Pub Date : 2022-09-30DOI: 10.20473/ccj.v3i2.2022.112-118
Imam Mahbub Zam Zami, Agus Subagjo
Prosthetic valve endocarditis is the most severe form endocarditis with prevalence of 5.7% at 5 years and mortality with medical treatment is 26%-75%. Case Summary: Male, 46 years old, with mechanic mitral prosthetic valve >5 years, hemiparesis sinistra due to embolic stroke >4 weeks prior, was suffering from persistent fever >38,5⁰ for 2 weeks without heart failure. Three separate blood cultures came positive with Micrococcus spp. and Osler’s node was noticed. Echocardiography shown 1.0 cm x 0.9 cm vegetation at mitral prosthetic valve without paravalvular leakage. Patient was assessed as late mitral PVE. Discussion: Gentamycin, Levofloxacin, and Erythromycin were given based on susceptibility test continued by Meropenem as therapy of urinary tract infection based on susceptibility test after second blood culture result was negative. The patient underwent 42 weeks of antibiotics course. The patient was discharged with good condition, no signs and symptoms of infection or heart failure, blood test was within normal limit, no vegetations with prosthetic mitral valve functioned normally. This case shows that late PVE caused by Micrococcus spp. can be treated by 42 weeks course of antibiotics according to microbial susceptibility test.
人工瓣膜心内膜炎是最严重的心内膜炎形式，5年患病率为5.7%，经药物治疗的死亡率为26%-75%。病例总结:男性，46岁，机械性二尖瓣人工瓣膜bbb50岁，4周前因栓塞性中风>引起的鼻窦炎偏瘫，持续发热>38,5⁰2周，无心力衰竭。三个单独的血培养结果为微球菌阳性，并注意到奥斯勒结。超声心动图显示人工二尖瓣1.0 cm x 0.9 cm赘生物，无瓣旁渗漏。评估患者为晚期二尖瓣PVE。讨论:第二次血培养阴性后，在药敏试验基础上给予庆大霉素、左氧氟沙星、红霉素治疗，继续给予美罗培南药敏试验治疗尿路感染。患者接受了42周的抗生素疗程。出院时病情良好，无感染及心力衰竭症状，血检正常，无赘生物，人工二尖瓣功能正常。本病例表明微球菌引起的晚期PVE可通过42周的抗生素治疗。
{"title":"A Late Prosthetic Mitral Valve Infective Endocarditis Caused by Micrococcus spp. that Fully Recovered by Antibiotics Treatment : A Rare Case","authors":"Imam Mahbub Zam Zami, Agus Subagjo","doi":"10.20473/ccj.v3i2.2022.112-118","DOIUrl":"https://doi.org/10.20473/ccj.v3i2.2022.112-118","url":null,"abstract":"Prosthetic valve endocarditis is the most severe form endocarditis with prevalence of 5.7% at 5 years and mortality with medical treatment is 26%-75%. Case Summary: Male, 46 years old, with mechanic mitral prosthetic valve >5 years, hemiparesis sinistra due to embolic stroke >4 weeks prior, was suffering from persistent fever >38,5⁰ for 2 weeks without heart failure. Three separate blood cultures came positive with Micrococcus spp. and Osler’s node was noticed. Echocardiography shown 1.0 cm x 0.9 cm vegetation at mitral prosthetic valve without paravalvular leakage. Patient was assessed as late mitral PVE. Discussion: Gentamycin, Levofloxacin, and Erythromycin were given based on susceptibility test continued by Meropenem as therapy of urinary tract infection based on susceptibility test after second blood culture result was negative. The patient underwent 42 weeks of antibiotics course. The patient was discharged with good condition, no signs and symptoms of infection or heart failure, blood test was within normal limit, no vegetations with prosthetic mitral valve functioned normally. This case shows that late PVE caused by Micrococcus spp. can be treated by 42 weeks course of antibiotics according to microbial susceptibility test.","PeriodicalId":371103,"journal":{"name":"Cardiovascular and Cardiometabolic Journal (CCJ)","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131674078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.20473/ccj.v3i2.2022.129-133
Yosua Hendriko Manurung, Yusuf Galenta
The worldwide health impact of the COVID-19 epidemic has been felt all across the world, mostly due to respiratory issues, but many additional signs such as cardiac manifestations and different thromboembolisms have also been observed. Case Summary. We provide you with a 48-year-old female patient with COVID-19 pneumonia following a severe infection, who developed Unstable Angina due to coronary thrombosis. She has a history of hypertension and obese posture. No diabetes, hypercholesterolemia, or smoking habit had been recorded. And she still has regular menstrual cycle. Around a month prior to being referred to our hospital, this patient has been admitted to ICU of satellite hospital. She was treated with ventilator and discharged around a week before she was admitted to our Emergency Department. She had typical chest pain with ST-segment depression ECG at antero-septal area. PCI was performed and a large thrombosis was found at LAD artery. Discussion: Many studies have showed that COVID-19, through various ways, has developed thromboembolism both in arteries and venous system. The actual process of thrombus development in the coronary arteries is unknown, however, it is thought that pro-inflammatory cytokinesis released by the body, which stimulates the coagulation cascade and prevent fibrinolysis, are the major cause. This condition that leads to hypercoagulable state which eventually makes an increased risk of thromboembolism.
{"title":"Coronary Thrombosis Case in Female Patient with COVID-19 Confirmed Case: Coincidence or Complication?","authors":"Yosua Hendriko Manurung, Yusuf Galenta","doi":"10.20473/ccj.v3i2.2022.129-133","DOIUrl":"https://doi.org/10.20473/ccj.v3i2.2022.129-133","url":null,"abstract":"The worldwide health impact of the COVID-19 epidemic has been felt all across the world, mostly due to respiratory issues, but many additional signs such as cardiac manifestations and different thromboembolisms have also been observed. Case Summary. We provide you with a 48-year-old female patient with COVID-19 pneumonia following a severe infection, who developed Unstable Angina due to coronary thrombosis. She has a history of hypertension and obese posture. No diabetes, hypercholesterolemia, or smoking habit had been recorded. And she still has regular menstrual cycle. Around a month prior to being referred to our hospital, this patient has been admitted to ICU of satellite hospital. She was treated with ventilator and discharged around a week before she was admitted to our Emergency Department. She had typical chest pain with ST-segment depression ECG at antero-septal area. PCI was performed and a large thrombosis was found at LAD artery. Discussion: Many studies have showed that COVID-19, through various ways, has developed thromboembolism both in arteries and venous system. The actual process of thrombus development in the coronary arteries is unknown, however, it is thought that pro-inflammatory cytokinesis released by the body, which stimulates the coagulation cascade and prevent fibrinolysis, are the major cause. This condition that leads to hypercoagulable state which eventually makes an increased risk of thromboembolism.","PeriodicalId":371103,"journal":{"name":"Cardiovascular and Cardiometabolic Journal (CCJ)","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122204607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.20473/ccj.v3i2.2022.75-86
Chelssi Gloria Tessari, A. Lefi, Y. Hernaningsih
Acute Coronary Syndrome (ACS) is one of the highest causes of death globally, with the number of deaths reaching more than 9 million people in 2016. Therefore, a fast and accurate ACS diagnosis is needed. This study aimed to determine the relationship between the neutrophil-lymphocyte ratio, the number of coronary artery lesions evaluated by angiography, and troponin I in ACS patients Material and Methods: This research is an analytic observational with a retrospective cross-sectional design. Sampling was carried out using a total sampling technique and obtained 87 samples that met the inclusion and exclusion criteria for the 2019-2020 period at Dr. Soetomo Regional General Hospital Surabaya. The correlation between the number of coronary artery lesions and the neutrophil-lymphocyte ratio to troponin I levels were respectively analyzed using chi-square and spearman-rho with SPSS ver. 25. Results: The results showed a moderately significant correlation between the neutrophil-lymphocyte ratio and troponin I levels (p =0.003, rs = 0.319). While the correlation analysis between the number of coronary artery lesions and the vessel score on troponin I showed insignificant results (p = 0.525), which means that the number of coronary artery lesions was not correlated with troponin I. Conclusion: This study concludes a significant correlation with moderate correlation between the neutrophil-lymphocyte ratio and troponin I. However, there is no significant correlation between the number of coronary artery lesions assessed by the Sullivan and troponin I levels.
{"title":"Correlation of Neutrophyl-Lymphocyte Ratio, Vessel Score based on Sullivan Scoring System, and Troponin in Acute Coronary Syndrome Patients","authors":"Chelssi Gloria Tessari, A. Lefi, Y. Hernaningsih","doi":"10.20473/ccj.v3i2.2022.75-86","DOIUrl":"https://doi.org/10.20473/ccj.v3i2.2022.75-86","url":null,"abstract":"Acute Coronary Syndrome (ACS) is one of the highest causes of death globally, with the number of deaths reaching more than 9 million people in 2016. Therefore, a fast and accurate ACS diagnosis is needed. This study aimed to determine the relationship between the neutrophil-lymphocyte ratio, the number of coronary artery lesions evaluated by angiography, and troponin I in ACS patients Material and Methods: This research is an analytic observational with a retrospective cross-sectional design. Sampling was carried out using a total sampling technique and obtained 87 samples that met the inclusion and exclusion criteria for the 2019-2020 period at Dr. Soetomo Regional General Hospital Surabaya. The correlation between the number of coronary artery lesions and the neutrophil-lymphocyte ratio to troponin I levels were respectively analyzed using chi-square and spearman-rho with SPSS ver. 25. Results: The results showed a moderately significant correlation between the neutrophil-lymphocyte ratio and troponin I levels (p =0.003, rs = 0.319). While the correlation analysis between the number of coronary artery lesions and the vessel score on troponin I showed insignificant results (p = 0.525), which means that the number of coronary artery lesions was not correlated with troponin I. Conclusion: This study concludes a significant correlation with moderate correlation between the neutrophil-lymphocyte ratio and troponin I. However, there is no significant correlation between the number of coronary artery lesions assessed by the Sullivan and troponin I levels.","PeriodicalId":371103,"journal":{"name":"Cardiovascular and Cardiometabolic Journal (CCJ)","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127252061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.20473/ccj.v3i2.2022.87-93
D. Tinduh, Felisita Maritza Abidanovanty, Nabila Sayyida Fairuz Zen, Fadhilah Rahmaputri
Abstract: Background: Coronary Artery Disease (CAD) is a disorder of heart function caused by blockage or narrowing of the coronary arteries so that there is an insufficiency of blood and oxygen flow to the myocardium and becomes the leading cause of death in the world. CAD is one of the causes of the decline in the quality of life of a human being. Methods: This study used a literature review method using 11 scientific articles as online data sources which were then further analyzed. Result and Discussion: Exercise is a recommended therapy as half of the pharmacotherapy. Moderate intensity exercise of 150 minutes per week and vigorous-intensity of more than 75 minutes per week greatly help CR also provide significant benefits when started within 15 days of cardiovascular symptoms appearing. Conclussion: CAD causes the most deaths in the world. From various scientific articles that have been analyzed, exercise, especially aerobic exercise, has been shown to have a good impact on people with CAD that affect lipid metabolism, heart remodeling, insulin resistance, and endothelial function.
{"title":"The Role of Aerobic Exercise to Prevent Coronary Artery Disease","authors":"D. Tinduh, Felisita Maritza Abidanovanty, Nabila Sayyida Fairuz Zen, Fadhilah Rahmaputri","doi":"10.20473/ccj.v3i2.2022.87-93","DOIUrl":"https://doi.org/10.20473/ccj.v3i2.2022.87-93","url":null,"abstract":"Abstract: Background: Coronary Artery Disease (CAD) is a disorder of heart function caused by blockage or narrowing of the coronary arteries so that there is an insufficiency of blood and oxygen flow to the myocardium and becomes the leading cause of death in the world. CAD is one of the causes of the decline in the quality of life of a human being. Methods: This study used a literature review method using 11 scientific articles as online data sources which were then further analyzed. Result and Discussion: Exercise is a recommended therapy as half of the pharmacotherapy. Moderate intensity exercise of 150 minutes per week and vigorous-intensity of more than 75 minutes per week greatly help CR also provide significant benefits when started within 15 days of cardiovascular symptoms appearing. Conclussion: CAD causes the most deaths in the world. From various scientific articles that have been analyzed, exercise, especially aerobic exercise, has been shown to have a good impact on people with CAD that affect lipid metabolism, heart remodeling, insulin resistance, and endothelial function.","PeriodicalId":371103,"journal":{"name":"Cardiovascular and Cardiometabolic Journal (CCJ)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132679313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.20473/ccj.v3i2.2022.119-128
Angela Bety Ratnasari, B. Dharmadjati
AVNRT is the most common regular arrhythmia in humans, and therefore the most commonly encountered during ablation attempts for regular tachycardias. Case Summary: We present a 41-year-old female patient with chest palpitations in the last 10 years, but prior to hospitalization felt heavy sensation on her chest and hospitalized due to heavy chest palpitations and documented SVT. She had no history of hypertension, diabetes mellitus, coronary heart conditions, or stroke. Physical examination showed fair general condition with GCS E4V5M6, blood pressure 130/80, pulse rate 96x / minute, breath rate 18 x / minute and saturation of 99%. Physical examinations are within normal limits. Discussion: Catheter ablation for AVNRT is the current treatment of choice in symptomatic patients. It reduces arrhythmia-related hospitalizations and costs, and substantially improves quality of life. Catheter ablation approaches aimed at the fast pathway have been abandoned; slow pathway ablation, using a combined anatomical and mapping approach, is now the method of choice. This approach offers a success rate of 95 %, has a recurrence rate of approximately 1.3 – 4.0 %, and has been associated with a low risk of atrioventricular (AV) block.
AVNRT是人类最常见的常规心律失常，因此在常规心动过速的消融尝试中最常遇到。病例总结:我们报告了一名41岁的女性患者，在过去的10年里出现了胸悸，但在住院前，她感到胸部有沉重的感觉，并因严重的胸悸和SVT而住院。无高血压、糖尿病、冠心病、中风病史。体格检查一般情况良好，GCS E4V5M6，血压130/80，脉搏96x /分钟，呼吸频率18 x /分钟，饱和度99%。身体检查在正常范围内。讨论:AVNRT的导管消融是目前有症状患者的治疗选择。它减少了心律失常相关的住院治疗和费用，并大大提高了生活质量。针对快速通路的导管消融方法已被放弃;缓慢路径消融，结合解剖和定位方法，现在是首选的方法。这种方法的成功率为95%，复发率约为1.3 - 4.0%，并且与房室传导阻滞的低风险相关。
{"title":"Successful Typical AVNRT Ablation","authors":"Angela Bety Ratnasari, B. Dharmadjati","doi":"10.20473/ccj.v3i2.2022.119-128","DOIUrl":"https://doi.org/10.20473/ccj.v3i2.2022.119-128","url":null,"abstract":"AVNRT is the most common regular arrhythmia in humans, and therefore the most commonly encountered during ablation attempts for regular tachycardias. Case Summary: We present a 41-year-old female patient with chest palpitations in the last 10 years, but prior to hospitalization felt heavy sensation on her chest and hospitalized due to heavy chest palpitations and documented SVT. She had no history of hypertension, diabetes mellitus, coronary heart conditions, or stroke. Physical examination showed fair general condition with GCS E4V5M6, blood pressure 130/80, pulse rate 96x / minute, breath rate 18 x / minute and saturation of 99%. Physical examinations are within normal limits. Discussion: Catheter ablation for AVNRT is the current treatment of choice in symptomatic patients. It reduces arrhythmia-related hospitalizations and costs, and substantially improves quality of life. Catheter ablation approaches aimed at the fast pathway have been abandoned; slow pathway ablation, using a combined anatomical and mapping approach, is now the method of choice. This approach offers a success rate of 95 %, has a recurrence rate of approximately 1.3 – 4.0 %, and has been associated with a low risk of atrioventricular (AV) block.","PeriodicalId":371103,"journal":{"name":"Cardiovascular and Cardiometabolic Journal (CCJ)","volume":"210 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123332888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.20473/ccj.v3i2.2022.100-111
Ken Christian Kawilarang, I. Hermawan, Febryanti Hartono
Case Summary: We present 2 cases of post-STEMI VSR. They had anterior AMI without reperfusion therapy because of patient delay and limited resources. Thereafter apical VSR occurs on 5th day. VSR was suspected because of sudden hemodynamic deterioration and new holosystolic murmur (Grade III/VI) at left parasternal line of fourth-fifth ICS. Then it was confirmed by echocardiography. Both patients underwent hemodynamic stabilization while waiting for surgical therapy. Unfortunately, they deceased because of cardiogenic shock accompanied by other comorbidities. Discussion: VSR causes shunt from left to the right ventricle, which overloads the RV, leading to cardiogenic shock. The peak incidence of VSR in the first 24 hours or 3-5 days post-AMI. This fits both of our cases. VSR occurs in total coronary occlusion, which then causes coagulation necrosis in the ischemic area, characterized by neutrophils that trigger apoptosis and lytic enzymes, so that septum becomes thin, brittle then ruptures. VSR is most common in anterior AMI and the defect is at apical septum, as in our patients. Definitive therapy for VSR is surgical closure, but the best timing is still under debate. This article is expected to make us more aware of post-AMI VSR, so we can quickly diagnose and promptly treat the patients with multidisciplinary approach. This is very important to optimize patient’s outcomes even in limited resources area.
{"title":"Ventricular Septal Rupture (VSR) in Post-Acute Anterior Myocardial Infarction Patients : A Case Series","authors":"Ken Christian Kawilarang, I. Hermawan, Febryanti Hartono","doi":"10.20473/ccj.v3i2.2022.100-111","DOIUrl":"https://doi.org/10.20473/ccj.v3i2.2022.100-111","url":null,"abstract":"Case Summary: We present 2 cases of post-STEMI VSR. They had anterior AMI without reperfusion therapy because of patient delay and limited resources. Thereafter apical VSR occurs on 5th day. VSR was suspected because of sudden hemodynamic deterioration and new holosystolic murmur (Grade III/VI) at left parasternal line of fourth-fifth ICS. Then it was confirmed by echocardiography. Both patients underwent hemodynamic stabilization while waiting for surgical therapy. Unfortunately, they deceased because of cardiogenic shock accompanied by other comorbidities. Discussion: VSR causes shunt from left to the right ventricle, which overloads the RV, leading to cardiogenic shock. The peak incidence of VSR in the first 24 hours or 3-5 days post-AMI. This fits both of our cases. VSR occurs in total coronary occlusion, which then causes coagulation necrosis in the ischemic area, characterized by neutrophils that trigger apoptosis and lytic enzymes, so that septum becomes thin, brittle then ruptures. VSR is most common in anterior AMI and the defect is at apical septum, as in our patients. Definitive therapy for VSR is surgical closure, but the best timing is still under debate. This article is expected to make us more aware of post-AMI VSR, so we can quickly diagnose and promptly treat the patients with multidisciplinary approach. This is very important to optimize patient’s outcomes even in limited resources area.","PeriodicalId":371103,"journal":{"name":"Cardiovascular and Cardiometabolic Journal (CCJ)","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114610740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.20473/ccj.v3i2.2022.94-99
S. Handari, Puspa Lestari
Background: A coronary artery fistula (CAF) is an aberrant vascular contact of coronary arteries with cardiac chambers or any section of the pulmonary or systemic circulation, which accounts for 0.3% of congenital heart disorders. CAFs have been observed to be as common as 0.9% at computed tomographic (CT) angiography, which is greater than the previously estimated prevalence of 0.002 – 0.3% at invasive angiography. Case Summary: A 76-year-old woman reported with repeated episodes of chest pain. A considerable diameter of fistula from the proximal LAD and proximal RCA to the MPA was discovered on CT angiography, which could be the cause of coronary steal syndrome. Microflex10 7 mm/22 cm was used to perform coil embolization at the proximal RCA. After the procedure, the patient had no more chest pain. Discussion: CT angiography is usefsul for determining coronary architecture and guiding therapeutic intervention. CAF data was gathered during pre- and post-procedural CT angiography evaluations. Keyword: Fistula coronary, coronary steal syndrome, CCTA, percutaneous coil embolization
{"title":"Fistula Coronary and Coronary Steal Syndrome: A Case Report","authors":"S. Handari, Puspa Lestari","doi":"10.20473/ccj.v3i2.2022.94-99","DOIUrl":"https://doi.org/10.20473/ccj.v3i2.2022.94-99","url":null,"abstract":"Background: A coronary artery fistula (CAF) is an aberrant vascular contact of coronary arteries with cardiac chambers or any section of the pulmonary or systemic circulation, which accounts for 0.3% of congenital heart disorders. CAFs have been observed to be as common as 0.9% at computed tomographic (CT) angiography, which is greater than the previously estimated prevalence of 0.002 – 0.3% at invasive angiography. \u0000Case Summary: A 76-year-old woman reported with repeated episodes of chest pain. A considerable diameter of fistula from the proximal LAD and proximal RCA to the MPA was discovered on CT angiography, which could be the cause of coronary steal syndrome. Microflex10 7 mm/22 cm was used to perform coil embolization at the proximal RCA. After the procedure, the patient had no more chest pain. \u0000Discussion: CT angiography is usefsul for determining coronary architecture and guiding therapeutic intervention. CAF data was gathered during pre- and post-procedural CT angiography evaluations. \u0000Keyword: Fistula coronary, coronary steal syndrome, CCTA, percutaneous coil embolization","PeriodicalId":371103,"journal":{"name":"Cardiovascular and Cardiometabolic Journal (CCJ)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129401099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-09DOI: 10.20473/ccj.v3i1.2022.60-74
Sinta Dwi Juniar, M. Y. Alsagaff, Pudji Lestari, B. Pikir
Abstract: Heart failure patients with reduced ejection fraction (HFrEF) respond well to pharmacological therapy and show a better prognosis. Heart failure patients with reduced ejection fraction and type 2 diabetes who were given SGLT-2 inhibitor therapy showed a strong and consistent reduction in the risk of death and hospitalization. The therapy that has recently begun to be investigated for its benefits for heart failure from the SGLT-2 inhibitor class is Dapagliflozin. The systematic review aims to analyze the effect of Dapagliflozin on the prognosis of HFrEF patients with type 2 diabetes mellitus. Material and Methods: The literature was searched from e-database PubMed, ScienceDirect, and ClinicalTrial.gov. Quality assessment was done using the Critical Appraisal Skills Program (CASP) Randomized Controlled Trial Standard Checklist. Results: A total of 22,167 patients from 4 RCTs eligible studies were included. The analysis results of all of the included studies indicate that Dapagliflozin affected the patient's prognosis. Two studies discuss mortality and hospitalization, and two studies discuss symptoms, functional status, and Quality of Life (QoL). Conclusion: Dapagliflozin can improve the prognosis of HFrEF patients with type 2 DM. The improved prognosis includes reduced mortality, reduced hospitalizations by minimizing disease worsening, reducing symptoms, improving functional status and QoL.Keyword: SGLT 2 inhibitor; Dapagliflozin; Prognosis; Cardiovascular disease; Diabetes.
{"title":"Dapagliflozin Use in Heart Failure with Reduced Ejection Fraction Accompanied by Type 2 Diabetes Mellitus: A Systematic Review","authors":"Sinta Dwi Juniar, M. Y. Alsagaff, Pudji Lestari, B. Pikir","doi":"10.20473/ccj.v3i1.2022.60-74","DOIUrl":"https://doi.org/10.20473/ccj.v3i1.2022.60-74","url":null,"abstract":"Abstract: Heart failure patients with reduced ejection fraction (HFrEF) respond well to pharmacological therapy and show a better prognosis. Heart failure patients with reduced ejection fraction and type 2 diabetes who were given SGLT-2 inhibitor therapy showed a strong and consistent reduction in the risk of death and hospitalization. The therapy that has recently begun to be investigated for its benefits for heart failure from the SGLT-2 inhibitor class is Dapagliflozin. The systematic review aims to analyze the effect of Dapagliflozin on the prognosis of HFrEF patients with type 2 diabetes mellitus. Material and Methods: The literature was searched from e-database PubMed, ScienceDirect, and ClinicalTrial.gov. Quality assessment was done using the Critical Appraisal Skills Program (CASP) Randomized Controlled Trial Standard Checklist. Results: A total of 22,167 patients from 4 RCTs eligible studies were included. The analysis results of all of the included studies indicate that Dapagliflozin affected the patient's prognosis. Two studies discuss mortality and hospitalization, and two studies discuss symptoms, functional status, and Quality of Life (QoL). Conclusion: Dapagliflozin can improve the prognosis of HFrEF patients with type 2 DM. The improved prognosis includes reduced mortality, reduced hospitalizations by minimizing disease worsening, reducing symptoms, improving functional status and QoL.Keyword: SGLT 2 inhibitor; Dapagliflozin; Prognosis; Cardiovascular disease; Diabetes.","PeriodicalId":371103,"journal":{"name":"Cardiovascular and Cardiometabolic Journal (CCJ)","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127478115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-06DOI: 10.20473/ccj.v3i1.2022.15-21
Astrid Aulia Artiono Puteri, Y. Oktaviono, A. Prasmono
Abstract: Atrial Septal Defect (ASD) is one of the three most common types of congenital heart disease in the world. Pulmonary arterial hypertension (PAH) is a complication that can be found in patients with secundum type of ASD. There is no research that shows the relationship between patient’s age and defect size with increased pulmonary artery pressure in secundum type of ASD patients in Indonesia, so further research needs to be done. Material and Methods: This study is a retrospective study using an observational analytical research design with cross sectionalapproach. The data from this study were taken from the medical records of ASD patients at the Cardiology and Vascular Department of Dr. Soetomo Public Hospital Surabaya. Results: Sex distribution of patients with secundum ASD was dominated by female patients with a total of 53 people (81.5%), the age distribution of patients was dominated by patients in the age group of 20-24 years as many as 18 people (27.7%). The most common comorbidities in adult secundum ASD patients were hypertension (3.08%) and minor CAD (3.08%). The mean diameter of the secundum ASD defect was 28.03±9.57 mm, and the data for the smallest defect diameter was 4 mm and the largest was 48 mm. Complications of increased PA pressure were dominated by 20 patients with mild PH (30.8%) and the mean mPAP pressure was 39.87±19.03. There were no patients with Eisenmenger syndrome.Conclusion: There was no correlation between patient age and inter-atrial septal diameter with mPAP pressure.
{"title":"Correlation between Age and Defect Size with Increased Pulmonary Arterial Pressure in Adult Atrial Septal Defect (ASD) Patients at Cardiology and Vascular Medicine Department dr. Seotomo Public Hospital Surabaya 2019-2021","authors":"Astrid Aulia Artiono Puteri, Y. Oktaviono, A. Prasmono","doi":"10.20473/ccj.v3i1.2022.15-21","DOIUrl":"https://doi.org/10.20473/ccj.v3i1.2022.15-21","url":null,"abstract":"Abstract: Atrial Septal Defect (ASD) is one of the three most common types of congenital heart disease in the world. Pulmonary arterial hypertension (PAH) is a complication that can be found in patients with secundum type of ASD. There is no research that shows the relationship between patient’s age and defect size with increased pulmonary artery pressure in secundum type of ASD patients in Indonesia, so further research needs to be done. Material and Methods: This study is a retrospective study using an observational analytical research design with cross sectionalapproach. The data from this study were taken from the medical records of ASD patients at the Cardiology and Vascular Department of Dr. Soetomo Public Hospital Surabaya. Results: Sex distribution of patients with secundum ASD was dominated by female patients with a total of 53 people (81.5%), the age distribution of patients was dominated by patients in the age group of 20-24 years as many as 18 people (27.7%). The most common comorbidities in adult secundum ASD patients were hypertension (3.08%) and minor CAD (3.08%). The mean diameter of the secundum ASD defect was 28.03±9.57 mm, and the data for the smallest defect diameter was 4 mm and the largest was 48 mm. Complications of increased PA pressure were dominated by 20 patients with mild PH (30.8%) and the mean mPAP pressure was 39.87±19.03. There were no patients with Eisenmenger syndrome.Conclusion: There was no correlation between patient age and inter-atrial septal diameter with mPAP pressure.","PeriodicalId":371103,"journal":{"name":"Cardiovascular and Cardiometabolic Journal (CCJ)","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117269566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypertension is a leading cause of death worldwide including in Indonesia. The World Health Organization (WHO) estimates that currently the global prevalence of hypertension is 22% (WHO, 2019). In 2018 the prevalence of hypertension in Indonesia reached 34,11% (Riskesdas, 2018). Every year, it is estimated that 10.4 million deaths are caused by hypertension (Unger et al., 2020). Hyperbaric Oxygen Therapy (HBOT) is a therapy with pure oxygen concentration (100%) in a high pressure room (Ortega et al., 2021). In previous studies it was found that HBOT improves the effects of vasodilation (Mihaljevic et al., 2018). However, other studies mention different results. It was found that HBOT initiates vasoconstriction and increases systemic vascular resistance. This causes a decrease in nitrite oxide (NO) production and increase NO oxidation (Goyal et al., 2021). Apart from a variety of different study results, the use of HBOT has indeed been widely studied even though it has not found a clear meeting point on the effects of blood pressure reduction on hypertension patients. Therefore, the author aims to find out more clearly the mechanism and benefits of hyperbaric oxygen therapy against decreased blood pressure in hypertension patients.
高血压是包括印度尼西亚在内的世界范围内死亡的主要原因。世界卫生组织(WHO)估计，目前全球高血压患病率为22% (WHO, 2019)。2018年，印度尼西亚的高血压患病率达到34.11% (Riskesdas, 2018年)。据估计，每年有1040万人死于高血压(Unger et al.， 2020)。高压氧治疗(Hyperbaric Oxygen Therapy, HBOT)是在高压室内进行纯氧浓度(100%)的治疗(Ortega et al.， 2021)。在之前的研究中发现，HBOT可以改善血管扩张的效果(Mihaljevic et al.， 2018)。然而，其他研究提到了不同的结果。研究发现，HBOT可引起血管收缩，增加全身血管阻力。这会导致亚硝酸盐氧化物(NO)的产生减少，并增加NO氧化(Goyal等，2021)。除了各种不同的研究结果外，HBOT的使用确实得到了广泛的研究，尽管在降压对高血压患者的影响上并没有找到一个明确的契合点。因此，笔者旨在更清楚地了解高压氧治疗高血压患者降压的机制和益处。
{"title":"Identification of The Effect of Hyberbaric Oxygen Therapy (HBOT) on Blood Pressure Lowering Effects in Hypertension Patients","authors":"Karindra Amadea Susetiyo, Agus Subagjo, Primadita Syahbani, Iqlima Rahmawati, Ikhsanuddin Qothi","doi":"10.20473/ccj.v3i1.2022.52-59","DOIUrl":"https://doi.org/10.20473/ccj.v3i1.2022.52-59","url":null,"abstract":"Hypertension is a leading cause of death worldwide including in Indonesia. The World Health Organization (WHO) estimates that currently the global prevalence of hypertension is 22% (WHO, 2019). In 2018 the prevalence of hypertension in Indonesia reached 34,11% (Riskesdas, 2018). Every year, it is estimated that 10.4 million deaths are caused by hypertension (Unger et al., 2020). Hyperbaric Oxygen Therapy (HBOT) is a therapy with pure oxygen concentration (100%) in a high pressure room (Ortega et al., 2021). In previous studies it was found that HBOT improves the effects of vasodilation (Mihaljevic et al., 2018). However, other studies mention different results. It was found that HBOT initiates vasoconstriction and increases systemic vascular resistance. This causes a decrease in nitrite oxide (NO) production and increase NO oxidation (Goyal et al., 2021). Apart from a variety of different study results, the use of HBOT has indeed been widely studied even though it has not found a clear meeting point on the effects of blood pressure reduction on hypertension patients. Therefore, the author aims to find out more clearly the mechanism and benefits of hyperbaric oxygen therapy against decreased blood pressure in hypertension patients. ","PeriodicalId":371103,"journal":{"name":"Cardiovascular and Cardiometabolic Journal (CCJ)","volume":"184 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131468883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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