Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Latar Belakang: Lupus Eritematosus Sistemik LES adalah suatu penyakit autoimun kronik yang melibatkan multiorgan dan multietiologi. Komplikasi kardiovaskular pada pasien LES merupakan salah satu penyebab morbiditas dan mortalitas terbesar. Proses aterosklerosis diketahui terjadi pada pasien LES usia muda dan menjadi salah satu faktor penyebab disfungsi diastolik. Penegakkan diagnosis disfungsi diastolik memerlukan pemeriksaan yang cukup mahal dan tidak merata di setiap fasilitas kesehatan. Oleh karena itu, diperlukan suatu metode diagnostik yang lebih mudah dan murah tetapi tetap dapat diandalkan untuk penegakkan diagnostik tersebut, seperti metode sistem skoring. Umur, lama sakit, komorbiditas hipertensi dan atau diabetes mellitus dan atau dislipidemia , anemia, Index Massa Tubuh IMT , kadar serum kreatinin, dan APS diketahui berhubungan dengan disfungsi diastolik dan dapat menjadi determinan diagnosis disfungsi diastolik pada pasien LES. Tujuan: Menetapkan sistem skoring diagnosis disfungsi diastolik pasien LES berdasarkan determinan umur, lama sakit, komorbiditas, anemia, IMT, kadar serum kreatinin, dan APS. Metode: Penelitian uji diagnostik potong-lintang cross sectional terhadap 127 pasien LES di RSCM sejak bulan April 2017 sampai Mei 2017. Data yang digunakan adalah data primer berupa wawancara, pemeriksaan fisik, dan pemeriksaan ekokardiografi transtorakal, serta data sekunder yang diperoleh dari rekam medis. Hasil: Terdapat 9 7.08 subjek penelitian yang mengalami disfungsi diastolik. Lima dari tujuh determinan masuk dalam analisis multivariat. Setelah pemodelan, didapatkan APS dengan bobot skor 2 dan komorbiditas dengan bobot skor 1 yang selanjutnya menjadi bagian dari sistem skoring diagnosis disfungsi diastolik pasien LES. Sistem skoring ini kemudian di uji dengan kurva ROC dan didapatkan AUC sebesar 80.3 95 IK 62.7-97.8 dengan titik potong terbaik adalah lebih sama dengan 2. Skor ge;2 memiliki sensitifitas 44 , spesifisitas 94.9 , nilai prediksi positif 60 , dan nilai prediksi negatif 95.7 . Uji validasi interna dan eksterna menghasilkan nilai yang baik. Simpulan: Proporsi disfungsi diastolik pasien LES di RSCM adalah 7.08 . Determinan diagnosis disfungsi diastolik pasien LES adalah APS dan komorbiditas. Skor ge;2 merupakan titik potong terbaik untuk menentukan bahwa pasien LES mengalami disfungsi diastolik.

---

Background : Systemic Lupus Erythematosus SLE is a chronic autoimmune disease involving multiorgan and multietiology. Cardiovascular complication in SLE patients is one of the highest causes of morbidity and mortality. It is known that premature atherosclerosis occurs in young SLE patients and related to diastolic dysfunction. The diagnostic of diastolic dysfunction requires a quite expensive and uneven examination at every health facilities. Therefore, it's necessary to have an accessible and inexpensive but reliable diagnostic method, such as a scoring system. Age, duration of pain, comorbidities hypertension and or diabetes mellitus and or dyslipidemia , anemia, Body Mass Index BMI , serum creatinine level, and APS are known to be associated with diastolic dysfunction and can be a determinant diagnostic of diastolic dysfunction in SLE patients. Objective : Establish a diagnostic scoring system of diastolic dysfunction in SLE patients with determinants of age, duration of pain, comorbidities, BMI, serum creatinine level, and APS. Methods : A cross sectional diagnostic study with 127 SLE patients in RSCM from April 2017 to May 2017. The data used are primary data such as interviews, physical examination, and transthoracic echocardiography, as well as secondary data was obtained from medical records. Results : There were 9 7.08 subjects with diastolic dysfunction. Five from seven determinants can be used in multivariate analysis. After modeling, APS was obtained with score of 2 and comorbidities with score of 1, further it becomes a part of diagnostic scoring system of diastolic dysfunction in SLE patients. The scoring system was tested with ROC curve and obtained AUC of 80.3 95 IK 62.7 97.8 with the best cut off point was ge 2. A score of ge 2 had a sensitivity of 44 , specificity of 94.9 , positive predictive value of 60 , and negative predictive value of 95.7 . Internal and external validation test produce a good value. Conclusions : The proportion of diastolic dysfunction in SLE patients in RSCM is 7.08 . Diagnostic determinants of diastolic dysfunction in SLE patients are APS and comorbidities. A score of ge 2 is the best cut off point for determining that SLE patients has a diastolic dysfunction.

Abstrak :
Latar Belakang : Indonesia memiliki angka kematian karena penyakit kardiovaskular yang semakin meningkat, dengan angka kematian diperkirakan sebanyak 17,3 juta kematian. Mengingat tingkat mortalitas yang sangat tinggi pada pasien dengan sindrom koroner akut SKA, maka diperlukan sebuah prediktor Major Adverse Cardiac Event MACE yang objektif dan terukur untuk manajemen pasien SKA dalam jangka panjang. Pada SKA dapat ditemukan heterogenitas repolarisasi ventrikel yang dapat dilihat pada elektrokardiografi EKG sebagai QTmax-QTmin, atau dapat disebut sebagai QTD.QTD disinyalir dapat dijadikan penanda untuk risiko MACE pada pasien SKA. Tujuan : Mengetahui peran dispersi QT dan QTcD sebagai prediktor MACE pada pasien sindrom koroner akut SKA. Metode : Penelitian ini merupakan studi kohort retrospektif pada 230 rekam medis pasien SKA yang dirawat di ICCU RSCM dalam rentang waktu Januari 2016 hingga November 2017. EKG standar 12 sadapan saat serangan dianalisis dan dilakukan pengukuran interval QTmax dan QTmin yang kemudian dihitung QTd. Selanjutnya dikoreksi dengan frekuensi nadi menggunakan rumus Bazett QTcD. Hasil : Pemanjangan QTD lebih dari 100mdet dapat menjadi prediktor MACE pada pasien dengan SKA OR 1,25 IK95 0,17 ndash; 2,71 . Setelah dikoreksi dengan frekuensi nadi menggunakan rumus Bazett, pemanjangan QTcD juga dapat menjadi prediktor MACE pada pasien SKA 1,89 IK95 0,05 ndash; 67,37. Kesimpulan : Pemanjangan QTD lebih dari 100mdet atau QTcD lebih dari 12,72mdet dapat menjadi prediktor MACE. ......Background: In Indonesia, the number of death due to cardiovascular disease is rapidly rising and it was approximated to have resulted in 17,3 million deaths. Due to this steadily increasing cases, it is necessary to find a predictor for Major Adverse Cardiac Event MACE that is objective and standardized for long term care of patients with acute coronary syndrome ACS. In ACS, one of the underlying mechanisms is the presence of heterogeneity in ventricle repolarization that is seen on ECG machine as QTmax ndash QTmin, or what is identified as QTD. QTD is hypothesized to have role as marker in patients with MACE in ACS. Aim: Identify the role of QTD and QTcD as MACE predictor in patients with acute coronary syndrome. Methods: This study is a retrospective cohort with the subject of 230 ACS patients that was hospitalised on RSCM ICCU among January 2016 to November 2017. Data was taken from medical record and 12 lead ECG during attack were taken and analysed manually to calculate QTmax and QTmin and substraction of both into QTD. Followed by correction using the heart rate with Bazett formula QTcD. Result: QTD prolongation of more than 100ms in patients with ACS may lead to MACE OR 1,25 IK95 0,17 ndash 2,71 . Following correction with Bazett formula, QTcD prolongation is also predictor 1,89 IK95 0,05 ndash 67,37. Conclusion: QTD prolongation of more than 100ms or QTcD of more than 12.72ms might lead to MACE

Abstrak :
Latar belakang: Penyakit kardiovaskular sangat umum ditemukan dan berakibat fatal pada pasien dengan usia lanjut. Disfungsi sistolik ventrikel kiri yang asimptomatik atau subklinis sering kali mendahului penyakit ini. Deteksi dini terhadap disfungsi sistolik ventrikel kiri dapat mengurangi morbiditas dan mortalitas akibat penyakit kardiovaskular. Salah satu metode deteksi dini adalah dengan penilaian global longitudinal strain (GLS). Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui nilai rerata GLS pada pasien usia lanjut dengan frailty maupun non frailty dan mengetahui faktor-faktor yang berhubungan. Metode: Penelitian potong lintang dilakukan pada pasien usia lanjut diatas 60 tahun di poliklinik geriatri dan kardiologi Ilmu Penyakit Dalam RSCM. Data diperoleh dari wawancara, rekam medik dan pemeriksaan ekokardiografi transtorakal. Variabel penelitian berupa usia, frailty, hipertensi, penyakit jantung koroner, dislipidemia, dan diabetes melitus dianalisis sebagai determinan penurunan GLS. Analisis univariat terhadap masing-masing variabel. Analisis bivariat menggunakan uji chi kuadrat dengan tingkat signifikan p<0,25 dan interval kepercayaan (IK) sebesar 95%. Analisis multivariat menggunakan uji regresi logistik. Hasil: Sebanyak 194 subjek yang memenuhi kriteria pemilihan diikutkan dalam penelitian, rerata usia 66 tahun dengan 118 (60,8%) di antaranya perempuan. Penelitian ini mendapatkan beberapa determinan yang memiliki nilai p<0,25 yaitu frailty, hipertensi, dislipidemia, dan diabetes melitus dengan hasil analisis multivariat, frailty memiliki OR sebesar 2,002 (95% IK 1,042-3,925), dan diabetes melitus memiliki OR sebesar 2,278 (95% IK 1,033-5,025). Simpulan : Nilai median GLS pada usia lanjut secara umum adalah sebesar -21,6% (minimal -5,3% sampai dengan maksimal -29,9%). Faktor yang mempengaruhi penurunan GLS adalah frailty dan diabetes melitus.

---

Background: Cardiovascular disease is very common and can be fatal in elderly patients. It is often preceded by asymptomatic or subclinical left ventricular systolic dysfunction (LVSD). Early detection of LVSD can reduce morbidity and mortality due to cardiovascular disease. One method used in the early detection of LVSD is an assessment of global longitudinal strain (GLS). Objective: To determine the mean value of GLS and GLS-related factors. Methods: This cross-sectional study was conducted among elderly patients aged > 60 years in the geriatric and cardiology polyclinic, Internal Medicine, CMH Hospital. Data were obtained from interviews, medical records, and transthoracic echocardiography examination. The variables of age, frailty, hypertension, coronary artery disease, dyslipidemia, and diabetes mellitus were analyzed as the determinants of a decrease in GLS. Univariate analysis was conducted for each variable. Bivariate analysis was conducted using the chi-square test with a significance level of p<0.25 and confidence interval (CI) of 95%, and multivariate analysis used a logistic regression test. Results: A total of 194 patients were admitted according to the study criteria, with a mean age of 66 years. The proportion of women was 60.8%. The study revealed that the determinants with p<0.25 are frailty, hypertension, dyslipidemia, and diabetes mellitus, with multivariate analysis frailty having an OR of 2.002 (95% CI 1.042-3.925) and diabetes mellitus having an OR of 2.278 (95% CI 1.033-5.025). Conclusions : The median value of GLS in elderly is -21,6% (minimum value -5,3% and maximum value 29,9%). The factors that influence the decrease of GLS are frailty and diabetes mellitus.

Abstrak :
Diabetes mellitus (DM) is one of the public health problems worldwide, including in Indonesia. Cardiovascular disease was the main cause of death (75-80%) in DM, three-fourths of this death was caused by coronary heart disease (CHD). Approximately 34.2% of patients with acute coronary syndrome (ACS) receiving care at ICCU of Dr. Cipto Mangunkusumo General Hospital (RSCM) suffered from DM. Mortality rates of ACS in DM patients were still high and ACS prognosis in DM patients were still unfavorable. There are many factors playing a part in atherosclerosis and ACS incidence in DM patients, such as metabolic disorders due to hyperglycemia and the fomration of advanced glycation end product (AGE), oxidative stress, atherogenic dyslipidemia in DM in the form of high triglyceride level and low HDL cholesterol as well as an increase in small dense LDL, and insulin resistance. In addition, other risk factors of CHD frequently encountered with DM were hypertension, obesity, thrombocytc hyperaggregation and hypercoagulation. The management ofthis disease which was based on the control of risk factors was not yet satisfactory. Inflammatory response played an important role in pathogenesis of atherosclerosis, beginning with early lesion up to acute coronary syndrome. Increase in inflammatory responses (hsCRP) could predict cardiovascular event and predict post-ACS prognosis. Studies in DM population showed an increase in inflammation. ln-depth studies on inflammatory responses in ACS DM patients have not yet been reported. In normal condition, there was a balance of proinflammatory and antiinflammatory cytokines. The ratio of proinflammatory and antiinflammatory cytokines in ACS, particularly DM patients has not been studied. The relationship between metabolic factor (blood glucose, glyco Hb and lipid) and inflammatory response in ACS DM patients has not yet also been studied. Currently, the effort to decrease inflammatory response is made, among others, by aspirin, statin hypolipidemic medication and insulin sensitizer. Although aspirin and statin were used routinely in ACS patients and have proved to reduce inflammation, morbidity and mortality rates of ACS patients were still high. Thus, we would like to observe whether an addition of other medications in standard therapy could reduce inflammation better. Curcumin in experimental animals-and humans) showed -hypolipidemic effect (decrease 'in absorption and increase in catabolism) and hypoglycemia (effect on PPAR-7). Curcumin also demonstrated antiinflammatory effect. In this study we would like to observe the effects of curcumin on both metabolic factors and inflammatory responses in ACS patients. PROBLEM IDENTIFICATION The above elaboration showed a discrepancy associated with inflammatory response in DM ACS patients. Up to now, the relationship of metabolic factor and inflammatory response in DM ACS has not been clear yet. Likewise, the effects of curcumin on metabolic factor and inflammatory response in ACS have not yet been identified. OBJECTIVES To evaluate inflammatory responses in DM ACS and its relationship with metabolic factors (glucose, blood; glyco Hb, total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride); to evaluate the ratio of proinflammatory and antiinflammatory cytokines (IL-6/IL-10) in ACS DM patients, and to identify the effects of curcumin on metabolic factors and inflammatory responses in ACS patients. SETTING The study was conducted at ICCU of RSCM, ICCU of Persahabatan, ICCU of RS MMC and ICCU of Medistra Hospital, Cardiology Polyclinic, Department of Internal Medicine, Faculty of Medicine University of Indonesia! RSCM and Integrated Cardiac Service Poiyclinic of RSCM. STUDY SUBJECTS ACS patients (DM and non-DM) and CHD (DM and non-DM). DESIGN There were two studies: l. Observational design to observe inflammatory responses (hscRP, IL-6, IL-IO, VCAM and ICAM) in DM ACS, non-DM ACS, DM CI-ID, and non-DM CHD; to evaluate the relationship between metabolic factors (fasting blood glucose, blood glucose 2 hours PP, glyco Hb, total cholesterol, LDL cholesterol, HDI.. cholesterol and triglyceride) and inflammatory responses (hsCRP, IL-6, IL-10, VCAM and ICAM) in ACS DM. 2. Interventional study which was a double-blind randomized trial to evaluate the effects of curcumin at escalating doses (low dose 3:-:IS mglday, moderate dose 3x30 mg/day and high dose 3x60 mg/day on metabolic factors (fasting blood glucose. blood glucose 2 hours PP and glyco Hb) and the effects of curcumin at escalating doses on inflammatory responses (hsCRP, ll.-6, VCAM and ICAM) in ACS patients. RESULTS In observational study, |46 subjects were analyzed, consisting of 84 ACS patients, (30 DM ACS patients and 54 non-DM ACS), and 62 CHD (25 DM CHD patients and 37 non-DM CHD patients). The results of the study in the four groups of patients showed: 1. Inflammatory response in DM ACS was higher than in DM CHD (hsCRP, p=0.00; II..-6, p=0.00; IL-10, p=0.00) and non-DM ACS (ICAM, P=0.03). 2. The ratio of proinflammatory and antiinflammatory cytokines (IL-6/II..-10) in DM ACS did not differ from that of DM CHD (p=0.2l) and non-DM ACS (p=0.5 l). 3. There was a relationship between metabolic factors and inflammatory responses in DM ACS: triglyceride and ll.-6 (r=O.39, p=0.03) and II..-I0 (r=0.37, p=o.o4). In interventional study we performed randomization in 75 ACS patients divided into four groups, consisting of low-dose curcumin group of 15 patients, moderate-dose curcumin group of 15 patients, high-dose curcumin group of IS patients, and placebo group of 30 patients. The results of the study in these four groups showed: l. Low-dose curcumin showed a decrease in hsCRP in one week ofthe first month after intervention, there was a significant difference liom that of placebo (p=0.04). Low-dose, moderate-dose, high-dose curcumin groups showed a decrease in IL-6, but was not significantly different from placebo. Low-dose, moderate-dose, high-dose curcumin did not show a decrease in VCAM and ICAM after intervention of 2 months. 2. Low-dose curcumin group tended to experience a decrease in glyco Hb level after intervention of 2 months (p=0.06); however, it was not significantly different from that of placebo. 3. There was a tendency that low-dose curcumin reduced total cholesterol and LDI. cholesterol; however, it was not significantly different from that of placebo. There was a tendency that low-dose curcumin increased HDL cholesterol; however, it was not significantly different from that of placebo. 4. There was a tendency that the pattern of escalating doses had some effects in inflammatory responses and metabolic factors, in which low-dose curcumin showed the best effects, followed by moderate-dose and finally high- dose curcumin. CONCLUSIONS In this study, inflammatory responses in DM ACS patients were higher than those in DM CHD and non-DM ACS patients. There was no difference in the ratio of proinflammatory and antiinflammatory cytokines (IL-6fIL-IO) in DM ACS compared with DM CHD and non-DM ACS. ln addition, the present study identified some of the relationships between metabolic factors and inflammatory responses. Low-dose curcumin reduced hsCRP in one week of the first month after the intervention in ACS patients. There was a tendency that low-dose curcumin reduced glyco Hb level in ACS.

Abstrak :
ABSTRAK
Latar Belakang: Penyakit kardiovaskular adalah penyebab kematian yang paling sering pada pasien AR dengan laju1,5-1,6 kali lebih tinggi dari populasi non AR. Prevalensi gagal jantung pada AR dua kali lipat dibanding non AR. Karakteristik pasien AR Indonesia berbeda dibanding pasien di Negara Barat. Masih sedikit penelitian yang melihat korelasi faktor resiko non tradisional dengan disfungsi diastolik. Tujuan: Mengetahui apakah ada korelasi faktor resiko non tradisional yaitu lama menderita penyakit, derajat aktivitas penyakit dan skor disabilitas dengan disfungsi diastolik pada wanita penderita AR Metode: Desain penelitian adalah potong lintang pada wanita penderita AR yang berobat ke poli Rematologi RSCM dari Oktober 2015-Januari 2016.Sampel penelitian belum pernah dinyatakan menderita penyakit jantung sebelumnya.Disfungsi diastolik dinilai secara ekhokardiografi. Lama menderita sakit diperoleh dengan wawancara langsung, sementara aktivitas penyakit dan tingkat disabilitas dinilai dengan menghitung skor DAS28 dan skor HAQ-DI. Hasil: Disfungsi diastolik dijumpai pada 30,8 % partisipan ( masing-masing 13,5% tingkat ringan dan sedang, dan berat sebesar 3,8% ). Rerata lama menderita AR 26,5 bulan (rentang 2-240), rerata DAS28-CRP 2,69±1,11 sementara DAS28-LED 3,65 (rentang 1,13-7,5), rerata skor HAQ-DI 0,29 (rentang 0-2,38). Hipertropi LV dijumpai pada 34,6% partisipan, rerata EF 66,7±5,76%. Kelainan katup dijumpai pada 34,6% partisipan. Korelasi antara lama sakit, DAS28-CRP, DAS28-LED and skor HAQDI dengan E/A secara berurutan adalah (r= - 0,065; p=0,89), (r=0,393; p=0,38), (r=0,357; p=0,43), (r=0,630; p=0,12) ; sementara dengan E/E? secara berurutan adalah (r=0,136; p=0,77), (r= - 0,536; p=0,21), (r= - 0,393; p=0,38), (r=0,374; p=0,41) Simpulan: Lama menderita sakit, derajat aktivitas penyakit dan derajat disabilitas, tidak memiliki korelasi yang bermakna secara statistik dengan disfungsi diastolik. Angka hipertropi jantung juga cukup tinggi, dan kelainan katup yang paling sering di jumpai adalah regurgitasi ringan.Dengan tingginya angka proporsi disfungsi diastolik pada penelitian ini maka diusulkan agar dirumuskan strategi penatalaksanaan jantung pada pasien-pasien AR untuk mencegah progresifitasnya.

---

ABSTRACT
Background: Cardiovascular is the main cause of death in RA, with the rate of 1.5-1.6 times higher than non RA population .The prevalence of HF in RA is 2 times fold of non RA. RA patients characteristics in Indonesia is different from the ones in western. There are only few studies about correlation between non traditional risk factor and diastolic dysfunction in RA patients. Objective: To study the correlation between each of the non traditional risk factors including disease duration,disease activity and disability score with the diastolic dysfunction in women with RA. Methods: A cross-sectional, consecutive sampling study conducted to 52 RA women without any previous history of cardiovascular disease. All participants underwent an echocardiography to asses the diastolic dysfunction and other findings associated. Duration of disease is assesed by direct interview, while the disease activity by calculating DAS28 and disability sore by HAQ-DI. Results: Diastolic dysfunction was found in 30.8 % of study participants ( 13.5 % for each low and moderate grade, while severe was 3.8% ). Mean of disease duration was 26.5 months (range 2-240), mean DAS28-CRP 2.69±1.11 while mean DAS28-ESR 3.65 (range 1.13-7.5), HAQ-DI score 0.29 (range 0-2.38). LV hypertrophy was found in 34.61% participants. Mean EF 66.7±5.76%. Valve abnormality was found in 34.6% study participants. Correlation between duration of disease, DAS28-CRP, DAS28-ESR and HAQDI score with E/A in sequence was (r= - 0.065; p=0.89), (r=0.393; p=0.38), (r=0.357; p=0.43), (r=0.630; p=0.12) ; while with E/E? in sequence was (r=0.136; p=0.77), (r= - 0.536; p=0.21), (r= - 0.393; p=0.38), (r=0.374; p=0.41) Conclusions; Duration of the disease, the disease activity score and disability score in our RA study participants had no correlation with diastolic dysfunction. The most valvular abnormality findings was mild regurgitation. Since there was a big proportion of participants with diastolic dysfunction, it is encouraged to make a stepwise approach of cardiovascular management in patients with RA.

Abstrak :
Latar belakang: Disfungsi ventrikel kanan merupakan salah satu komplikasi penyakit paru obstruktif kronik (PPOK). Penilaian fungsi ventrikel kanan penting, karena berkaitan dengan keterbatasan kemampuan kerja pasien serta prognosis yang buruk. Tujuan: Untuk mengetahui proporsi disfungsi sistolik dan diastolik ventrikel kanan pada PPOK stabil, serta untuk mengetahui korelasi forced expiratory volume in one second (FEV1) % prediksi dengan nilai Tricuspid annular plane systolic excursion (TAPSE) dan nilai titik potong kedua variabel tersebut. Metode: Dilakukan pemeriksaan spirometri terhadap 30 pasien PPOK stabil (rerata usia: 65 ± 6 tahun). Kemudian semua pasien menjalani pemeriksaan ekokardiografi standar, TAPSE, mengukuran dimensi ruang jantung kanan dan inflow trikuspid. Hasil: Rerata nilai rerata FEV1 28 ± 8% prediksi. Tidak terdapat pasien dengan derajat obstruksi yang ringan, 57% subjek mengalami derajat obstruksi yang sangat berat. Semua pasien menunjukan pola spirometri campuran obstruktif dan restriktif. Rerata dimensi ruang jantung kanan pasien dalam batas normal. Terdapat 40% pasien yang mengalami disfungsi diastolik. Rerata nilai TAPSE 16, 96 ± 96 mm. Terdapat 60% pasien yang mengalami penurunan nilai TAPSE. Tidak terdapat beda rerata nilai TAPSE antara kelompok dengan derajat obstruksi sedang-berat dengan derajat obstruksi sangat berat. Tidak terdapat korelasi yang signifikan antara FEV1 % prediksi dengan TAPSE, sehingga titik potong kedua variabel tidak dapat ditentukan. Simpulan: Proporsi disfungsi sistolik ventrikel kanan 60% dan disfungsi diastolik 40%. Tidak terdapat korelasi nilai FEV1 % prediksi dengan nilai TAPSE, sehingga nilai titik potong kedua variabel tidak dapat ditentukan pada PPOK stabil.

---

Background: Right ventricular dysfunction is one of the common complication of chronic obstructive pulmonary disease (COPD). Right ventricular assessment is importance, since it related with exercise intolerance and poor prognosis. Objective: To determine the proportion of systolic and diastolic dysfunction of right ventricle in stable COPD patients and to determine the correlation between forced expiratory volume in one second (FEV1) % prediction and Tricuspid annular plane systolic excursion (TAPSE) and also to determine the cut-off value between the two variables. Methods: Thirty stable COPD men (mean age: 65 ± 6 yr) underwent spirometry. In addition to conventional echocardiographic parameters, TAPSE, right heart chambers, and trans tricuspid inflow were determined. Results: The mean value of FEV1 was 28 ± 8% of the predicted value. There was no subject with mild airflow limitation, 57% subjects were with very severe airflow obstruction. All of pulmonary function test showed mixed restrictive-obstructive pattern. Mean of right chamber was in normal limit. Forty percent of the patients suffered right ventricular diastolic dysfunction. Means of TAPSE was 16.96 ± 96 mm. Sixty percent of the patients suffered right ventricular systolic dysfunction. There was no significant difference in TAPSE between groups with moderate-severe flow obstruction and very severe airflow obstruction. There was no significant correlation between FEV1 % prediction and TAPSE, so the cut-off value between the two variables cannot be determined. Conclusions: The proportion of right ventricular systolic dysfunction was 60% and diastolic dysfunction was 40%. There was no correlation between FEV1 % prediction and TAPSE. The cut-off value between the two variable in stable COPD patients cannot be determined.

Abstrak :
Latar Belakang: Pasien diabetes melitus tipe 2 menunjukkan peningkatan risiko penyakit jantung koroner dengan kondisi aterosklerosis arteri koroner yang lebih berat. Ketebalan lemak epikardial diperkirakan berhubungan dengan kondisi inflamasi dan derajat stenosis arteri koroner pada pasien DM tipe 2 dengan chronic coronary syndrome (CCS), dimana kadar HsCRP dapat digunakan sebagai penanda inflamasi dan skor Gensini digunakan untuk menilai derajat stenosis arteri koroner. Tujuan: Penelitian ini bertujuan untuk mengetahui korelasi antara ketebalan lemak epikardial dengan kadar dan HsCRP derajat stenosis arteri koroner pada pasien DM tipe 2 dengan CCS. Metode: Studi potong lintang pada 47 pasien DM tipe 2 dengan CCS yang berusia antara 35 sampai 87 tahun dan menjalani angiografi koroner di Laboratorium Kateterisasi Jantung PJT-RSCM. Nilai ketebalan lemak epikardial diperoleh dari hasil pemeriksaan ekokardiografi, skor Gensini dihitung berdasarkan hasil pemeriksaan angiografi koroner, dan kadar HsCRP diperiksa menggunakan metode Imunoturbidimetri. Hasil: Diperoleh median kadar HsCRP sebesar 1,9 mg/L (RIK 0,8–3,30 mg/L), rerata ketebalan lemak epikardial sebesar 6,06 ± 2,14 mm, dan median skor Gensini sebesar 34 (RIK 14–84). Didapatkan korelasi positif sedang antara ketebalan lemak epikardial dan HsCRP (p<0,05; r = 0,500, namun tidak menemukan adanya korelasi yang bermakna antara ketebalan lemak epikardial dan skor Gensini (p > 0,05). Kesimpulan: Ketebalan lemak epikardial hanya menunjukkan adanya korelasi yang bermakna dengan kadar HsCRP pada pasien DM tipe 2 dengan CCS, namun tidak dengan derajat stenosis arteri koroner yang dinilai berdasarkan skor Gensini. Jadi dengan memeriksa ketebalan lemak epikardial dengan ekokardiografi kita dapat memperkirakan tingkat inflamasi pada pasien DM tipe 2 dengan CCS ......Background: T2DM patients showed an increased risk of CAD with more severe coronary artery atherosclerosis. Epicardial fat thickness (EFT) was presumed to be associated with inflammatory conditions and the severity of coronary artery stenosis in patients with T2DM and CCS, wherein HsCRP levels can be used as an inflammatory marker and Gensini score to quantify the severity of coronary artery stenosis. Objective: To determine the correlation between EFT and HsCRP levels and the severity of coronary artery stenosis in patients with T2DM and CCS. Methods: A cross sectional study conducted among 47 patients with T2DM and CCS between the age of 35 to 87 that had underwent coronary angiography at the Heart Catheterization Laboratory of PJT-RSCM. Results of echocardiography was evaluated to determine EFT, while the Gensini score was calculated based on the results of coronary angiography, and HsCRP levels was evaluated using a commercial Immunoturbidimetry kit. Results: Median HsCRP levels was 1.9 mg/L (IQR 0.8–3.30 mg/L), mean EFT was 6.06 ± 2.14 mm, and median Gensini score was 34 (IQR 14–84). There was a moderate positive correlation between EFT and HsCRP (p < 0.05, r = 0.500), but found no significant correlation between EFT and Gensini score (p > 0.05). Conclusion: EFT only showed significant correlation with HsCRP levels in patients with T2DM and CCS, but showed no correlation with the severity of coronary artery stenosis that was quantified by Gensini score. So, by echocardiography evaluation of epicardial fat thickness, we could have an estimation of inflamation degree in patients with T2DM and CCS.