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"The prevalence of coronary heart disease in the adult population with diabetes mellitus (DM) is far greater (55%) than in the general public (2-4%). There is an acknowledged correlation between type I hidden ischemia and the incidence of myocardiac infarct. There needs to be a way to determine the presence or absence of ischemia. An alternative examination method is the Dobutamine Stress Echocardiography (DSE).This study was conducted at the Metabolic-Endocrine and the Cardiology Out-Patient Clinics of the Department of Internal Medicine ofCipto Mangunkusumo Central Public General Hospital, Jakarta, from February to August 2001.The aim of the study is to detect undetected myocardiac ischemia using the electrocardiography among patients with type 2 diabetes mellitus and podiatric abnormality and testing the correlation between certain factors (sex, age, body mass index, lipid profile, fasting blood glucose, post prandial blood glucose, HbAlc, peripheral vascular disease, smoking, retinopathy, and neuropathy) with myocardiac ischemia.Methodology: The study was designed as a comparative study of the incidence of myocardiac ischemia between type 2 diabetes mellitus patients with and without podiatric abnormalities. The sample consisted of 28 patients. Samples underwent the dobutamine stress echocardiographyResults: dobutamine stress echocardiography examination using Apogee on 14 patients with type 2 diabetes mellitus with podiatric abnormality demonstrated a positive ischemic response in 4 people (28.6%). No positive findings were found in type 2 diabetes mellitus patients without podiatric abnormality.Conclusion: 1. DSE could detect myocardiac ischemia in 28.6% of type 2 diabetes mellitus undetected with electrocardiography. 2. Other factors that influenced a positive dobutamine stress echocardiography were autonomic neuropathy, diabetic retinopathy, the duration of diabetes mellitus, fasting blood glucose, and podiatric abnormality."

"Latar belakang: Penyakit jantung koroner (PJK) masih menjadi masalah di Indonesia bahkan di dunia. Berdasarkan patofisiologinya, PJK dibagi menjadi sindrom koroner akut (SKA) dan kronik (SKK). Salah satu tatalaksana PJK adalah revaskularisasi otot jantung. Namun sangat penting untuk mengetahui viabilitas miokardium untuk kepentingan pengembalian fungsi kontraktilitas miokardium. Saat ini, magnetic resonance imaging (MRI) jantung adalah baku emas yang digunakan untuk mengevaluasi viabilitas miokardium. Namun ketersediaan modalitas ini sangat terbatas. Dobutamine stress echocardiography (DSE) juga dapat mengevaluasi viabilitas miokardium dan memiliki ketersediaan yang lebih luas di Indonesia. Tujuan: Meta analisis ini bertujuan membandingkan sensitivitas dan spesifisitas DSE terhadap MRI kardiak pada pasien dengan SKK. Metode: Meta analisis ini mencari literatur dari empat database yaitu Pubmed, Embase, Cochrane dan Scopus. Meta analisis ini mengacu pada Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 dan Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. Forest plot menampilkan sensitivitas dan spesifisitas DSE dan MRI kardiak. Hasil: Terdapat tiga belas studi yang diinklusi. Dari penyusunan forest plot didapatkan DSE memiliki sensitivitas 75% (CI 0,61 – 0,86) dan spesifisitas 87% (CI 0,82 –0,91), dimana MRI kardiak memiliki sensitivitas 93% (CI 0,88 – 0,96) dan spesifisitas 77% (CI 0,61 – 0,87). Walaupun demikian, perlu diperhatikan beberapa faktor yang dapat menyebabkan overestimation pada sensitivitas dan spesifisitas DSE dan underestimation pada sensitivitas dan spesifisitas MRI kardiak. Kesimpulan: DSE memiliki sensitivitas yang lebih rendah dan spesifistas yang lebih tinggi dibandingkan MRI kardiak. Dengan mempertimbangkan overestimation dan underestimation kedua modalitas tersebut, MRI kardiak memiliki akurasi yang lebih baik dibandingkan DSE. Kata kunci: Sindrom koroner kronik, viabilitas miokardium, dobutamine stress echocardiography, magnetic resonance imaging kardiak.

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Background: Coronary heart disease (CHD) still becomes a health problem in Indonesia, even in the world. Based on its pathophysiology, CHD is classified to acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). One of the treatment of CHD is myocardial revascularization, however it’s important to know the myocardial viability in prior in order to reverse the contractility function of the myocardium. Nowadays, cardiac magnetic resonance imaging (MRI) is the gold standard for evaluating myocardial viability. Nevertheless, the availibility of MRI is limited. Dobutamine stress echocardiography (DSE) is also able to evaluate myocardial viaiblity and widely available across Indonesia. Purpose: This meta analysis compares the sensitivity and specificity of DSE and cardiac MRI in patients with CCS. Method: This meta analysis searches literatures from four database: Pubmed, Embase, Cochrane and Scopus. We used Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 dan Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy as references. Forest plot is constructed to show the sensitivity and specificity of DSE and cardiac MRI. Result: Thirteen studies were included. The Forest plot shows that DSE has sensitivity of 75% (CI 0,61 – 0,86) and specificity of 87% (CI 0,82 – 0,91), while cardiac MRI has sensitivity of 93% (CI 0,88 –0,96) and specificity of 77% (CI 0,61 – 0,87). Conclusion: DSE has lower sensitivity yet higher specificity than cardiac MRI. Considering the overestimation and underestimation of these modalities, cardiac MRI has higher diagnostic accuracy than DSE."