Erika Maharani - Academia.edu (original) (raw)

Papers by Erika Maharani

CRT has been established as standard treatment for refractory heart failure in many major clinica... more CRT has been established as standard treatment for refractory heart failure in many major clinical trials. Insertion of left ventricle lead is frequently most challenging step. Coronary sinus anatomy is of the most technical burden. A case of CRT implantation with presence of prominent Thebesian valve and stenotic posterolateral vein is presented in thic case report.Cardiac resynchronization therapy (CRT) telah terbukti pada berbagai uji klinis menurunkan morbiditas dan mortalitas penderita gagal jantung refrakter. Insersi lead ventrikel kiri sering menjadi tantangan dan bagian tersulit pada implantasi CRT. Hal ini terutama karena anatomi sinus koronarius yang mengalami kelainan. Akan diulas satu kasus implantasi CRT dengan keberadaan katup Thebesian yang prominen dan stenosis cabang vena posterolateral

Indonesian Journal of Cardiology, 2013

CRT has been established as standard treatment for refractory heart failure in many major clinica... more CRT has been established as standard treatment for refractory heart failure in many major clinical trials. Insertion of left ventricle lead is frequently most challenging step. Coronary sinus anatomy is of the most technical burden. A case of CRT implantation with presence of prominent Thebesian valve and stenotic posterolateral vein is presented in thic case report.

ACI (Acta Cardiologia Indonesiana), 2021

Background: Rheumatic mitral stenosis is the most common valvular abnormalities found in developi... more Background: Rheumatic mitral stenosis is the most common valvular abnormalities found in developing countries. Mortality risk in those populations was poorly investigated. In addition, hemodynamic, morphological, and mechanical factors that influence or predict outcome of rheumatic mitral stenosis have not been identified. Aims: To determine predictive factors affecting outcome in rheumatic mitral stenosis patients. Method: This retrospective cohort study was conducted at the National General Hospital Dr. Sardjito, Yogyakarta, Indonesia. The study recruited patients from the Valvular Heart Disease Registry from May 2014 to November 2020. New York Heart Association (NYHA) functional classification, invasive or surgical treatment, and incidence of death were recorded. The baseline rhythm from electrocardiography (ECG) was categorized as sinus rhythm and atrial fibrillation or atrial flutter. Based on the findings of trans thoracal echocardiography (TTE), subjects who had moderate to s...

ACI (Acta Cardiologia Indonesiana), 2021

The rapid spread of the coronavirus disease 2019 (COVID-19) has resulted in significant morbidity... more The rapid spread of the coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality globally. Hydroxychloroquine is one of the medications for eradicating COVID-19. Despite concerns due to its potential cardiac toxicity, hydroxychloroquine is widely used in treating mild and moderate COVID-19 pneumonia. In this case report, we report two cases of Indonesian adult patients with suspected COVID-19 pneumonia who received hydroxychloroquine as part of the medications and experienced deterioration of cardiac conduction which required stopping the drug prematurely. This case report highlights the need for risk stratification, electrocardiogram monitor and QTc evaluation before and during hydroxychloroquine therapy.

Background: An isolated persistent left SVC with concomittant agenesis of right SVC in adult pati... more Background: An isolated persistent left SVC with concomittant agenesis of right SVC in adult patients is a very rare abnormality. Physician should consider it particularly in patients, in which venous acces will be performed. Our rare case deals with the importance of detailed echocardiographic examination with screening of coronary sinus dilatation before the electrophysiology study. Case: A 65-year-old woman came to outpatient clinic for a chief complaint of palpitations. Her ECG showed paroxysmal SVT with WPW syndrome. She underwent echocardiography examination before electrophysiology study and it was found that she had a dilated coronary sinus. Therefore we performed cardiac CT. It was found that she had a persistent left superior vena cava (SVC) and an absence of a right SVC with no other congenital anomaly. Conclusion: A comprehensive echocardiography examination to look for a dilation of coronary sinus is a first suggestion to screen this anomaly, eventually followed by echo...

Background: Moderate risk Duke treadmill score (DTS) in threadmill test (TMT), needs additional d... more Background: Moderate risk Duke treadmill score (DTS) in threadmill test (TMT), needs additional diagnostic tool to increase its sensitivity of detecting severe coronary artery stenosis in patients with stable angina pectoris. A P wave dispersion (PWD) during TMT currently has a significant relationship with DTS value and can increase the sensitivity in identifying an ischemia. This study aimed to investigate whether the addition of PWD in moderate risk DTS can improve the prediction of the severity of coronary artery stenosis in patients with stable angina pectoris. Methods: This study is a diagnostic test with cross-sectional design. The subjects were patients who had undergone TMT and coronary angiography at the Dr. Sardjito General Hospital Yogyakarta. The outcomes were sensitivity and specifi city of abnormal PWD in moderate risk DTS patients for predicting the severe stenosis in those with stable angina pectoris as compared with moderate risk DTS and normal PWD. Results: The ad...

Methods : A 50-year-old woman with secundum ASD was admitted for percutaneous ASD. Two months bef... more Methods : A 50-year-old woman with secundum ASD was admitted for percutaneous ASD. Two months before admission, she was noted to have junctional rhythm albeit she did not complain of any specific cardiac symptom. Percutaneous closure was aborted because of unsuitable device’s size and documented multifocal VPC frequent. Intermittent AV Block 2:1 and 41% burden of multifocal VPC were diagnosed in Holter monitoring after percutaneous procedure. On 6th August 2019, she underwent surgical closure with the placement of a temporary epicardial pacemaker. There was no residual shunt and complication during the surgery. Post-surgery ECG evaluation showed VPC bigeminy without junctional or AV Block. A week after surgery, the patient had PPM implantation.

The prevalence of Chronic Venous Insufficiency (CVI) give a high social impact. In Europe, approx... more The prevalence of Chronic Venous Insufficiency (CVI) give a high social impact. In Europe, approximately 40% of the adult population affected by venous disorders. In general, the prevalence of CVI is about 5% - 15%. The prevalence is increasing by age.

Introduction : Previous studies demonstrated a relation of deep terminal negativity of P wave in ... more Introduction : Previous studies demonstrated a relation of deep terminal negativity of P wave in V1 (DTNPV1) with risk of sudden cardiac death, all-cause mortality, and newly diagnosed of atrial fibrillation in general population. Electrocardiogram (ECG) parameter DTNPV1 defined as negative P prime >100 200 μV in V1. This simplified ECG metric represents the development of left atrium (LA) and left ventricle (LV) fibrosis. The association of DTNPV1 with severity and all-cause mortality in mitral stenosis (MS) patient were poorly investigated. The aim of this study was to evaluate the relationship between DTNPV1 with severity and all-cause mortality in rheumatic MS patient.

Coronary circulation is the circulation of blood in the blood vessels of the heart muscle (myocar... more Coronary circulation is the circulation of blood in the blood vessels of the heart muscle (myocardium). The vessels that deliver oxygenrich blood to the myocardium are known as coronary arteries. The vessels that remove the deoxygenated blood from the heart muscle are known as cardiac veins.

Open Access Macedonian Journal of Medical Sciences, 2021

BACKGROUND: Engagement in health-promoting behaviors (HPB) among patients with cardiovascular dis... more BACKGROUND: Engagement in health-promoting behaviors (HPB) among patients with cardiovascular diseases (CVD) is important, particularly for the high-and-very-high-risk group. However, information concerning HPB and risk of cardiovascular events among patients with CVD is limited. AIM: This study aimed to explore HPB and risk of cardiovascular events among patients with CVD. METHODS: A cross-sectional quantitative study was conducted among adults with confirmed CVD (n = 167) using multistage cluster sampling. Health-Promoting Lifestyle Profile 2 and World Health Organization/International Society of Hypertension Risk Prediction Chart were used for measuring HPB and cardiovascular risk levels. Data were analyzed using Pearson correlation, one-way ANOVA and multiple linear regression tests. RESULTS: Women, marriage, low income, and hypertension dominated with 60 years as mean age. Among the subscales of HPB, interpersonal relationship had the highest score while physical activity in th...

Cardiology Research, 2018

Background: Idiopathic outflow tract ventricular premature contraction (VPC) can evolve into vent... more Background: Idiopathic outflow tract ventricular premature contraction (VPC) can evolve into ventricular tachycardia (VT) via triggered activity mechanism. Transmural dispersion of repolarization (TDR) might play a role in idiopathic outflow tract VT by inducing phase 2 early afterdepolarization (EAD) and serve as the functional substrate for VT. Tp-Te/QT ratio as an arrhythmogenesis index has been reported to be associated with the incidence of ventricular arrhythmia. This study aims to investigate the association between Tp-Te/QT ratio with VT incidence in idiopathic outflow tract VPC. Methods: Observational research with cross sectional design was conducted. VT episodes were retrospectively tracked from electrocardiogram (ECG), treadmill test (TMT), Holter monitor and electrophysiology study data in Sardjito Hospital of patients with idiopathic outflow tract VPC during September to October 2017. Tp-Te/QT was defined as the time from the peak of T wave to the intersection between the tangent and isoeectric line, divided with QT interval. Tp-Te/QT ratio measurement was performed in leads V4, V5 and V6 by single observer. Tp-Te/QT ratio was categorized into increased (> 0.25) and normal (< 0.25). Chi-square and logistic regression test were performed. Results: Out of 46 patients, there were 28 patients who had VT. Increased Tp-Te/QT ratio of lead V4 was found in 11 patients, the increased ratios in leads V5 and V6 were found in 13 patients. The prevalence ratio (PR) of Tp-Te/QT ratio to VT incidence in lead V4 was 2.059 (95% CI: 1.464-2.895; P = 0.007), while in leads V5 and V6 was 2.200 (95% CI: 1.514-3.197; P = 0.002). Tp-Te/QT ratios in leads V4, V5 and V6 were not significantly different and equally strong in predicting VT events (P < 0.001; 95% CI). Adjustment of confounding factor hypertension with multivariate test gave insignificant results (PR: 1.290; 95% CI: 0.444-3.747). Conclusions: Increased Tp-Te/QT ratio in idiopathic outflow tract VPC patients was associated with higher prevalence ratio for VT, although this was affected by hypertension. Leads V4, V5 and V6 were equally strong in predicting VT events.

Coronavirus 2019 (COVID-19) is an infectious disease that is becoming a pandemic. Hydroxychloroqu... more Coronavirus 2019 (COVID-19) is an infectious disease that is becoming a pandemic. Hydroxychloroquine in combination with azythromycin are among drugs currently in use to eradicate COVID-19. Despite concerns due to its potential cardiac toxicity, hydroxychloroquine is widely accepted in mild and moderate COVID-19 pneumonia. In this case report, we report a case of a young Indonesian adult male with suspected COVID-19 pneumonia who received hydroxychloroquine and azythromycin therapies and during 24 hour experienced deterioration of atrioventricular block.

ACI (Acta Cardiologia Indonesiana), 2017

Background: In STEMI patients, the duration of action potential dispersion occurs between normal ... more Background: In STEMI patients, the duration of action potential dispersion occurs between normal and ischemic tissue due to the lengthening of the refractory period, causing transmural dispersion of repolarization, which could be detected with Tp-Te interval prolongation on the electrocardiogram (ECG). Benefits of fibrinolytic therapy in patients with STEMI has been demonstrated, with reduced mortality significantly and improve coronary patency in order to increase myocardial perfusion. The goal of this study was to determine Tp-Te interval alteration in STEMI patients before and after the fibrinolytic therapy between successful fibrinolysis compared to failed fibrinolysis. Method: Cross-sectional study was conducted to collect ECG from medical records at Dr. Sardjito General Hospital in January–September 2016. STEMI patients with onset less than 12hours whom reperfused with fibrinolytic therapy were registered. Tp-Te interval was measured before, soon after (0 minute), and 30 minut...

Indonesian Journal of Cardiology, 2015

Atrial fibrillation is the most frequent arrhythmia in clinical practice and causing huge health ... more Atrial fibrillation is the most frequent arrhythmia in clinical practice and causing huge health problem. Therefore, a national guidelines in management of AF that comprise of pathomechanism, clasifications, anticoagulants management for stroke prevention, rate and rhythm control is developed to ensure patients get best therapeutic option. The guidelines is developed in line with variable health care level in Indonesia from primary up to tertiary care.

Indonesian Journal of Cardiology, 2017

Background: Duke Treadmill Score (DTS) is a well known score to stratify prognosis with good diag... more Background: Duke Treadmill Score (DTS) is a well known score to stratify prognosis with good diagnostic value in predicting number of diseased coronary arteries in ischemic heart disease patient. DTS has also been shown to have a strong correlation with the severity of coronary lesion based on the Syntax score. However, the diagnostic value of DTS in predicting the coronary lesions severity based on Syntax score has not been well established. Methods: Cross-sectional study was performed in Dr. Sardjito General Hospital based on data from 1 st January 2012. Patients with positive exercise test results and already had coronary angiography were included in the study. DTS was calculated based on the assessment of the exercise test result and Syntax score I was measured from the coronary angiography result. Results: There were 76 patients with average age of 56.64±7.41 year old consisting of 53 male subjects (70%) and 23 female subjects (30%). Hypertension was found to be the most common risk factors in 57 subjects (75%), dyslipidaemia in 33 subjects (43.3%), Diabetes Mellitus in 27 subjects (35.5%), smoking in 24 subjects (31.6%) and family history in 1 subject (1.3%). Subjects with high Syntax score and the low Syntax score were found in 30 subjects (39.5%) and 46 subjects (60.5%) respectively. In this study, the DTS diagnostic value in predicting high Syntax score was determined by the value of area under the curve based on the the Receiver Operating Characteristic (ROC) curve analysis was 92% (95% CI: 86%-97%, p<0.0001). Moreover, DTS with value-8.5had 83% sensitivity, 82% specificity, 75% positive predictive value, 88% negative predictive value, and 83% accuracy to predict high Syntax score. Conclusion: DTS has a good diagnostic value in predicting coronary lesions severity, particularly in patients with suspected stable coronary artery diseases. DTS value of-8.5 has shown to have the best cut point in this study.

Indonesian Journal of Cardiology, 2017

Background: QT Dispersion (QTd) is known as a spatial dispersion indicator during myocardial repo... more Background: QT Dispersion (QTd) is known as a spatial dispersion indicator during myocardial repolarization, and elongation of QTd is related with ventricular arrhythmia event and sudden cardiac death in ischemic heart disease. The increase of QTd happens in coronary heart disease during myocardial ischemia induced by treadmill test. There is no research linking changes of the QTd (ΔQTd) on exercise test with the severity of coronary lesions in patients with suspected stable coronary artery disease. The aim of this study was to determine the relationship between QTD changes on exercise test with the severity of coronary lesions in patients with stable coronary artery disease and to determine discriminatory value of QTD changes based on the degree of coronary lesions. Methods: This study was a cross-sectional study in Dr. Sardjito Hospital using data from January 1, 2012. Patients with positive exercise test result, already performed coronary angiography and meet the inclusion and exclusion criteria included in the study. QTd changes during exercise test were measured and Syntax scores were assessed based on the results of coronary angiography. Statistical analysis was performed to determine the relationship between two variables. Results: There were 76 patients with average of 56.64±7.41 years old, with 54 male subjects (71.1%). The most frequent risk factor were hypertension, there were 57 subjects (75%), followed by 32 subjects of dyslipidemia (42.1%), 27 subjects of DM (35.5%), 24 smoker (31.6%), and 2 subjects with family history of CHD (2.6%). Subjects with high Syntax score were 30 subjects (39.5%) and the low Syntax score were 46 subjects (60.5%). In this research, there was positive relationship with medium strength (r=0.531, p<0.001) between ΔQTd and Syntax score. Value of QT dispersion changes of 44.78 milliseconds is optimal cutoff point that discriminates between high and low Syntax score. Conclusion: There were positive correlations between changes of QTd dispersion with degree of coronary lesion that was analyzed using Syntax with medium strength.

Indonesian Journal of Cardiology, 2017

Background: Erectile Dysfunction (ED) is defined as the inability to achieve or maintain an erect... more Background: Erectile Dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient to permit satisfactory sexual intercourse. Erectile dysfunction affects more than 150 million men worldwide and impairs psychological well-being and personal relationships, hence quality of life. Recent studies have shown that ED is present in 42% to 76% of men with coronary artery disease (CAD). Epidemiological study showed clearly role of traditional cardiovascular risk factors such as diabetes, hypertension, dyslipidemia and smoking in CAD. Erectile dysfunction and vascular diseases share a similar risk factors and pathogenic involvement of nitric oxide (NO)-pathway leading to impairment of endothelium-dependent vasodilatation (early phase) and structural vascular abnormalities (late phase). This study was conducted to determine whether the stable CAD patients who have traditional cardiovascular risk factors has a higher risk for ED compared with stable CAD patients wit...

International Journal of Nursing Practice, 2020

Aim: The aim of this study is to examine psychometric properties of the Indonesian version of med... more Aim: The aim of this study is to examine psychometric properties of the Indonesian version of medical outcome survey short form 12 version 2 (SF12v2). Methods: A cross-sectional study was conducted in three primary healthcare units in Yogyakarta, Indonesia. Patients with cardiovascular diseases who were able to respond to questionnaires and provide their consent were invited. The validity test included face, content, discriminant, and construct validity. The internal consistency was used as the reliability indicator. Results: The item and subscale of content validity index were 0.97 and 0.83, respectively. The instrument had 100% for equivalence and clarity outcomes, whereas the readability outcome was 91.7%. More than 80% of participants agreed and considered SF12v2 understandable. The correlations among physical and mental subscales were substantial, supporting discriminant validity. The Bartlett test of sphericity was significant with the Kaiser-Meyer-Olkin test of 0.74. The principal component analysis resulted in eight components, explaining 88.4% of total variance. α coefficients for subscale were ranging from.58 to.81, whereas the physical and mental component summaries were.77 and.67, respectively. Conclusions: The Indonesian version of SF12v2 indicated a reliable and valid instrument. The SF12v2, available in a Bahasa Indonesia version, is an applicable instrument to assess quality of life on patients with cardiovascular diseases.

CRT has been established as standard treatment for refractory heart failure in many major clinica... more CRT has been established as standard treatment for refractory heart failure in many major clinical trials. Insertion of left ventricle lead is frequently most challenging step. Coronary sinus anatomy is of the most technical burden. A case of CRT implantation with presence of prominent Thebesian valve and stenotic posterolateral vein is presented in thic case report.Cardiac resynchronization therapy (CRT) telah terbukti pada berbagai uji klinis menurunkan morbiditas dan mortalitas penderita gagal jantung refrakter. Insersi lead ventrikel kiri sering menjadi tantangan dan bagian tersulit pada implantasi CRT. Hal ini terutama karena anatomi sinus koronarius yang mengalami kelainan. Akan diulas satu kasus implantasi CRT dengan keberadaan katup Thebesian yang prominen dan stenosis cabang vena posterolateral

Indonesian Journal of Cardiology, 2013

CRT has been established as standard treatment for refractory heart failure in many major clinica... more CRT has been established as standard treatment for refractory heart failure in many major clinical trials. Insertion of left ventricle lead is frequently most challenging step. Coronary sinus anatomy is of the most technical burden. A case of CRT implantation with presence of prominent Thebesian valve and stenotic posterolateral vein is presented in thic case report.

ACI (Acta Cardiologia Indonesiana), 2021

Background: Rheumatic mitral stenosis is the most common valvular abnormalities found in developi... more Background: Rheumatic mitral stenosis is the most common valvular abnormalities found in developing countries. Mortality risk in those populations was poorly investigated. In addition, hemodynamic, morphological, and mechanical factors that influence or predict outcome of rheumatic mitral stenosis have not been identified. Aims: To determine predictive factors affecting outcome in rheumatic mitral stenosis patients. Method: This retrospective cohort study was conducted at the National General Hospital Dr. Sardjito, Yogyakarta, Indonesia. The study recruited patients from the Valvular Heart Disease Registry from May 2014 to November 2020. New York Heart Association (NYHA) functional classification, invasive or surgical treatment, and incidence of death were recorded. The baseline rhythm from electrocardiography (ECG) was categorized as sinus rhythm and atrial fibrillation or atrial flutter. Based on the findings of trans thoracal echocardiography (TTE), subjects who had moderate to s...

ACI (Acta Cardiologia Indonesiana), 2021

The rapid spread of the coronavirus disease 2019 (COVID-19) has resulted in significant morbidity... more The rapid spread of the coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality globally. Hydroxychloroquine is one of the medications for eradicating COVID-19. Despite concerns due to its potential cardiac toxicity, hydroxychloroquine is widely used in treating mild and moderate COVID-19 pneumonia. In this case report, we report two cases of Indonesian adult patients with suspected COVID-19 pneumonia who received hydroxychloroquine as part of the medications and experienced deterioration of cardiac conduction which required stopping the drug prematurely. This case report highlights the need for risk stratification, electrocardiogram monitor and QTc evaluation before and during hydroxychloroquine therapy.

Background: An isolated persistent left SVC with concomittant agenesis of right SVC in adult pati... more Background: An isolated persistent left SVC with concomittant agenesis of right SVC in adult patients is a very rare abnormality. Physician should consider it particularly in patients, in which venous acces will be performed. Our rare case deals with the importance of detailed echocardiographic examination with screening of coronary sinus dilatation before the electrophysiology study. Case: A 65-year-old woman came to outpatient clinic for a chief complaint of palpitations. Her ECG showed paroxysmal SVT with WPW syndrome. She underwent echocardiography examination before electrophysiology study and it was found that she had a dilated coronary sinus. Therefore we performed cardiac CT. It was found that she had a persistent left superior vena cava (SVC) and an absence of a right SVC with no other congenital anomaly. Conclusion: A comprehensive echocardiography examination to look for a dilation of coronary sinus is a first suggestion to screen this anomaly, eventually followed by echo...

Background: Moderate risk Duke treadmill score (DTS) in threadmill test (TMT), needs additional d... more Background: Moderate risk Duke treadmill score (DTS) in threadmill test (TMT), needs additional diagnostic tool to increase its sensitivity of detecting severe coronary artery stenosis in patients with stable angina pectoris. A P wave dispersion (PWD) during TMT currently has a significant relationship with DTS value and can increase the sensitivity in identifying an ischemia. This study aimed to investigate whether the addition of PWD in moderate risk DTS can improve the prediction of the severity of coronary artery stenosis in patients with stable angina pectoris. Methods: This study is a diagnostic test with cross-sectional design. The subjects were patients who had undergone TMT and coronary angiography at the Dr. Sardjito General Hospital Yogyakarta. The outcomes were sensitivity and specifi city of abnormal PWD in moderate risk DTS patients for predicting the severe stenosis in those with stable angina pectoris as compared with moderate risk DTS and normal PWD. Results: The ad...

Methods : A 50-year-old woman with secundum ASD was admitted for percutaneous ASD. Two months bef... more Methods : A 50-year-old woman with secundum ASD was admitted for percutaneous ASD. Two months before admission, she was noted to have junctional rhythm albeit she did not complain of any specific cardiac symptom. Percutaneous closure was aborted because of unsuitable device’s size and documented multifocal VPC frequent. Intermittent AV Block 2:1 and 41% burden of multifocal VPC were diagnosed in Holter monitoring after percutaneous procedure. On 6th August 2019, she underwent surgical closure with the placement of a temporary epicardial pacemaker. There was no residual shunt and complication during the surgery. Post-surgery ECG evaluation showed VPC bigeminy without junctional or AV Block. A week after surgery, the patient had PPM implantation.

The prevalence of Chronic Venous Insufficiency (CVI) give a high social impact. In Europe, approx... more The prevalence of Chronic Venous Insufficiency (CVI) give a high social impact. In Europe, approximately 40% of the adult population affected by venous disorders. In general, the prevalence of CVI is about 5% - 15%. The prevalence is increasing by age.

Introduction : Previous studies demonstrated a relation of deep terminal negativity of P wave in ... more Introduction : Previous studies demonstrated a relation of deep terminal negativity of P wave in V1 (DTNPV1) with risk of sudden cardiac death, all-cause mortality, and newly diagnosed of atrial fibrillation in general population. Electrocardiogram (ECG) parameter DTNPV1 defined as negative P prime >100 200 μV in V1. This simplified ECG metric represents the development of left atrium (LA) and left ventricle (LV) fibrosis. The association of DTNPV1 with severity and all-cause mortality in mitral stenosis (MS) patient were poorly investigated. The aim of this study was to evaluate the relationship between DTNPV1 with severity and all-cause mortality in rheumatic MS patient.

Coronary circulation is the circulation of blood in the blood vessels of the heart muscle (myocar... more Coronary circulation is the circulation of blood in the blood vessels of the heart muscle (myocardium). The vessels that deliver oxygenrich blood to the myocardium are known as coronary arteries. The vessels that remove the deoxygenated blood from the heart muscle are known as cardiac veins.

Open Access Macedonian Journal of Medical Sciences, 2021

BACKGROUND: Engagement in health-promoting behaviors (HPB) among patients with cardiovascular dis... more BACKGROUND: Engagement in health-promoting behaviors (HPB) among patients with cardiovascular diseases (CVD) is important, particularly for the high-and-very-high-risk group. However, information concerning HPB and risk of cardiovascular events among patients with CVD is limited. AIM: This study aimed to explore HPB and risk of cardiovascular events among patients with CVD. METHODS: A cross-sectional quantitative study was conducted among adults with confirmed CVD (n = 167) using multistage cluster sampling. Health-Promoting Lifestyle Profile 2 and World Health Organization/International Society of Hypertension Risk Prediction Chart were used for measuring HPB and cardiovascular risk levels. Data were analyzed using Pearson correlation, one-way ANOVA and multiple linear regression tests. RESULTS: Women, marriage, low income, and hypertension dominated with 60 years as mean age. Among the subscales of HPB, interpersonal relationship had the highest score while physical activity in th...

Cardiology Research, 2018

Background: Idiopathic outflow tract ventricular premature contraction (VPC) can evolve into vent... more Background: Idiopathic outflow tract ventricular premature contraction (VPC) can evolve into ventricular tachycardia (VT) via triggered activity mechanism. Transmural dispersion of repolarization (TDR) might play a role in idiopathic outflow tract VT by inducing phase 2 early afterdepolarization (EAD) and serve as the functional substrate for VT. Tp-Te/QT ratio as an arrhythmogenesis index has been reported to be associated with the incidence of ventricular arrhythmia. This study aims to investigate the association between Tp-Te/QT ratio with VT incidence in idiopathic outflow tract VPC. Methods: Observational research with cross sectional design was conducted. VT episodes were retrospectively tracked from electrocardiogram (ECG), treadmill test (TMT), Holter monitor and electrophysiology study data in Sardjito Hospital of patients with idiopathic outflow tract VPC during September to October 2017. Tp-Te/QT was defined as the time from the peak of T wave to the intersection between the tangent and isoeectric line, divided with QT interval. Tp-Te/QT ratio measurement was performed in leads V4, V5 and V6 by single observer. Tp-Te/QT ratio was categorized into increased (> 0.25) and normal (< 0.25). Chi-square and logistic regression test were performed. Results: Out of 46 patients, there were 28 patients who had VT. Increased Tp-Te/QT ratio of lead V4 was found in 11 patients, the increased ratios in leads V5 and V6 were found in 13 patients. The prevalence ratio (PR) of Tp-Te/QT ratio to VT incidence in lead V4 was 2.059 (95% CI: 1.464-2.895; P = 0.007), while in leads V5 and V6 was 2.200 (95% CI: 1.514-3.197; P = 0.002). Tp-Te/QT ratios in leads V4, V5 and V6 were not significantly different and equally strong in predicting VT events (P < 0.001; 95% CI). Adjustment of confounding factor hypertension with multivariate test gave insignificant results (PR: 1.290; 95% CI: 0.444-3.747). Conclusions: Increased Tp-Te/QT ratio in idiopathic outflow tract VPC patients was associated with higher prevalence ratio for VT, although this was affected by hypertension. Leads V4, V5 and V6 were equally strong in predicting VT events.

Coronavirus 2019 (COVID-19) is an infectious disease that is becoming a pandemic. Hydroxychloroqu... more Coronavirus 2019 (COVID-19) is an infectious disease that is becoming a pandemic. Hydroxychloroquine in combination with azythromycin are among drugs currently in use to eradicate COVID-19. Despite concerns due to its potential cardiac toxicity, hydroxychloroquine is widely accepted in mild and moderate COVID-19 pneumonia. In this case report, we report a case of a young Indonesian adult male with suspected COVID-19 pneumonia who received hydroxychloroquine and azythromycin therapies and during 24 hour experienced deterioration of atrioventricular block.

ACI (Acta Cardiologia Indonesiana), 2017

Background: In STEMI patients, the duration of action potential dispersion occurs between normal ... more Background: In STEMI patients, the duration of action potential dispersion occurs between normal and ischemic tissue due to the lengthening of the refractory period, causing transmural dispersion of repolarization, which could be detected with Tp-Te interval prolongation on the electrocardiogram (ECG). Benefits of fibrinolytic therapy in patients with STEMI has been demonstrated, with reduced mortality significantly and improve coronary patency in order to increase myocardial perfusion. The goal of this study was to determine Tp-Te interval alteration in STEMI patients before and after the fibrinolytic therapy between successful fibrinolysis compared to failed fibrinolysis. Method: Cross-sectional study was conducted to collect ECG from medical records at Dr. Sardjito General Hospital in January–September 2016. STEMI patients with onset less than 12hours whom reperfused with fibrinolytic therapy were registered. Tp-Te interval was measured before, soon after (0 minute), and 30 minut...

Indonesian Journal of Cardiology, 2015

Atrial fibrillation is the most frequent arrhythmia in clinical practice and causing huge health ... more Atrial fibrillation is the most frequent arrhythmia in clinical practice and causing huge health problem. Therefore, a national guidelines in management of AF that comprise of pathomechanism, clasifications, anticoagulants management for stroke prevention, rate and rhythm control is developed to ensure patients get best therapeutic option. The guidelines is developed in line with variable health care level in Indonesia from primary up to tertiary care.

Indonesian Journal of Cardiology, 2017

Background: Duke Treadmill Score (DTS) is a well known score to stratify prognosis with good diag... more Background: Duke Treadmill Score (DTS) is a well known score to stratify prognosis with good diagnostic value in predicting number of diseased coronary arteries in ischemic heart disease patient. DTS has also been shown to have a strong correlation with the severity of coronary lesion based on the Syntax score. However, the diagnostic value of DTS in predicting the coronary lesions severity based on Syntax score has not been well established. Methods: Cross-sectional study was performed in Dr. Sardjito General Hospital based on data from 1 st January 2012. Patients with positive exercise test results and already had coronary angiography were included in the study. DTS was calculated based on the assessment of the exercise test result and Syntax score I was measured from the coronary angiography result. Results: There were 76 patients with average age of 56.64±7.41 year old consisting of 53 male subjects (70%) and 23 female subjects (30%). Hypertension was found to be the most common risk factors in 57 subjects (75%), dyslipidaemia in 33 subjects (43.3%), Diabetes Mellitus in 27 subjects (35.5%), smoking in 24 subjects (31.6%) and family history in 1 subject (1.3%). Subjects with high Syntax score and the low Syntax score were found in 30 subjects (39.5%) and 46 subjects (60.5%) respectively. In this study, the DTS diagnostic value in predicting high Syntax score was determined by the value of area under the curve based on the the Receiver Operating Characteristic (ROC) curve analysis was 92% (95% CI: 86%-97%, p<0.0001). Moreover, DTS with value-8.5had 83% sensitivity, 82% specificity, 75% positive predictive value, 88% negative predictive value, and 83% accuracy to predict high Syntax score. Conclusion: DTS has a good diagnostic value in predicting coronary lesions severity, particularly in patients with suspected stable coronary artery diseases. DTS value of-8.5 has shown to have the best cut point in this study.

Indonesian Journal of Cardiology, 2017

Background: QT Dispersion (QTd) is known as a spatial dispersion indicator during myocardial repo... more Background: QT Dispersion (QTd) is known as a spatial dispersion indicator during myocardial repolarization, and elongation of QTd is related with ventricular arrhythmia event and sudden cardiac death in ischemic heart disease. The increase of QTd happens in coronary heart disease during myocardial ischemia induced by treadmill test. There is no research linking changes of the QTd (ΔQTd) on exercise test with the severity of coronary lesions in patients with suspected stable coronary artery disease. The aim of this study was to determine the relationship between QTD changes on exercise test with the severity of coronary lesions in patients with stable coronary artery disease and to determine discriminatory value of QTD changes based on the degree of coronary lesions. Methods: This study was a cross-sectional study in Dr. Sardjito Hospital using data from January 1, 2012. Patients with positive exercise test result, already performed coronary angiography and meet the inclusion and exclusion criteria included in the study. QTd changes during exercise test were measured and Syntax scores were assessed based on the results of coronary angiography. Statistical analysis was performed to determine the relationship between two variables. Results: There were 76 patients with average of 56.64±7.41 years old, with 54 male subjects (71.1%). The most frequent risk factor were hypertension, there were 57 subjects (75%), followed by 32 subjects of dyslipidemia (42.1%), 27 subjects of DM (35.5%), 24 smoker (31.6%), and 2 subjects with family history of CHD (2.6%). Subjects with high Syntax score were 30 subjects (39.5%) and the low Syntax score were 46 subjects (60.5%). In this research, there was positive relationship with medium strength (r=0.531, p<0.001) between ΔQTd and Syntax score. Value of QT dispersion changes of 44.78 milliseconds is optimal cutoff point that discriminates between high and low Syntax score. Conclusion: There were positive correlations between changes of QTd dispersion with degree of coronary lesion that was analyzed using Syntax with medium strength.

Indonesian Journal of Cardiology, 2017

Background: Erectile Dysfunction (ED) is defined as the inability to achieve or maintain an erect... more Background: Erectile Dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient to permit satisfactory sexual intercourse. Erectile dysfunction affects more than 150 million men worldwide and impairs psychological well-being and personal relationships, hence quality of life. Recent studies have shown that ED is present in 42% to 76% of men with coronary artery disease (CAD). Epidemiological study showed clearly role of traditional cardiovascular risk factors such as diabetes, hypertension, dyslipidemia and smoking in CAD. Erectile dysfunction and vascular diseases share a similar risk factors and pathogenic involvement of nitric oxide (NO)-pathway leading to impairment of endothelium-dependent vasodilatation (early phase) and structural vascular abnormalities (late phase). This study was conducted to determine whether the stable CAD patients who have traditional cardiovascular risk factors has a higher risk for ED compared with stable CAD patients wit...

International Journal of Nursing Practice, 2020

Aim: The aim of this study is to examine psychometric properties of the Indonesian version of med... more Aim: The aim of this study is to examine psychometric properties of the Indonesian version of medical outcome survey short form 12 version 2 (SF12v2). Methods: A cross-sectional study was conducted in three primary healthcare units in Yogyakarta, Indonesia. Patients with cardiovascular diseases who were able to respond to questionnaires and provide their consent were invited. The validity test included face, content, discriminant, and construct validity. The internal consistency was used as the reliability indicator. Results: The item and subscale of content validity index were 0.97 and 0.83, respectively. The instrument had 100% for equivalence and clarity outcomes, whereas the readability outcome was 91.7%. More than 80% of participants agreed and considered SF12v2 understandable. The correlations among physical and mental subscales were substantial, supporting discriminant validity. The Bartlett test of sphericity was significant with the Kaiser-Meyer-Olkin test of 0.74. The principal component analysis resulted in eight components, explaining 88.4% of total variance. α coefficients for subscale were ranging from.58 to.81, whereas the physical and mental component summaries were.77 and.67, respectively. Conclusions: The Indonesian version of SF12v2 indicated a reliable and valid instrument. The SF12v2, available in a Bahasa Indonesia version, is an applicable instrument to assess quality of life on patients with cardiovascular diseases.