Ganesja M Harimurti
Department of Cardiology and Vas-cular Medicine, Faculty of Medicine - University of Indonesia National Cardiac Center, Harapan Kita, Jakarta

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Korelasi Antara Durasi QRS, Fungsi Ventrikel Kanan dan Disinkroni Ventrikel Kiri Pasca Koreksi Tetralogi Fallot Retna Dewayani; Bambang Budi Siswanto; Poppy S Roebiono; Anna Ulfah Rahajoe; Indriwanto Sakidjan; Ganesja M Harimurti
Jurnal Kardiologi Indonesia Vol. 28, No. 4 Juli 2007
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v28i4.229

Abstract

Background. QRS duration has long been established as a strong predic-tor of sudden cardiac death in patients after surgical correction of Tetral-ogy of Fallot (TOF). Several factors has been correlated to QRS duration, i.e severity of pulmonal regurgitation and right ventricular volume after TOF correction. But there is no established relation between right ven-tricular function and QRS duration after surgical correction TOF.Objectives. We aimed to investigate the relation between QRS duration and right ventricular function and whether patients after TOF repair with right bundle branch block have left ventricular dissynchrony.Methods.50 patients with repaired TOF were studied. Right ventricular function were derived from tissue Doppler imaging Tei index. Left ven-tricular dissynchrony were derived from tissue Doppler imaging. The time interval between the onset of QRS complex and the onset of systolic ejec-tion was measured for six left ventricular basal wall, i.e septal, lateral, anteroseptal, posterior, anterior and inferior wall. Mechanical delay from septal to lateral wall, antero-septal to posterior wall and anterior to infe-rior wall was calculated. Measured data were correlated with QRS dura-tion.Results.There was relation between QRS duration and right ventricular function (P = 0.028, r = 0.44). Ten (20%) of the examined patients after TOF repair had LV dissnynchrony particularly in patients with RBBB and prolonged QRS duration (160 ± 9 ms).Conclusions.There is correlation between right ventricular function and QRS duration. Left ventricular dissynchrony may exist in patients after TOF repair with RBBB.
Myeloperoksidase Sebagai Prediktor Kejadian Kardiovaskular Pada Pasien Infark Miokard Akut Starry H Rampengan; Harmani Kalim; Santoso Karo Karo; Sunarya Soerianata; Ganesja M Harimurti
Jurnal Kardiologi Indonesia Vol. 28, No. 4 Juli 2007
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v28i4.230

Abstract

Background. Inflammation has been linked to all stages of the develop-ment of vulnerable plaque which not only causes platelet activation but also proceeded by activation of polymorphonuclear neutrophils (PMNs). Myeloperoxidase (MPO), a hemoprotein abundantly expressed by PMNs and secreted during activation, possesses potent proinflammatory prop-erties and may contribute directly to tissue injury. Among predictors of major adverse cardiovascular events (MACE) that we have been widely used and known, such as hs-CRP and Troponin T, it still unknown whether MPO also provides prognostic information in patients with acute myocar-dial infarction (AMI). Objectives. The aim of our study is to search predictive value of MPO and to compare MPO with hs-CRP and Troponin T as a predictor of MACE in patients with AMI.Methods.Cohort-prospective study was done, conducted from April to June 2006 in the emergency department of National Cardiovascular Cen-tre - Harapan Kita, (NCVC-HK), Jakarta. MPO, hs-CRP, and troponin T serum levels were assessed in 93 patients with AMI. It recorded death, re-infarctions, angina, revascularization, and heart failure during 6 months of follow-up.Results.Patients with MPO serum level > 204,9 µg/l have increased risk of cardiovascular events (HR 6.76; 95% CI 3.37-13.56, P < 0.001). In statistical analysis, MPO (sensitivity 83.1%; specificity 82.4%) is a stronger independent predictor for subsequent cardiovascular events than Tropo-nin T (sensitivity 59.8%; specificity 71.6%) and hs-CRP (sensitivity 48.5%; specificity 46.1%).Conclusions.MPO serum levels powerfully predict an increased risk for subsequent cardiovascular events in patients with acute myocardial infarction.