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The Relationship between Pre Discharge Left Ventricle Diastolic Dysfunction and 30 days And 6 Months Rehospitalization in Patients with Heart Failure with Reduced Ejection Fraction (HFrEF) at Haji Adam Malik General Hospital Medan Khaidirman, Sophia Khairina; Mukhtar, Zulfikri; Sarastri, Yuke; Ketaren, Andre Pasha; Raynaldo, Abdul Halim; Andra, Cut Aryfa
Journal of Society Medicine Vol. 2 No. 5 (2023): May
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i5.33

Introduction: Heart failure (HF) is a complex clinal manifestation that cause abnormality of structural and/or functional of the heart. HF is due to diastolic dysfunction and systolic dysfunction of the left ventricle (LV). The aim of this study is to assess the relationship between grading of pre-discharge LV diastolic dysfunction and readmission at 30 days post discharge and 6 months post discharge. Method: This is a cohort retrospective study in HFrEF patients which are treated at Pusat Jantung Terpadu RSUP H. Adam Malik Medan on January 2021 until December 2021. Pre discharge echocardiography has been done to assess LV diastolic dysfunction and the we do the follow up of readmission at 30 days and 6 months by phone. Results: From 93 patients, there are 40 patients (43%) with grade I LV diastolic dysfunction, 22 patients (23,7%) with grade II LV diastolic dysfunction and 31 patients (33,3%) with grade III LV diastolic dysfunction. There are 34 patients (26,6%) with readmission at 30 days and 21 patients (26,6%) readmission at 6 months. There is a significant relationship between grading of pre-discharge LV diastolic dysfunction and readmission at 30 days post discharge (p value 0,000), but not at 6 months post discharge (p value 1,000). Conclusion: Grading of pre-discharge LV diastolic dysfunction on HFrEF patient is correlated with readmission at 30 days post discharge.

The Relationship Between Aerobic Physical Exercise to Functional Capacity in Heart Failure Patients at Haji Adam Malik General Hospital Medan Khairunnisah, Dina; Hasan, Harris; Reynaldo, Abdul Halim; Haykal, Teuku Bob; Sarastri, Yuke
Journal of Society Medicine Vol. 2 No. 9 (2023): September
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i9.87

Introduction: The prevalence of heart failure is known to increase day by day, as well as the incidence of rehospitalization and death. One way that can be done is to optimize health status and perform cardiac rehabilitation. Aerobic exercise is recommended for patients with heart failure. Aerobic exercise has been shown to increase functional capacity in patient with heart failure. The aim of this study is to assess the relationship between aerobic exercise with functional capacity improvement in patient with heart failure in Haji Adam Malik General Hospital, Medan. Method: This study was conducted using prospective cohort method on 35 patients with heart failure in a cardiac rehabilitation program at Haji Adam Malik General Hospital, Medan. Functional capacity and 6-Minute Walk Test (6MWT) data were collected before and after aerobic exercise. Univariate and bivariate data analysis were performed using SPSS. Results: 35 samples were included in this study, with an average age of 54,57±1,28 years and dominated by male. The result showed an increase in distance after aerobic exercise program compared to the initial examination (373,6±133,64 vs 192,57±64,68) with p-value <0,001. There was an increase in functional capacity from 3,55±1,12 MET to 6,6±2,44 MET after aerobic exercise (P<0,001). Conclusion: There is a significant relationship between aerobic exercise and functional capacity improvement in patients with heart failure at Haji Adam Malik General Hospital, Medan.

The Relationship between D-Dimer Levels and Coronary Lesion Severity in Patients with Acute Myocardial Infarction with ST-Segment Elevation at Haji Adam Malik Hospital Medan Rialdy, M. Isfan; Akbar, Nizam Zikri; Haykal, T. Bob; Ketaren, Andre Pasha; Andra, Cut Aryfa; Sarastri, Yuke
Journal of Society Medicine Vol. 2 No. 9 (2023): September
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i9.89

Introduction: Acute coronary syndrome results from rupture or erosion of an atherosclerotic plaque. D-dimer is a direct marker of fibronolysis events and an indirect marker of hypercoagulable state associated with atherosclerotic plaque formation and acute coronary syndrome. The purpose of this study was to determine the relationship between D-dimer levels and the severity of coronary lesions in ST Elevation Myocardial Infarction patients at H. Adam Malik Hospital Medan. Method: This study was conducted with a cross-sectional method on 72 ST Elevation Myocardial Infarction patients at H. Adam Malik Medan Hospital who underwent coronary angiography from December 2022 to May 2023. Definition of ST Elevation Myocardial Infarction followed the definition of Universal Definition of Myocardial Infarction and the severity of coronary lesions was calculated based on syntax score. Data were analyzed univariately and bivariately using SPSS to assess the association of D-dimer levels with syntax score with p<0.05 considered statistically significant. Results: The total study subjects were 72 people with an average age of 56,5410,84years. Most of the study samples were male 56 people (77.8%). The median D-dimer level was 605 and mean syntax score 22.027 + 14.61. There is a significant relationship between D-dimer levels and the severity of coronary lesions based on the syntax score (p: <0.001). Conclusion: There is a significant relationship between D-dimer and severity of coronary lesions in patients with acute myocardial infarction with ST segment elevation at H. Adam Malik General Hospital, Medan.

Interleukin-6 Reduction as a Predictor of Functional Capacity Improvement after Phase II Cardiac Rehabilitation Programme in Coronary Artery Bypass Surgery Patients Ferhat E.S, Muhammad; Safri, Zainal; Sarastri, Yuke
Journal of Society Medicine Vol. 3 No. 2 (2024): February
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i2.126

Introduction: Improved functional capacity is a good prognostic value in patients after CABG. Phase II cardiac rehabilitation provides beneficial effects on physical function, cardiopulmonary function, inflammatory response, autonomic function, and improves functional capacity, and there is a significant decrease in Interleukin-6 values in patients after CABG. Several studies have selected Interleukin 6 as an inflammatory cytokine that can be used to assess the beneficial effects of cardiac rehabilitation in coronary heart disease conditions. The aim of the study was to determine the relationship of Interleukin-6 value as a predictor of functional capacity improvement after phase II cardiac rehabilitation in patients undergoing CABG. Method: This study was analytic observational study conducted retrospectively on 31 CABG patients who underwent phase II cardiac rehabilitation. Data collection on functional capacity, Interleukin-6 examination before and after phase II cardiac rehabilitation. Data were analyzed univariately and bivariately to assess the relationship between Interleukin-6 and functional capacity. Multivariate analysis will then be performed using linear regression. The relationship test will be performed with Pearson correlation test. Statistical data analysis using SPSS software, p value <0.05 is statistically significant. Results: There were 29 samples. The results of the cardiac exercise test showed an increase in distance at the end of phase II cardiac rehabilitation compared to the initial examination (457,655 ± 24,346 vs 180,482 ± 13,941). At the end of the examination there was a decrease in the average Interleukin-6 level from 24.412 ± 2.516 to 13.647 ± 1.413. There was a significant relationship between improvement in functional capacity and Interleukin-6 (p=0.032, r=0.40). An increase of 1 MET will decrease Interleukin-6 by 2.238 pg/mL. There was a decrease in mean Interleukin-6 from 24,412±2,516 to 13,647±1,413 at the end of phase II with p value <0.001. Conclusion: Interleukin-6 can be a predictor of improved cardiac functional capacity after phase II cardiac rehabilitation program in patients undergoing CABG.

The Relationship between Myocardial Strain Using 2D Speckle Tracking Echocardiography and Coronary Lesion Severity Measured by Syntax Score in Patients with Chronic Coronary Syndrome at Haji Adam Malik Hospital Purba, Antonius Leonardo; Akbar, Nizam Zikri; Sarastri, Yuke
Journal of Society Medicine Vol. 3 No. 4 (2024): April
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i4.137

Introduction: Coronary heart disease continues to be the leading cause of morbidity and death worldwide. The cardiac dysfunction known as chronic coronary syndrome is caused by atherosclerosis-related obstruction or constriction of coronary arteries. Currently, One interesting non-invasive technique is GLS assessment, which has shown to be useful in predicting coronary lesions in chronic coronary syndrome patients. This study aims to evaluated the correlation between myocardial strain based on 2-D Speckle-Tracking Echocardiography and the severity of coronary lesions in chronic coronary syndrome patients at Haji Adam Malik Hospital Medan Method: This research is an analytical observational study with a cross sectional design on patients who diagnosed with chronic coronary syndrome and treated at H Adam Malik General Hospital Medan which met the inclusion and exclusion criteria. Sampling was carried out starting in January to December 2023. In bivariate analysis, the Fisher Exact test is used if the data is not normally distributed, and the chi square test is used if the data is normally distributed. P values less than 0.05 indicate statistical significance in data analysis using computer statistical methods. Results: Myocardial global longitudinal strain (GLS) based on 2-D Speckle-Tracking Echocardiography was significantly associated with the severity of coronary lesions as measured by syntax score in chronic coronary syndrome patients (p value 0.0001, OR 2.732, 95% CI 1, 81-4,11). As a predictor of coronary lesions severity based on the Syntax score in patients with chronic coronary syndrome, the global longitudinal strain (GLS) cut-off value of -17.37 demonstrates a sensitivity of 92.9% and a specificity of 83.6%. Conclusion: Myocardial global longitudinal strain (GLS) with a cut-off value of -17.37 can be used as a predictor coronary lesions severity in chronic coronary syndrome patients with a sensitivity of 92.9% and a specificity of 83.6%.

Cardiometabolic Profile Screening as an Early Detection of Cardiometabolic Risk Sarastri, Yuke; Raynaldo, Abdul Halim; Ilyas, Kamal Kharrazi; lubis, Dian Anindita
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 4 No. 2 (2022): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v4i2.9156

Background: Cardiometabolic risk profile is a set of interconnected risk factors, namely abdominal obesity, hypertension, dyslipidemia, hyperglycemia, and hyperinsulinemia, and causes global death. This study was conducted to obtain data on cardiometabolic profiles of people who participated in the Commemoration of World Hypertension Day 2021 at RSUP H Adam Malik Medan Method: This research is a descriptive study with a cross-sectional research design peoples namely by looking at the description of the cardiometabolic profile. The sample is an affordable population that meets the inclusion criteria, people with age >18 years old. Variables of blood pressure, waist circumference, blood sugar levels, and total cholesterol levels are numerical variables. Blood pressure examination is measured using a sphygmomanometer and expressed in mmHg units. The measurement of the abdominal circumference is carried out by examining the size of the abdominal circumference obtained using a tape measure in cm. Blood sugar levels are obtained from the results of measuring blood sugar levels during laboratory examination of blood in mg/dl units. Cholesterol levels are obtained from the results of measuring total cholesterol levels from blood laboratory examinations in mg/dl. Results: All subjects in this study (n= 100) are 42 men and 58 women with normal waist circumference, and education level strata -1, only 9% of the subjects had high blood sugar levels, and 41% of subjects were classified as central obesity 9% of subjects. Most patients (91%) with normal postprandial glucose and high total cholesterol 66%. Conclusion: In this study, most of the cardiometabolic risks of patients are overweight/obesity and dyslipidemia

Inflammatory Mediators as Predictors of Improved Functional Capacity after Phase 2 Cardiac Rehabilitation in Coronary Artery Bypass Surgery Patients Raynaldo, Abdul Halim; Sarastri, Yuke; Ilyas, Kamal Kharrazi; Tarigan, Stefanie
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 5 No. 1 (2023): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v5i1.12145

Background: Inflammatory parameters correlate with the atherosclerotic acute coronary syndrome (ACS) process and can predict future cardiovascular events in healthy populations. Coronary heart disease (CHD) subjects who had undergone coronary artery bypass grafting (CABG) procedures and underwent cardiac rehabilitation must be prevented from increased cardiovascular events. The study aims to evaluate the effect of cardiac rehabilitation programs on marker inflammation of cardiovascular risk factors. Method: This study was conducted at Departement Cardiology and Vascular Diseases Integrated Heart Center H. Adam Malik Hospital Medan who had undergone CABG procedures and underwent phase I and II cardiac rehabilitation. All subjects were carried out to collect basic patient data based on anamnesis, physical examination, results of laboratory tests, and functional capacity of the heart. Result: The subjects of this study were male 26 (89.7%) subjects and female 3 (10.2%) subjects. The average BMI in this study was 26.4207±0.675 kg/m2, the most common CHD risk factor was smoking in 21 (72.4%) subjects, dyslipidemia in 20 (69%) subjects, hypertension in 18 (62.1%) subjects, obesity 14 (48.3%) subjects and T2DM 13 (44.8%) subjects. Based on echocardiography results, the average ejection fraction was 47.931±2.17 %, and 18 (62.1%) subjects had cardiomegaly. After undergoing phase I and II cardiac rehabilitation, there was improved significantly of the 6-minute walk test to hsCRP, IL-6, neutrophil-lymphocyte ratio (NLR), and functional capacity (all, p <0.001). IL-6 value is correlated significantly with functional capacity improvement (p<0.05) in both phase I and II cardiac rehabilitation. Conclusion: Cardiac rehabilitation (CR) should be considered as a preventive plan in the treatment of CHD patients. Physical exercise is noteworthy and they reduce morbidity and mortality due to reduced inflammation.

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