meeting 2021   Abstracts: Case Reports
印度尼西亚介入心脏病学学会2021年年会摘要:病例报告
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引用次数: 0
Original Articles 原来的文章
Pub Date : 2020-11-26 DOI: 10.30701/ijc.1087
Isic Isic
Abstracts of the 12th Indonesian Society of Interventional Cardiology Annual Meeting (ISICAM) 2020 27-29 November 2020
2020年11月27日至29日第12届印度尼西亚介入心脏病学学会年会摘要
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引用次数: 0
Improvement of exercise capacity after early phase II cardiac rehabilitation in patients who undergo rheumatic mitral valve surgery 风湿性二尖瓣手术患者早期II期心脏康复后运动能力的改善
Pub Date : 2020-11-11 DOI: 10.30701/ijc.1038
A. M. Ambari, B. Setianto, A. Santoso, B. Radi, B. Dwiputra, E. Susilowati, F. Tulrahmi, P. Doevendans, M. Cramer
Background: Rheumatic heart disease still become a major concern in developing countries. Recent studies showed the benefits of early phase II cardiac rehabilitation (CR) on improving the exercise capacity but the evidence in patients after rheumatic mitral valve surgery due to rheumatic heart disease is limited. This study aims to investigate the effects of early phase II CR program on increasing exercise capacity in the rheumatic mitral valve surgery patients. Methods: This is a cohort retrospective study. A review of medical records identified 254 patients who underwent early phase II CR after rheumatic mitral valve  surgery between July 2009 – June 2019. Effects of CR was assessed by 6 Minutes Walking Distance (6MWD) pre and post early phase II CR and peak oxygen uptake (VO2 peak) calculated by Cahallin formula. In this study, we observed and analyzed the increasing of 6MWD and VO2 peak. Results: Our findings showed that 6MWD and VO2 peak increased significantly in these patients after early phase II CR program (p = 0.001). Mean of 6MWD increased from 316.3 ± 71.7 meters to 378.6 ± 60.3 meters and VO2 peak increased from 7.7 ±2.4 mL/kg/min to 8.9 ± 2.2 mL/kg/min. The mean difference of 6MWD was 62.3 meters and VO2 peak was 1.2 mL/kg/min. There was a strong correlation between VO2 peak and 6MWD (r = 71%; R2 = 51%; p = 0.001). Conclusion: Early phase II CR in patients with Rheumatic Mitral Stenosis after mitral valve surgery improved the exercise capacity. Based on 6MWD, we can predict the value of VO2 peak patients with rheumatic mitral stenosis surgery patients.   Keywords: Cardiac rehabilitation, rheumatic mitral stenosis, 6MWD, VO2 peak
背景:风湿性心脏病仍然是发展中国家关注的主要问题。最近的研究表明,早期II期心脏康复(CR)对提高运动能力有好处,但在因风湿性心脏病而进行风湿性二尖瓣手术的患者中,证据有限。本研究旨在探讨早期II期CR方案对提高风湿性二尖瓣手术患者运动能力的影响。方法:这是一项队列回顾性研究。一项医疗记录审查确定,在2009年7月至2019年6月期间,254名患者在风湿性二尖瓣手术后接受了早期II期CR。通过早期II期CR前后的6分钟步行距离(6MWD)和通过Cahallin公式计算的峰值摄氧量(VO2峰值)来评估CR的效果。在本研究中,我们观察并分析了6MWD和VO2峰值的增加。结果:我们的研究结果显示,在早期II期CR方案后,这些患者的6MWD和VO2峰值显著增加(p=0.001)。6MWD的平均值从316.3±71.7米增加到378.6±60.3米,VO2峰值从7.7±2.4 mL/kg/min增加到8.9±2.2 mL/kg/min。6MWD的平均差异为62.3米,VO2峰值为1.2 mL/kg/min。结论:风湿性二尖瓣狭窄患者二尖瓣手术后早期Ⅱ期CR可提高运动能力。基于6MWD,我们可以预测风湿性二尖瓣狭窄手术患者的VO2峰值值。关键词:心脏康复,风湿性二尖瓣狭窄,6MWD,VO2峰值
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引用次数: 1
Colchicine as an Adjuvant Therapy for Coronary Artery Disease: A Systematic Review 秋水仙碱辅助治疗冠心病的系统评价
Pub Date : 2020-11-11 DOI: 10.30701/ijc.990
N. Andre, Patricia Renata, Muhamad Hafiz Mahruzza, R. M. Santoso
Background:Inflammation plays a significant role in atherosclerosis at all phases. Colchicine is a pleiotropic anti-inflammatory agent that may be beneficial in various stages of coronary artery disease (CAD). Methods:We searched for literatures in PubMed, Cochrane Library, ScienceDirect, and Proquest regarding the use of colchicine on top of current optimal medical therapy for CAD. Results: Twelve studies were identified: three studies in stable CAD patients and the remaining nine assessed in acute coronary syndrome (ACS) and post-ACS patients. The majority of studies used a colchicine dose of 0.5 mg/day. Adjuvant colchicine of 0.5 mg daily reduced the risk of developing ACS, cardiac arrest, or ischemic stroke in stable CAD: HR (hazard risk) 0.33 (95% CI 0.18-0.59), p<0.001. Patients admitted with ACS who received a 2 mg loading dose of colchicine pre-percutaneous coronary intervention (PCI) showed smaller infarct size than control: 18.3 (IQR 7.6-29.9) ml/1.73 m2vs 23.2 (18.5-33.4) ml/1.73 m2(p=0.019).In post-ACS patients, adjuvant colchicine of 0.5 mg daily significantly reduced the rate of ischemic cardiovascular events: HR 0.77 (95% CI 0.61-0.96), p=0.02. Conclusion: Stable CAD patients benefit from 0.5 mg daily dose of adjuvant colchicine to reduce the incidence of future cardiovascular events. For patients presenting with ACS, a loading dose of 2 mg of colchicine pre-PCI followed by a week of 0.5 mg colchicine twice daily on top of optimal medical care can reduce infarct size. This should be followed by consumption of 0.5 mg daily dose of adjuvant colchicine post-ACS for at least 20 months to prevent future reinfarctions.
背景:炎症在动脉粥样硬化的各个阶段都起着重要作用。秋水仙碱是一种多效性抗炎剂,可能对冠状动脉疾病(CAD)的各个阶段有益。方法:我们在PubMed、Cochrane Library、ScienceDirect和Proquest上检索了关于在当前CAD最佳药物治疗的基础上使用秋水仙碱的文献。结果:确定了12项研究:3项研究针对稳定型CAD患者,其余9项研究针对急性冠状动脉综合征(ACS)和ACS后患者。大多数研究使用的秋水仙碱剂量为0.5 mg/天。每天0.5 mg的秋水仙碱佐剂可降低稳定型CAD患者患ACS、心脏骤停或缺血性中风的风险:HR(危险风险)0.33(95%CI 0.18-0.59),p<0.001。接受2mg秋水仙碱负荷剂量经皮冠状动脉介入治疗(PCI)的ACS患者显示出比对照组更小的梗死面积:18.3(IQR 7.6-29.9)ml/1.73m2 vs 23.2(18.5-3.4)ml/1.73 m2(p=0.019)。在ACS后患者中,每天0.5mg的辅助秋水仙碱显著降低缺血性心血管事件的发生率:HR 0.77(95%CI 0.61-0.96),p=0.02。结论:稳定型CAD患者每天服用0.5 mg秋水仙碱辅助治疗可降低未来心血管事件的发生率。对于ACS患者,PCI前2 mg秋水仙碱的负荷剂量,然后在最佳医疗护理的基础上,每天两次0.5 mg秋水仙素一周,可以减少梗死面积。随后应在ACS后至少20个月内每天服用0.5mg的秋水仙碱佐剂,以防止未来再次感染。
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引用次数: 0
Modifiable Survival Factors of Out-of-Hospital Cardiac Arrest among Global Population: Systematic Review and Meta-Analysis 全球人群院外心脏骤停可改变生存因素的系统评价和荟萃分析
Pub Date : 2020-11-11 DOI: 10.30701/ijc.1014
J. R. Tandaju, Kareen Tayuwijaya
Out-of-hospital cardiac arrest (OHCA) is the most common type of cardiac arrest and causing much mortality and burden even preventive measure has been made. Therefore, we conducted study to reduce OHCA morbidity and mortality by finding modifiable survival factors in-order to interfere them. We did systematic review of large cohort studies (n>100,000) on general population from four databases, then filtered 3,560 studies into 9 studies and appraised them using Newcastle-Ottawa scale for quality and Cochrane risk-of-bias before being synthesized. Among 486,012 subjects, we found out that age and shockable rhythm is unmodifiable but could be helped with lifestyle. Modifiable factors are grouped into two: bystander response including public location (OR=1.24; CI 95%=1.16–1.32), bystander witness (OR=1.45; CI 95%=1.36–1.56), bystander CPR (OR=1.45; CI 95%=1.36–1.56); and emergency service delivery including paramedic response <10 minutes (OR=1.55; CI 95%=1.41–1.70), ambulance physician (OR=1.52; CI 95%=1.37–1.68). Having OHCA in public means bigger chance of being resuscitated. However, resuscitation by uneducated bystander shown harmful thus public education was needed. Emergency services were considered important to arrive with competent workers, especially physicians who was trained on defibrillator usage and management regiment. Therefore, increasing public awareness, provide more ambulance and district health center facility, and training of health care workers are essential. In conclusion, management of OHCA involved multidisciplinary action throughout the nation to increase outcome of OHCA and lessen the burden. More area-specified and factor-specified studies should be conducted to improve applicability.
院外心脏骤停(OHCA)是最常见的心脏骤停类型,即使采取了预防措施,也会导致大量死亡和负担。因此,我们进行了一项研究,通过寻找可改变的生存因素来干预OHCA的发病率和死亡率。我们对四个数据库中关于普通人群的大型队列研究(n>100000)进行了系统回顾,然后将3560项研究筛选为9项研究,并在合成之前使用Newcastle Ottawa量表对其质量和Cochrane偏倚风险进行评估。在486012名受试者中,我们发现年龄和令人震惊的节奏是不可改变的,但生活方式可以帮助他们。可修改因素分为两类:旁观者反应,包括公共场所(OR=1.24;CI 95%=1.16–1.32)、旁观者目击者(OR=1.45;CI 95%=1.36–1.56)、旁观者心肺复苏(OR=1.45;CI 95%=1.36–1.56;以及紧急服务提供,包括医护人员反应<10分钟(OR=1.55;CI 95%CI=1.41-1.70)、救护车医生(OR=1.52;CI 95%CI1.37-1.68)。在公共场所进行OHCA意味着更大的复苏机会。然而,未受过教育的旁观者的复苏是有害的,因此需要进行公共教育。急救服务被认为是重要的,要有合格的工作人员,特别是受过除颤器使用和管理培训的医生。因此,提高公众意识,提供更多的救护车和地区卫生中心设施,以及培训卫生保健工作者至关重要。总之,OHCA的管理涉及全国各地的多学科行动,以提高OHCA的成果并减轻负担。应进行更多特定领域和特定因素的研究,以提高适用性。
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引用次数: 0
Wire Crossing Time Correlate with Left Ventricular End-Diastolic Pressure in Patients with ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention 经皮冠状动脉介入治疗ST段抬高型心肌梗死患者的导线穿越时间与左室舒张末期压相关
Pub Date : 2020-11-11 DOI: 10.30701/ijc.936
I. W. Nugraha, A. B. Hartopo, N. Taufiq
Backgrounds: Mortality and morbidity in acute myocardial infarction depend on the extent of the infarct area. Rapid recovery of coronary artery blood flow with primary percutaneous coronary intervention (pPCI) can limit the extent of infarction and improve left ventricular function. Acute myocardial infarction reduce diastolic function, which in the early stage of diastolic dysfunction, there is an increase in left ventricular end-diastolic pressure (LVEDP). The non-invasive marker of E/e’ ratio is an accurate parameter of increased LVEDP.Methods: This was a cross-sectional study enrolled consecutive patients with ST Segment Elevation Myocardial Infarction (STEMI) who underwent pPCI at Dr. Sardjito Hospital. The wire crossing time was calculated from the onset of chest pain until the guidewire crossed the infarct-related artery during the pPCI procedure. The E/e’ ratio was determined by transthoracic echocardiography which performed within 48 hours after the primary PCI. Correlation between the wire crossing time and the E/e’ ratio was assessed by the Pearson correlation test. The value of p <0.05 was considered statistically significant.Results: A total of 40 patients were enrolled in this study. The mean wire crossing time was 12.73±5.22 hours. The median value of the E/e’ ratio was 8.36 (range: 4.71-22.00). There was a moderate strength and significant correlation between the wire crossing time and the E/e’ ratio (r = 0.572; p <0.001). Patients with E/e’ ratio >15 had significantly longer wire crossing time than in patient with E/e’ ratio ≤15 (20.21±2.5 hours vs. 11.41±4.39 hours; p <0.001; respectively). The wire crossing time was independently associated the E/e’ ratio (r = 0.463; p = 0.003).Conclusion: There was a moderate strength and significant positive correlation between the wire crossing time and increased LVEDP, an earlier marker of diastolic dysfunction, measured by E/e’ ratio using TTE in patients with STEMI underwent pPCI.
背景:急性心肌梗死的死亡率和发病率取决于梗死区域的范围。经皮冠状动脉介入治疗(pPCI)能迅速恢复冠状动脉血流,限制梗死范围,改善左心室功能。急性心肌梗死使舒张功能降低,其中在舒张功能不全的早期,存在左室舒张末期压(LVEDP)升高。E/ e€™比率的无创标志物是LVEDP升高的准确参数。方法:这是一项横断面研究,纳入了在Dr. Sardjito医院接受pPCI治疗的ST段抬高型心肌梗死(STEMI)患者。在pPCI过程中,从胸痛开始到导丝穿过梗死相关动脉,计算导丝穿过时间。E/ e€™比值通过首次PCI术后48小时内的经胸超声心动图确定。通过Pearson相关检验评估导线穿越时间与E/ e€™比率之间的相关性。p15值明显长于E/ e€™比值为‰·15的患者(20.21±2.5小时vs. 11.41±4.39小时);p < 0.001;分别)。导线穿越时间与E/ e€™比值独立相关(r = 0.463;P = 0.003)。结论:在STEMI患者行pPCI时,导线穿过时间与LVEDP(舒张功能障碍的早期标志物)升高之间存在中等强度和显著正相关。
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引用次数: 1
Review Articles 评论文章
Pub Date : 2020-10-24 DOI: 10.30701/ijc.1076
Asmiha Indonesian Heart Association
Abstracts of the 29th Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 1st ASMIHA Digital Conference, 23-25 October 2020
印度尼西亚心脏协会(ASMIHA)第29届年度科学会议摘要第1届ASMIHA数字会议,2020年10月23日至25日
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引用次数: 0
Case Reports 案例报告
Pub Date : 2020-10-24 DOI: 10.30701/ijc.1075
Asmiha Indonesian Heart Association
Abstracts of the 29th Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 1st ASMIHA Digital Conference, 23-25 October 2020
2020年10月23日至25日,印度尼西亚心脏协会(ASMIHA)第29届年度科学会议摘要
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引用次数: 0
期刊
Majalah Kardiologi Indonesia
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