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"Latar Belakang : Pasien gagal jantung mengalami penurunan kapasitas fungsional akibat timbulnya sesak dan kelelahan saat aktifitas. Kondisi ini juga memberikan dampak psikologis berupa depresi dan kecemasan. Masalah fisik dan mental tersebut dapat menurunkan kualitas hidup. Short Form-36 merupakan instrumen yang dapat digunakan untuk menilai kualitas hidup dari aspek fisik dan mental dan bersifat generik. Tujuan: Mengetahui hubungan kapasitas fungsional melalui uji jalan 6 menit dengan kualitas hidup yang dinilai dengan SF-36. Metode : Responden penelitian adalah pasien gagal jantung kronis stabil klasifikasi NYHA fungsional kelas II dan III. Setiap responden dianamnesis,dan dilakukan pemeriksaan fisik, kemudian mengisi kuesioner SF-36. Untuk menilai kapasitas fungsional, responden melakukan uji jalan 6 menit pada lintasan sepanjang 30 m. Hasil : Responden pada penelitian ini berjumlah 36 orang. Nilai tengah jarak tempuh pasien gagal jantung klasifikasi NYHA fungsional kelas II dan III masing-masing 333.65m, dan 123.72 m. Jarak tempuh uji jalan 6 menit memiliki hubungan dengan kualitas hidup yang dinilai dengan SF-36 pada domain Fungsi Fisik (r=0.527), Peran Fisik (r=0.459) dan Peran Emosi (r = 0.35). Kesimpulan : Terdapat korelasi sedang antara kapasitas fungsional pasien gagal jantung kronis stabil klasifikasi NYHA fungsional kelas II dan III dengan kualitas hidup pada domain Fungsi Fisik, Peran Fisik dan Peran Emosi.

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Background : Heart failure patients experience reduced functional capicity due to dyspnea and fatigue during activity. The condition also cause psychological problems such as depression and anxiety. Both the mental and physical ailments results in decreased quality of life. The Short Form-36 (SF-36) is a generic assessment tool that can be utilized to measure quality of life from both the physical and mental aspect.

Objective : To measure the correlation between the functional capacity measured using the 6-minute walk test and the quality of life measured using the SF-36.

Methods : The study subjects are chronic stable heart failure patients with New York Heart Association (NYHA) functional class II and III. Each subjects were interviewed, examined, and asked to fill the SF-36 questionnaire. The 6-minute walk test was performed on a 30m long track to measure the finctional capacity.

Results : A total of 36 subjects were included in the study. The median for the total distance walked of heart failure patient with NYHA functional class II and III are 333.65m and 123.72 m. The total distance walked in 6-minute walk test and the quality of life measured using the SF-36 have correlation in the domain of Physical Function (r = 0.527), Role-Physical (r = 0.459) and Role-Emotional (r = 0.35).

Conclusion : There is a moderate positive correlation between the functional capacity of chronic stable heart failure patient with NYHA functional class II and III with the quality of life in the domain of Physcial Function, Role-Physical and Role-Emotional."

"Hipertrofi ventrikel kanan (HVKa) pada tetralogy fallot (TF) merupakan suatu respon adaptif akibat dari peningkatan tekanan di ventrikel kanan (VKa) dan hipoksia. HVKa yang berat vektor jantung akan mengarah ke kanan-posterior dapat menyebabkan gelombang S yang dalam di sadapan V6. Sementara itu pasien TF yang lama tidak dikoreksi akan mengalami paparan tekanan berlebih dan sianosis yang lebih lama juga, yang dapat menyebabkan perubahan-perubahan di tingkat seluler kardiomiosit yang pada akhirnya menyebabkan disfungsi VKa, dan sindrom curah jantung rendah (SCJR). Walaupun angka kesintasan pasca operasi baik, tapi perburukan SCJR dapat mengakibatkan kematian. Saat ini belum jelas bagaimana hubungan antara gelombang S di V6 dengan luaran total koreksi TF khususnya kejadian SCJR. Metode: Penelitian dengan metode potong lintang. Subyek penelitian adalah TF yang menjalani total koreksi selama tahun 2013 sebanyak 150 pasien, 35 diantaranya dikeluarkan dari penelitian karena tidak memenuhi kriteri inklusi. Subyek dibagi menjadi 2 kelompok yaitu kelompok subyek dengan temuan kriteria S di V6 dan subyek yang untuk melihat hubungan temuan kriteria tersebut dengan variabel dasar. Kemudian dilakukan analisis bifariat terhadap kejadian SCJR, variabel dengan nilai p < 0.25 di masukkan dalam analisa multivariat. Nilai p< 0.05 dianggap bermakna. Hasil: Usia yang lebih muda, saturasi dan hematokrit yang lebih tinggi ditemukan pada kelompok subyek memenuhi kriteria gelombang S di V6. Kemudian, usia yag lebih muda, saturasi yang tinggi, kriteria gelombang R di aVR, kriteria gelombang S di I dan kriteria gelombang S di V6 berhubungan dengan kejadian SCJR. Analisis multivariat kriteria gelombang S di V6 berhubungan dengan kejadian SCJR dengan OR 3.2, interval kepercayaan 95% 1.2 - 8.5 dan nilai p=0.02. Kesimpulan: Kriteria EKG gelombang S di sadapan V6 untuk diagnosis HVKa berhubungan dengan kejadian SCJR pasca total koreksi pasien TF.

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Tetralogy of Fallot (TOF) is a common cyanotic congenital heart disease. Right ventricular hypertrophy (RVH) is an adaptive response due to pressure overload and hypoxia in right ventricle (RV); it can be manifested as tall R wave in right precordial leads. This is due to changing direction of cardiac-vector to right In severe RVH, the cardiac vector rotated to right posterior causing deep S wave in V6. Uncorrected TF will expossed to prolong pressure overload and hypoxia, it can caused changes in cardiomyocite that can leads to RV dysfunction, low cardiac output syndrom (LCOS), and arrhythmias. Although the post operation survival rate was quite good, but worsening LCOS could increase mortality. In present time, the association between S wave in V6 and postoperative TOF outcomes, especially LCOS, has not been explained.

Methods: This is a cross sectional study. 150 TOF patients underwent total correction in 2013 included in this study. 35 patients who didn?t meet the inclusion criteria were excluded. Subjects divided in 2 groups: (1) patients who meets S in V6 criteria, and (2) control subjects as baseline characteristic. Bivariate analysis was done for incidence of LCOS, the variable with P<0.25 included in multivariate analysis. The significant value was p<0.5.

Results: Multivariate analysis showed S wave in V6 correlated with the incidence of LCOS with odds ratio 3.2, CI 95% (1.2-8.5), p=0.02.

Conclusion: The ECG findings S wave in V6 leads to diagnose RVH correlated with incidence of LCOS in post total correction TOF. An S wave criterion in V6 of RVH patients? OR was 3.2 to predicts LCOS."

"This book is a practical guide to the use of TEE (transoesophageal echocardiography) in the diagnosis of congenital heart disease (CHD). Beginning with an introduction to TEE for CHD, the following chapters describe procedures to be used for different cardiac conditions. 3D TEE allowing multi-dimensional perspectives is also covered."

"This book presents a comprehensive picture of ischemic heart disease for practitioners, students, and investigators dealing with the varied facets of this complex subject. Individual chapters introduce the anatomy of the coronary blood vessels and cardiac development, while others consider current imaging modalities utilized for ischemic heart disease, including stress echo, nuclear diagnostic tests, non-invasive coronary artery imaging, and coronary angiography. Imaging chapters provide key clinical information on techniques and indications, and include examples of both normal and abnormal patterns. The principle thrust of the book concerns coronary atherosclerosis, the pathology of which is presented in conjunction with the results of anatomic, non-invasive imaging and angiographic studies. Related chapters cover atherogenesis, presenting new insights into the pathophysiology of the vulnerable plaque, the role of progenitor cells in vascular injury, inflammation and atherogenesis, and the genomics of vascular remodeling. Additional topics covered include angina pectoris, acute coronary syndromes, healed myocardial infarction and congestive heart failure, catheter-based and surgical revascularization, and surgical treatment of myocardial infarction and its sequelae. With contributions from a diverse group of internationally-known physicians with broad experience in the diagnosis and treatment of coronary heart disease."

"Percutaneous and coronary interventions, used to treat narrow arteries of the heart caused by/found in those with coronary heart disease. This book is a detailed guide for performing percutaneous procedures and it covers in-depth the procedures that cardiologists and interested specialists must be aware of in order to use the devices proficiently."

"ABSTRAKPemberian edukasi terkait Pola hidup merupakan salah satu intervensi keperawatan yang dapat diberikan pada klien post PCI dalam mencegah terjadinya kejadian nyeri dada kardiak berulang. Penelitian ini bertujuan untuk mengidentifikasi hubungan karakteristik dan pola hidup terhadap kejadian nyeri dada kardiak berulang pada klien post PCI dengan menggunakan metode survei analitik pendekatan cross sectional. Sampel berjumlah 110 klien post PCI. Teknik sampling yang digunakan adalah purposive sampling. Responden mengisi kuesioner berupa data demografi, kejadian nyeri dada kardiak berulang, dan 20 pertanyaan tentang pola hidup. Hasil penelitian menunjukan adanya hubungan antara pola hidup dengan kejadian nyeri dada kardiak berulang post PCI dengan nilai p < 0,05 (p=0,001). Penelitian ini bermanfaat bagi pelayanan keperawatan dalam mengevaluasi terjadinya penyumbatan kembali pembuluh darah yang menyebabkan nyeri dada berulang sehingga dapat memberikan ataupun menyusun strategi dalam memodifikasi intervensi keperawatan untuk mengurangi kejadian nyeri dada berulang, dan dapat meningkatkan status kemampuan fungsional pada klien post PCI.

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ABSTRACT

Pattern of life or lifestyle is one of the nursing interventions that can be given to post PCI clients in preventing the occurrence of recurrent cardiac chest pain. This study aims to identify the relationship of characteristics and lifestyle to the incidence of recurrent cardiac chest pain in post PCI clients by using cross sectional analytical survey method. The sample numbered 110 post PCI clients. The sampling technique used is purposive sampling. Respondents fill out questionnaires in the form of demographic data, incidence of recurrent cardiac chest pain, and 20 questions about lifestyle. This study was analyzed using Chi square test, independent T-Test and mann whitney test. The result of this research showed that there was a correlation between the age and the incidence of recurrent cardiac chest pain post PCI (0,03), there was a correlation the history of diabetes of the respondent and the incidence of recurrent cardiac chest pain post PCI (0001), the correlation between frequency of PCI and the incidence of recurrent cardiac chest pain post PCI (0.03), and the lifestyle relation with recurrent cardiac chest pain post PCI (p = 0.001). Further research may require adding an independent variable that affects the occurrence of recurrent pain in post PCI clients or specifying research topics such as factors that affect the incidence of recurrent chest pain in post PCI clients. This study is useful for nursing services in evaluating the occurrence of blockage of blood vessels that cause chest pain, can provide or develop strategies in modifying nursing interventions to reduce the incidence of recurrent chest pain in post PCI clients, in order to improve functional ability status in post PCI clients.

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Health-related quality of life (HRQoL) memiliki peranan yang penting bagi pasien jantung. HRQoL pada pasien jantung bisa ditingkatkan dengan melihat faktor-faktor yang menjadi prediktornya, seperti spiritual well-being, illness perception, dan kecenderungan depresi. Penelitian ini melihat lebih jauh apakah spiritual well-being (SWB) dan illness perception (IP) memengaruhi HRQoL secara signifikan dan kecenderungan depresi memediasi hubungan antara SWB dengan HRQoL dan hubungan IP dengan HRQoL secara signifikan. Sebanyak 161 partisipan yang memiliki penyakit jantung terlibat dalam penelitian ini. Setiap partisipan mendapatkan tiga alat ukur yang berbeda, yaitu FACIT-Sp (spiritual well-being), Brief IPQ (illness perception), dan PHQ-2 (kecenderungan depresi). Hasil penelitian menunjukkan bahwa spiritual well-being (B=14,415, p=0,000) dan illness perception (B=-7,8838, p=0,000) menjadi prediktor yang signifikan terhadap HRQoL. Sementara itu, kecenderungan depresi tidak memediasi hubungan spiritual well-being dengan HRQoL (effect= 1,0934), namun menjadi mediator yang signifikan dalam hubungan illness perception dengan HRQoL (effect= -2,0332). Hasil penelitian ini bermanfaat untuk penyusunan intervensi bagi pasien jantung agar dapat meningkatkan kualitas hidup dan keberfungsiannya.  

Kata kunci:

spiritual well-being, illness perception, kecenderungan depresi, HRQoL

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Health-Related Quality of Life (HRQoL) is the most important thing to be considered as a treatment for heart disease patients. There are some variables to be considered as significant predictors of HRQoL such as spiritual well-being, illness perception, and depressive symptoms. Based on previous research, spiritual well-being (SWB) and illness perception (IP) significantly predicted heart disease patients HRQoL. Depressive symptoms variable can be a mediator for explaining the relationship between SWB and HRQoL and IP and HRQoL`s relationship.  The main aim of this research is to investigate whether SWB and IP are significant for predicting heart disease patients HRQoL and depressive symptoms is a significant mediator for explaining those relationships. This research involves n=161 heart disease patients with minimum of age 18. Every partient is measured using three measurements. The measurements include FACIT-Sp (spiritual well-being), Brief IPQ (illness perception), and PHQ-2 (depressive symptoms). The result shows that spiritual well-being (B=14,415, p=0,000) and illness perception (B=-7,8838, p=0,000) predict HRQoL`s patients. Depressive symptoms does not mediate significantly the relationship between SWB and HRQoL (effect= 1,0934), but it mediates the relationship between IP and HRQoL significantly (effect= -2,0332). This research can be used for medical worker in designing intervention for heart disease patients.

 

 

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"Angiografi Koroner dan Intervensi Koroner Perkutan Transradial adalah salah satunya pengobatan penyakit jantung koroner. Penggunaan akses transradial ini bisa menimbulkan beberapa komplikasi. Penelitian ini bertujuan untuk mengetahui gambarannya komplikasi akses radial pada angiografi pasca koroner dan/atau pasien Intervensi Koroner Perkutan di salah satu rumah sakit rujukan nasional. Penelitian dilakukan secara retrospektif menggunakan desain penampang berurutan pengambilan sampel melibatkan 111 responden. Hasil penelitian menunjukkan kejadian itu Komplikasi akses radial terjadi pada 33 (29,7%) responden dengan jenis komplikasi ini bervariasi yaitu obstruksi arteri radial (5,4%), spasme arteri radial (8,1%), perdarahanarea insersi (8,1%), hematoma area insersi (10,8%) dan ekimosis (23,4%). Studi ini merekomendasikan perlunya peran perawat, terutama dalam asesmen dan pemantauan pasien untuk mendeteksi komplikasi setelah angiografi Intervensi Koroner dan/atau Perkutan.

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Coronary Angiography and Transradial Percutaneous Coronary Intervention is one of the treatments for coronary heart disease. The use of transradial access can cause several complications. This study aims to describe the complications of radial access in post-coronary angiography and/or Percutaneous Coronary Intervention patients at one of the national referral hospitals. The study was conducted retrospectively using a sequential cross-sectional design. Sampling involved 111 respondents. The results showed that the incidence of radial access complications occurred in 33 (29.7%) respondents with varied types of complications, namely radial artery obstruction (5.4%), radial artery spasm (8.1%), bleeding. insertion area (8.1%), insertion area hematoma (10.8%) and ecchymosis (23.4%). This study recommends the need for a nurse role, especially in the assessment and monitoring of patients to detect complications after coronary and/or percutaneous interventional angiography."

"ABSTRAKLatar belakang: Risk Adjusted Classification for Congenital Heart Surgery (RACHS-1) merupakan sistem stratifikasi risiko terbaru yang dikembangkan sebagai prediktor mortalitas dan morbiditas pascoperasi penyakit jantung bawaan (PJB), namun belum pernah divalidasi di populasi Indonesia.Tujuan: Melakukan validasi eksternal RACHS-1 pada populasi Indonesia sebagai prediktor mortalitas pascoperasi PJB.Metode: Uji validasi dengan studi kohort, menggunakan data retrospektif dari bank data bagian bedah jantung anak dan kongenital Rumah Sakit Pusat Jantung Nasional Harapan Kita dari Januari 2015-Desember 2019. Uji diagnostik memperlihatkan nilai sensitivitas, spesifisitas dan area under curve-receiving operator characteristic (AUC-ROC) sebagai luaran utama dalam menilai kemampuan prediksi luaran mortalitas.Hasil: Penelitian melibatkan 4139 subjek dengan mortalitas pada 230 subjek (5,6%). RACHS-1 category memiliki sensitivitas 71% dengan spesifisitas 60% dalam memprediksi mortalitas. Kemampuan diskriminasi memperlihatkan hasil yang kurang baik dalam prediksi mortalitas (AUC-ROC 0,673).Kesimpulan: RACHS-1 memiliki kemampuan diskriminasi yang kurang baik sebagai prediktor mortalitas di Indonesia dengan nilai AUC-ROC 0,673.

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ABSTRACTBackground: Risk Adjusted Classification for Congenital Heart Surgery (RACHS-1) were the latest risk stratification methods for congenital heart disease (CHD) surgery that were developed to predict mortality and morbidity outcome, it hasn't been validated in Indonesian population.Objectives: To validate RACHS-1 category as a predictor of mortality in Indonesia.Methods: A Retrospective Cohort study using the database Pediatric and Congenital Heart Surgery Department of National Cardiovascular Harapan Kita Database from January 2015-December 2019. Statistical analysis was done using area under curve-receiving operator characteristic (AUC-ROC) to determine the predictive discrimination of mortality.Results: This study enrolled 4139 subjects with mortality rate of 230 subjects (5.4%). The RACHS-1 category have the sensitiviy of 71% with specificity of 60% to predict mortality. Both of the methods showed a fine discrimination to predict mortality (AUC-ROC 0.673).Conclusion: RACHS-1 has a poor discrimination ability as a predictor of mortality in Indonesia with an AUC-ROC value of 0.673."