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Lubis, Andika Rizki
Pengaruh karakter ventrikel kiri terhadap luaran klinis jangka pendek in-hospital dan jangka menengah pasca pembedahan katup aorta pada regurgutasi aorta kronik = The effect of left ventricular character to short term in hospital and mid term clinical outcome after aortic valve replacement due to chronic aortic regurgitation
"Latar belakang: Waktu yang tepat untuk pembedahan katup aorta masihmerupakan tantangan saat ini. Pasien sering datang dengan kondisi lanjut denganperubahan geometri ventrikel kiri sebagai mekanisme kompensasi terhadappeningkatan beban tekanan dan volume berkepanjangan yang akan mempengaruhiluaran klinis pascabedah.
Tujuan: Penelitian ini bertujuan untuk mengetahuiapakah terdapat pengaruh karakter ventrikel kiri meliputi ukuran dimensi ventrikelkiri EDD, ESD, FEVKi, indeks massa ventrikel kiri LVMI terhadapmorbiditas dan mortalitas di rumah sakit pascabedah katup aorta pada pasiendengan regurgitasi aorta kronik serta luaran klinis jangka menengah.
Metode: 168 pasien dengan regurgitasi aorta kronik yang menjalani pembedahankatup aorta terseleksi sesuai kriteria inklusi dan eksklusi, pascapembedahandilakukan follow-up terhadap luaran klinis morbiditas dan mortalitas di rumahsakit, kemudian diikuti 1 tahun hingga 5 tahun setelah operasi, morbiditas danmortalitas dievaluasi,
Hasil: Tidak terdapat perbedaan bermakna pada tiap tiapparameter ventrikel kiri EDD, ESD, FEVKi, LVMI terhadap morbiditas danmortalitas saat di rumah sakit p>0,05, terdapat faktor-faktor yang mempengaruhimorbiditas intrahospital yaitu laju filtrasi ginjal p< 0,001 dan usia p=0,001 ,riwayat Penyakit Jantung Koroner PJK, riwayat PPOK dan riwayat stroke, sedangkan morbiditas jangka menengah dipengaruhi oleh kejadian aritmia pascapembedahan p=0,009, terdapat perbaikan pada NYHA functional class.Mortalitas di rumah sakit dipengaruhi oleh usia p=0,001 dan laju filtrasi ginjal p
Background: The optimal timing of aortic valve replacement is still challenging.The patients often come to hospital in end stage clinical performance withalteration in left ventricular LV geometry due to compensatory mechanism tovolume and pressure overload in long term period.
Objective: This study soughtto determine the effect of left ventricular characters diameter of the left ventricle,end diastolic diameter EDD, end systolic diameter ESD, left ventricularejection fraction LVEF, left ventricular mass index LVMI to in hospitalmorbidity and mortality following aortic valve replacement in patients withchronic aortic regurgitation and postoperative mid term outcome.
Methods: 168 patients with chronic aortic regurgitation underwent aortic valve replacementselected according to inclusion and exclusion criteria. Outcomes morbidity andmortality were observed during hospitalization and 1 year until 5 years aftersurgery. Mid term outcomes consisted of NYHA functional class, rehospitalizationand redo operation.
Results: There was no significant difference to in hospitalmorbidity and mortality for each of left ventricular characters p 0,05. Other factors which influenced in hospital morbidity were glomerularfiltration rate p"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Rienna Diansari
Prediktor Mortalitas In-hospital dan Kesintasan Jangka Menengah Bedah Aorta Torakalis Kompleks dibandingkan dengan Non-Kompleks = Predictors of In-Hospital Mortality and Mid-Term Survival in Patients Undergoing Complex vs Non-Complex Thoracic Aortic Surgery
"Latar Belakang: Menurut Global and Regional Burden of Aortic Dissection and Aneurysm, laju kematian akibat patologi aorta torakalis di negara berkembang lebih tinggi dibandingkan negara maju, dengan median pertambahan percepatan +0,71 per 100.000 vs +0,22 per 100.000 pada tahun 1990 dibandingkan 2010. Asia Tenggara merupakan salah satu negara dengan penambahan laju kematian tertinggi yaitu 41%. Di Indonesia, pasien datang dalam kondisi penyakit lanjut karena keterlambatan diagnosis dan manajemen dan hal ini menjadikan pasien berada pada kondisi patologi aorta yang kompleks. Kondisi patologi aorta yang kompleks tentunya membutuhkan tindakan bedah aorta yang kompleks pula. Sejauh ini belum terdapat studi yang secara khusus meneliti luaran klinis bedah aorta torakalis kompleks dibandingkan dengan non-kompleks, terutama pada populasi di negara berkembang.
Tujuan: Mengetahui hubungan kompleksitas pembedahan dengan mortalitas in-hospital dan kesintasan jangka menengah pasca bedah aorta torakalis serta faktor lain yang berhubungan.
Metode: Studi kohort retrospektif ini menggunakan data sekunder. Dilakukan pengambilan data dasar melalui rekam medis dan registri terhadap pasien pasca bedah aorta torakalis (1 Januari 2018 – 31 Desember 2021) di PJNHK. Analisa kesintasan 1 dan 3 tahun dilakukan dengan follow up melalui telepon dan pesan digital. Kemudian dilakukan analisa statistik untuk mencari hubungan antara kompleksitas pembedahan sebagai prediktor utama serta variabel lainnya dengan luaran primer (mortalitas in-hospital) dan sekunder (kesintasan jangka menengah).
Hasil: Total 208 pasien diinklusikan ke dalam analisis luaran primer; 157 (75,5%) menjalani bedah aorta torakalis kompleks dan 51 (24,5%) menjalani bedah aorta torakalis non-kompleks. Mortalitas in-hospital serupa pada kedua kelompok (23,6% vs 13,7%; p = 0,194). Pada analisa multivariat, sindrom malperfusi (OR 3,560; p = 0,002), durasi CPB > 180 menit (OR 4,331; p = 0,001), dan prioritas pembedahan (urgent OR 4,196; p = 0,003; emergency OR 10,879; p = 0,001) adalah prediktor independen mortalitas in-hospital. Follow-up kesintasan 1 dan 3 tahun pasca bedah aorta torakalis adalah 92,6% dan 80,3%, secara berurutan. Regresi Cox mengidentifikasi diabetes (HR 4,539; p = 0,025) dan status prosedur emergensi (HR 9,561; p = 0,015) sebagai prediktor independen mortalitas 1 tahun, dan diabetes (HR 3,609; p = 0,004), diseksi aorta (HR 2,795; p = 0,029) dan diameter aorta maksimum (HR 1,034; p = 0,003) sebagai prediktor independen mortalitas 3 tahun. Kompleksitas pembedahan tidak berhubungan dengan peningkatan mortalitas in-hospital maupun kesintasan jangka menengah.
Kesimpulan: Pada pasien yang menjalani tindakan bedah aorta torakalis terbuka, kompleksitas pembedahan tidak berhubungan dengan mortalitas in-hospital maupun kesintasan jangka menengah. Kesintasan jangka pendek dan menengah lebih banyak dipengaruhi faktor komorbid maupun faktor durante pembedahan
Background: According to Global and Regional Burden of Aortic Dissection and Aneurysm, a prominent increase of overall global death rate is seen on developing country compared to developed country, with relative change in median daeath rate of +0,71 per 100.000 vs +0,22 per 100.000 in 1990 vs 2010. South-east Asia is nation with highest increase of 41%. This is due to delayed in diagnosis and treatment and leads to late stage and complex aortic disease. The more complex the disease, the more complex the surgical procedure will be. Up until now, there is no data regarding the impact of surgical complexity on short and mid-term survival in patients underwent aortic surgery, especially in developing country.
Objectives: This study aimed to investigate the impact of surgical complexity on short and mid-term mortality and other influencing factors.
Methods: This retrospective cohort study used secondary data. Basic data was obtained through medical record and registry of patients underwent thoracic aortic surgery (January 1st, 2018 to December 31st, 2021) in National Cardiovascular Center Harapan Kita (NCCHK). One-year and 3-year survival analysis was obtained through phone calls and digital messages. Statistical analysis was done to investigate the impact of surgical complexity as the main predictor and other variables on primary (in-hospital mortality) and secondary (mid-term survival) outcome.
Results: A total of 208 patients were included in the analysis; 157 (75,5%) underwent complex surgery, and 51 (24,5%) underwent non-complex surgery. In-hospital mortality was similar actoss 2 groups (23,6% vs 13,7%; p = 0,1240). On multivariable analysis, malperfusion syndrome (OR 3,560; p = 0,002), CPB duration > 180 minutes (OR 4,331; p = 0,001), and surgical priority (urgent OR 4,196; p = 0,003; emergency OR 10,879; p = 0,001) were identified as independent predictor of in-hospital mortality. One and 3-year survival were 92,6% and 80,3%, respectively. Cox regression identified diabetes (HR 4,539; p = 0,025) and emergency procedure (HR 9,561; p = 0,015) as independent predictors for 1-year mortality, and diabetes (HR 3,609; p = 0,004), aortic dissection (HR 2,795; p = 0,029), and maximum aortic diameter (HR 1,034; p = 0,003) for 3-year mortality. Surgical complexity was not associated with early and mid-term mortality.
Conclusions: In patients undergoing thoracic aortic surgery, surgical complexity was not associated with early and mid-term survival. Short and mid-term survival was largely determined by patient comorbidities and intra-surgery factors."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
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Percutaneous treatment of left side cardiac valves : a practical guide for the interventional cardiologist / Corrado Tamburino, Gian Paolo Ussia
"The success of the first edition of Percutaneous treatment of left side cardiac valves has convinced us of the need to update this book in order to keep pace with the continuing rapid and dynamic evolution in the discipline. Once again, this practical guide is designed to provide the reader with complete state of the art information on the techniques and approaches to percutaneous treatment of left side cardiac valve disease. Numerous images will help the reader to understand in detail the steps of each procedure. The potential complications and expected or potential morbidity from each procedure are discussed in depth, and the best ways to manage them are carefully explained. The book is also intended as a reference covering the up-to-date knowledge contained in the literature on the application of transcatheter techniques to cardiac valves."
Milan: Springer, 2012
e20426370
eBooks  Universitas Indonesia Library
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Ismail
Luaran Penggunaan Strip Tunggal Perikardium dan Katup Mekanik dalam Penggantian Katup Aorta: Kajian terhadap Left Ventricle Reverse Remodeling, Six Minute Walking Test dan Soluble Suppression of Tumorigenicity-2 = Outcome of Single-Strip Pericardium and Mechanical Valve in Aortic Valve Replacement: Study on Left Ventricle Reverse Remodeling, Six Minute Walking Test and Soluble Suppression of Tumorigenicity-2
"Penggantian katup aorta dengan katup mekanik memerlukan biaya mahal, meningkatkan risiko endokarditis dan tromboemboli, serta memerlukan antikoagulan seumur hidup. Perikardium autolog merupakan alternatif untuk penggantian katup aorta. Tujuan penelitian ini adalah membandingkan luaran penggantian katup aorta antara katup mekanik dan perikardium autolog dengan teknik strip tunggal perikardium. Penelitian ini merupakan uji klinis terandomisasi di Pelayanan Jantung Terpadu Rumah Sakit Cipto Mangunkusumo (PJT-RSCM). Subjek dibagi ke dalam 2 kelompok berdasarkan jenis katup yang diterima, yaitu katup mekanik (kelompok mekanik) dan strip perikardium (kelompok strip). Luaran left ventricular reverse remodeling (LVRR), 6 minute walking test (6MWT), dan kadar soluble suppression of tumorigenicity-2 (sST-2) diperiksa preoperasi, 3 bulan, dan 6 bulan pascabedah. Terdapat 34 subjek yang ikut serta dari Juli 2016-Februari 2022, 17 subjek pada masing-masing kelompok. Tidak terdapat beda kejadian LVRR pada kedua kelompok, yaitu 26,7% pada kelompok mekanik dan 29,4% pada kelompok strip (p = 0,703). Pada pemeriksaan jarak 6 minute walking test (6MWT) tidak terdapat perbedaan bermakna jarak 6MWT antara kelompok strip perikardium dan kelompok mekanik pada 6 bulan pascabedah, yaitu 431,93 (SB 93,41) m vs. 404,28 (SB 79,25) m, p = 0,427 pascabedah. Kadar sST-2 kelompok mekanik 16,12 (SB 5,92) pg/mL secara bermakna lebih tinggi dibandingkan kelompok strip 11,52 (SB 6,96) pg/mL, p = 0,023) pada 6 bulan pascabedah. Disimpulkan teknik strip tunggal perikardium memiliki luaran yang sebanding dengan katup mekanik sehingga dapat digunakan sebagai alternatif penggantian katup aorta.
Aortic valve replacement with mechanical valves are quite expensive, increased the risk of adverse events such as endocarditis and thromboembolism, and requires patients to take anticoagulants for the rest of their life. Autologous pericardium is an alternative for aortic valve replacement. This study aims to compare outcomes of aortic valve replacement using mechanical valve and prosthetic valve with single-strip pericardium technique. This was a randomized clinical trial conducted at the Cipto Mangunkusumo Hospital (PJT-RSCM). Eligible subjects were randomized to either receive mechanical valve (mechanical group) or single-strip pericardium (single-strip group). Outcome assessments of left ventricular reverse remodeling (LVRR), 6 minute walking test (6MWT), and soluble suppression of tumorogenicity-2 (sST-2) were carried out at preoperation, 3 months, and 6 months postoperation. There were 34 subjects recruited from July 2016 to February 2022, 17 subjects in each groups. There was no difference in postoperative LVRR incidence between both groups, 26.7% in mechanical group vs. 29.4% in single strip group (p = 0.703). There was no significant difference of 6MWT between the mechanical and pericardial strip at six months post-operation, 404.28 (SD 79.25) m vs. 431.93 (SD 93.41) m, p = 0.427. The sST-2 level is significantly higher in mechanical group 16.12 (SD 5.92) pg/mL compared to single strip group 11.52 (SD 6.96) pg/mL, p = 0.023 at six months post-operation. We concluded that single strip pericardium technique showed comparable outcomes to mechanical valve and is considered a feasible alternative for aortic valve replacement."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
D-pdf
UI - Disertasi Membership  Universitas Indonesia Library
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Moch Arrol Iswahyudi
Luaran 1 tahun pada pasien diseksi aorta stanford A dengan lesi hingga arkus aorta yang dilakukan pembedahan dan faktor-faktor yang berhubungan = One year outcome of post operative standford a aortic dissection with extending aortic arch lession and associated factors
"ABSTRAK
Latar belakang. Diseksi aorta Stanford A adalah penyakit dengan tingkat mortalitas yang tinggi. Penelitian ini bertujuan mencari ketahanan hidup satu tahun pasien diseksi aorta Stanford A dengan lesi hingga arkus aorta yang dibedah serta untuk mengetahui karakteristik pasien, tindakan dan faktor- faktor yang berhubungan.
Metode. Studi kohort retrospektif dengan data diambil melalui rekam medis pada pasien diseksi aorta Stanford A yang dilakukan operasi dari periode 1 Januari 2014 sampai dengan 31 Oktober 2017. Tingkat ketahanan hidup satu tahun dinilai menggunakan metode Kaplan Meier dan faktor faktor yang berhubungan dengan ketahanan hidup akan dianalisis dengan regresi Cox
ABSTRACT
Background: Stanford type A Aortic Dissection is a disease with high mortality rate. This study not only to find a one-year survival of patients with Stanford type A Aortic Dissection with lesion to the aortic arch that is dissected but also to determine patient characteristics and its related factors.
Methods: A retrospective cohort study with datas taken from medical records in Stanford type A Aortic Dissection patients who were operated from 1st January 2014 to 31st October 2017. One-year survival rate was assessed using the Kaplan-Meier method and its survival-related factors will be analyzed by Cox regression"
Depok: Fakultas Kedokteran Universitas Indonesia, 2018
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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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
Aryo Agung Prabowo Mukti
Analisis faktor risiko kejadian kerusakan ginjal akut pascaoperasi modifikasi bentall. Perbandingan kasus diseksi aorta tipe A dan nondiseksi aorta = Risk factors analysis of Postoperative Acute Kidney Injury after Bentall modification procedure: a comparative study between type A Aortic Dissection and nondissection aortic disease
"

Latar belakang: Operasi modifikasi Bentall merupakan pilihan utama terhadap tatalaksana penyakit aorta diseksi dan nondiseksi yang membutuhkan perbaikan pangkal aorta. Kerusakan ginjal akut (KGA) pascaoperasi modifikasi Bentall merupakan kejadian yang cukup sering ditemukan. Metode: Desain penelitian ini adalah kohort analitik retrospektif. Pasien dengan penyakit aorta diseksi tipe A dan nondiseksi aorta yang telah menjalani prosedur modifikasi Bentall (Januari 2015 sampai Desember 2018), dilakukan analisis faktor risiko preoperasi dan intraoperasi terhadap kejadian KGA pascaoperasi. Uji statistik dengan melakukan analisis bivariat dan multivariat. Hasil: Total subjek penelitian 82 pasien (43 pasien diseksi, dan 39 pasien nondiseksi). KGA tampak lebih besar pada kelompok diseksi (79,1% vs 39%, p = 0,001). Onset dini KGA pascaoperasi banyak ditemukan pada grup diseksi (p <0,05). Riwayat merokok (OR 4,130; p = 0,01) dan lama MHCA (OR 1,054; p = 0,001) merupakan faktor risiko yang paling memengaruhi kejadian KGA pascaoperasi tanpa membedakan stadium KGA. Simpulan: AKI pascaoperasi modifikasi Bentall ditemukan lebih banyak pada grup diseksi aorta. Riwayat merokok dan lama MHCA merupakan faktor risiko yang paling memengaruhi kejadian KGA pascaoperasi modifikasi Bentall tanpa membedakan stadium KGA. Onset kejadian KGA pascaoperasi dini didominasi oleh pasien pada grup diseksi aorta. 

Introduction: the Bentall modification procedure is considered the gold standard in treatment of patients with various aortic dissease requiring aortic root replacement. Postoperative acute kidney injury (AKI) are common among patients undergoing Bentall modification procedure. Methods: study design was retrospective cohort analytic. From January 2015 - December 2018, patients with type A aortic dissection and nondissection aortic who had undergone Bentall modification procedure was analize to find the correlation of preoperative and intraoperative risk factors with postoperative AKI. Bivariate and multivariate statistical analysis was perform. Results: 82 patients included, devided in to aortic dissection group (N = 43) and nondissection group (N = 39). Incidence of postoperative AKI found greater in aortic dissection group (79,1% vs 39%). early onset of postoperative AKI found greater in aortic dissection group (p < 0,05). History of smoking (OR 4,130; p = 0,01), and MHCA time (OR 1,054; p = 0,001) were associate with postoperative AKI. Conclusions: postoperative AKI after Bentall modification procedure found greater in aortic dissection. History of smoking and MHCA time associated with postoperative AKI after Bentall modification procedure. early onset of postoperative AKI dominated by patients in aortic dissection. 

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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
T55581
UI - Tesis Membership  Universitas Indonesia Library
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Lully Kurniawan
Pengaruh penambahan platelet rich plasma pada autogenous bone graft terhadap klinis dan laboratoris (studi pada ovis aries sebagai model manusia = THE EFFECT OF ADDITIONAL RICH PLASMA PLATELETS ON AUTOGENOUS BONE GRAFT ON CLINIC AND LABORATORY (STUDY ON OVIS ARIES AS A HUMAN MODEL)
"Latar Belakang : Defek pada mandibula yang tidak direkonstruksi dapat menyebabkan
morbiditas yang berat seperti gangguan mastikasi, bicara, dan estetika. Defek mandibula
dapat disebabkan oleh berbagai sebab diantaranya trauma, infeksi, kondisi patologis,
dan kongenital. Diperlukan tindakan rekonstruksi untuk memperbaiki defek tersebut.
Penggunaan autogenus bone graft masih merupakan pilihan utama dalam hal
rekonstruksi. Pada defek mandibula, rekonstruksi autogenus yang digunakan terdapat
dua pilihan yaitu vascularized graft dan non vascularized graft. Di Indonesia sendiri,
penggunaan vascularized bone graft sebagai penutupan defek belum banyak dilakukan
akibat dari kurangnya alat dan keterbatasan operator. Pemilihan rekonstruksi defek yang
lebih reliable yaitu dengan non vascularized bone graft. Non vascularized bone graft
memiliki beberapa keunggulan yaitu morbiditas donor site lebih kecil, tidak
membutuhkan alat yang lebih kompleks dan tidak membutuhkan skill operator yang
lebih besar, walaupun tingkat keberhasilannya kurang. Resiko resorbsi dan infeksi pada
non vascularized graft lebih besar daripada vascularized graft. Semakin panjang non
vascularized bone graft yang digunakan maka semakin kecil pula tingkat kesuksesan
graft tersebut
Tujuan : Mengevaluasi pengaruh Platelet Rich Plasma (PRP) yang dicampur dengan
autogenous bone graft pada penyembuhan tulang mandibula (studi pada Ovis aries
sebagai model manusia). Material dan Metode : Penelitian metode quasi eksperimental dengan bentuk post test
with control group design ini dilakukan untuk mengevaluasi pengaruh Platelet Rich
Plasma (PRP) yang dicampur dengan autogenous bone graft pada penyembuhan
mandibula Ovis aries secara klinis dan laboratoris (studi pada Ovis aries sebagai model
manusia).
Kesimpulan : Pemeriksaan klinis pada PRP dan Non-PRP dari hasil rata-rata tidak
terdapat perbedaan yang bermakna. Pemeriksaan laboratoris pada PRP dengan Non-
PRP sebelum dan sesudah operasi juga didapatkan hasil yang tidak berbeda bermakna
Background: Mandibular defects that are not reconstructed can cause serious
morbidity such as impaired mastication, speech, aesthetics. Mandibular defects can be
caused by a variety of causes including trauma, infection, pathological conditions and
congenital. Reconstruction is required to correct the defect. Autogenus bone graft is
still the main choice in terms of reconstruction. In mandibular defects there are two
options, vascularized graft and non vascularized graft. In Indonesia, the use of
vascularized bone graft as a closure defect has not been done much due to lack of tools
and operator limitations. The selection of reconstruction of more reliable defects i.e.
with non vascularized bone graft. Non vascularized bone graft has several advantages
namely smaller donor site morbidity, does not require more complex tools and does not
require greater operator skills, although the success rate is less. The risk of resorbsi
and infection in non vascularized graft is greater than vascularized graft The longer
non vascularized bone graft is used the smaller the success rate of the graft.
Purpose: Evaluating the influence of Platelet Rich Plasma (PRP) mixed with
autogenous bone graft on the amount of collagen in sheep (Ovis aries as a human
model).
Materials and Methods: Research on this experimental analytical method was
conducted to determine the influence of Platelet Rich Plasma (PRP) mixed withautogenous bone graft in clinical examination and laboratoris in sheep (Ovis aries as a
human model).
Conclusion: Clinical examination in PRP with Non-PRP from the average result there
is not a meaningful difference. Laboratory examination before and after operation in
PRP with Non-PRP also obtained not significantly different meaning"
Depok: Fakultas Kedokteran Gigi Universitas Indonesia, 2021
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Hananto Anggoro Wiryawan
Faktor Predisposisi Kejadian Komplikasi Terkait Plat Pasca Reseksi Tumor Jinak Mandibula (Studi pada Divisi Bedah Mulut Rumah Sakit Cipto Mangunkusumo tahun 2012-2017) = Predisposing Factors of Plate Complication Post Mandibular Benign Tumors Resection (Study at Oral Surgery division Cipto Mangunkusumo Hospital in 2012-2017)
"Latar belakang: Tatalaksana rekonstruksi pada pasien reseksi mandibula dengan hanya menggunakan rekonstruksi plat umum dilakukan dibeberapa rumah sakit di Indonesia. Beberapa komplikasi yang dapat terjadi pasca rekonstruksi mandibula dapat berupa ekspose plat, fraktur plat dan fistula.
Tujuan: Tujuan penelitian ini akan mencari beberapa faktor yang mempengaruhi terjadinya komplikasi tersebut.
Material dan metode: Penelitian ini merupakan studi retrospektif dari tahun 2012-2017 yang diambil dari rekam medis. Data tumor jinak mandibula (lokasi, ukuran, panjang), data sistemik pasien (riwayat merokok, diabetes, status gizi) dan data operasi (durasi, sistem plat rekonstruksi) dihubungkan dengan kejadian komplikasi yang dianalisis dengan menggunakan Kaplan Meier Survival Curve dan Cox Regresi Proportional Hazard.
Hasil: Terkumpul 69 data dengan prevalensi terjadinya komplikasi sebesar 21,73%(15/69) dengan rerata lama observasi 15,4 bulan. Terdapat pengaruh riwayat merokok (p=0,000) dan faktor usia (p=0,000) terhadap terjadinya komplikasi pasca pemasangan plat dengan hazard ratio riwayat merokok 9,19 dan faktor usia 10-20 tahun dibanding diatas 60 tahun sebesar 153,8. Angka survival plat pada pasien tidak merokok berada diatas 80% pada 2 tahun pertama, tahun ketiga 60% dan setelah itu dapat menurun hingga 20-40%.
Kesimpulan: Merokok dan faktor usia berpengaruh terhadap kejadian komplikasi pasca rekonstruksi mandibula. Jika memungkinkan, rekonstruksi mandibula hanya dengan plat rekonstruksi merupakan tindakan sementara, perlu dipertimbangkan penggunaan graft baik vascularized maupun non-vascularized.
Background: Treatment of reconstruction in post-mandibular resection patients using only plate reconstruction is commonly performed in several hospitals in Indonesia. Some complications that can occur after reconstruction of the mandible can be expose plates, plate fractures and fistulas.
Aim: The purpose of this study will look for several factors that influence the occurrence of these complications.
Material and method: A retrospective study from 2012-2017 taken from medical records. Data on benign mandibular tumors (location, size, length), patient systemic data (smoking history, diabetes, nutritional status) and operating data (duration, reconstruction plate system) were associated with the incidence of complications, analyzed using Kaplan Meier Survival Curve and Cox Proportional Regression Hazard.
Result: Sixty-nine data with the prevalence of complications 21.73% (15/69) with an average observation time 15.4 months. There was an effect of smoking history (p = 0,000) and age factor (p = 0,000) on the occurrence of postoperative complications with hazard ratio of smoking history 9,19 and age factor 10-20 years compared to over 60 years is 153,8. The plate survival rate in patients who do not smoke is above 80% in the first 2 years, the third year is 60% and after that it can decrease by 20-40%.
Conclusion: Smoking and age factors influence the incidence of post-reconstruction mandibular complications. If possible, mandible reconstruction using a reconstruction plate is temporary procedure, it is necessary to consider the use of either vascularized or non-vascularized grafts."
Jakarta: Fakultas Kedokteran Gigi Universitas Indonesia, 2018
SP-pdf
UI - Skripsi Membership  Universitas Indonesia Library
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Nurul Afifah Hijami
Faktor Risiko Gangguan Otot dan Tulang Rangka Akibat Kerja pada Pekerja Bagian Perkantoran di RS. X = Risk Factors for Work-related Musculoskeletal Disorder among Office Workers in Hospital
"Gangguan otot dan tulang rangka akibat kerja (Gotrak) tersebar di seluruh dunia dan meningkatkan masalah kesehatan di tempat kerja serta menurunkan efisiensi fisiologis tubuh manusia, sehingga menjadi masalah kesehatan masyarakat yang serius. Selain terjadi pada pekerja yang menggunakan fisik, Gotrak juga umum terjadi pada pekerja di perkantoran karena terlibat dalam pekerjaan statis dan gerakan berulang dengan durasi yang lama dan monoton. Pada sektor kesehatan, kejadian Gotrak pada tenaga kesehatan telah banyak dilakukan penelitian dan pengendalian, namun sedikit referensinya pada pekerja perkantoran di RS, sehingga perlu dilakukan kajian faktor risiko ergonomi perkantoran di RS. Tujuan penelitian ini menganalisis faktor risiko Gotrak pada pekerja perkantoran di RS. X. Desain penelitian ini cross sectional dengan pendekatan semikuantitatif. Teknik total samping mendapatkan 50 orang responden. Instrumen penelitian yang digunakan adalah kuesioner, lembar periksa ROSA untuk postur kerja, dan alat ukur antropometri. Analisis data menggunakan uji chisquare. Hasil telitian mendapatkan 70% pekerja ada keluhan Gotrak. Terdapat hubungan antara faktor pekerjaan yaitu postur kerja, faktor individu yaitu jenis kelamin dan aktivitas fisik, faktor psikososial yaitu stres kerja dan kecemasan serta faktor pelayanan kesehatan kerja, dan kejadian Gotrak. Pelayanan kesehatan kerja pada Gotrak perlu ditingkatkan agar pekerja mengetahui dan mampu mengendalikan faktor risiko Gotrak di tempat kerja.
Work-related musculoskeletal disorders (WMSDS) are widespread throughout the world and increase health problem in the workplace and reduce the physiological efficiency of human body and becomes serious public health problem. Besides occurring in blue collar workers, wmsds is also common in office workers because involved in static work and repetitive movement with a long and monotonous duration. In health sector, the incidence of WMSDs in
health workers has been widely stidied and controlled, but there are few references to office workers in hospitals, so it is necessary tostudy ergonomic risk factors in hospitals. The purpose of this study was to analyze the risk factors for WMSDs in office worker at the hospital. The design of this study was cross sectional with a semi-quantitative approach. Total technique aside to get 50 respondents. The research instrument used was a questionnaire, ROSA check sheets for work posture, and anthropometric measuring instruments. Data analysis using chisquare test. The results of this study found that 70% of workers had WMSDS complaints. There is a relationship between work factor, namely work posture, individual factors, namely gender
and physical activity, psychosocial factors, namely work stress and anxiety, and organization factor, namely occupational health service. Occupational health services in hospital for WMSDs need to be improved so that workers understand WMSDs risk factors and able to control WMSDS in workplace"
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2022
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UI - Tesis Membership  Universitas Indonesia Library
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