Rizky Adriansyah
Department of Child Health, Universitas Sumatera Utara Medical School, Medan, North Sumatera

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Time period after transcatheter PDA closure with changes in left ventricular function and nutritional status Muhammad Irfan; Muhammad Ali; Tina Christina Lumban Tobing; Wisman Dalimunthe; Rizky Adriansyah
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.100-6

Abstract

Background Few studies perform follow ups on patent ductus arteriosus (PDA) patients who undergo transcatheter closure. In addition to side effects from the procedure, it is important to evaluate changes in left ventricular function (LVF) parameters and nutritional status. Objective To compare LVF and nutritional status before and during the one-year period post-transcatheter PDA closure, and evaluate potential associated factors in post-closure PDA transcatheter patients. Methods This retrospective cohort study was done in a single center in patients diagnosed with PDA who had undergone transcatheter closure. Data were obtained from subjects’ medical records. The relationship between the post-closure PDA time span and LVF parameters [ejection fraction (EF) and fractional shortening (FS)] was analyzed by Friedman and repeated ANOVA tests; the post-closure PDA time period and nutritional status was analyzed by Friedman test. The time periods analyzed were 1, 3, 6, and 12 months post-closure. Factors potentially associated with LVF 12 months post-closure were analyzed by linear regression. Results A total of 30 patients who had undergone transcatheter PDA closure were included. The body weight mean of at the time of transcatheter PDA closure was 13.1 kg. We found a significant relationship between time period after PDA closure and nutritional status, before and 1, 3, 6, and at 12 months post-closure. In a comparison of pre-closure to 12 months post-closure, subjects’ mean EF (66.6 vs. 70.9%, respectively; P<0.001) and FS (34.4 vs. 37.8%, respectively; P<0.001) were significantly higher. In addition, significantly more patients had normal nutritional status 12 months post-closure than before closure. Age was not related to LVF parameters (EF: r=0.212; P=0.260; FS: r=0.137; P=0.471). Conclusion Both LVF and nutritional status significantly improve gradually over the 12 months post-closure compared to pre-closure. PDA size is not significantly associated with improved LVF parameters and nutritional status.
Accuracy of NADAS criteria to establish diagnosis in children with suspected congenital heart disease Rahmawati Rahmawati; Rizky Adriansyah; Yunnie Trisnawati; Juliandi Harahap; Pertin Sianturi; Ayodhia Pitaloka Pasaribu
Paediatrica Indonesiana Vol 63 No 4 (2023): July 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.4.2023.267-73

Abstract

Background The majority of congenital heart disease is diagnosed during evaluation of a murmur detected either during a routine follow-up or while assessing an intercurrent illness. NADAS criteria might be useful as a screening test to differentiate pathologic from innocent murmurs. Objective To assess the accuracy of NADAS criteria in diagnosing pathology in children with suspected congenital heart disease. Methods This diagnostic study included children aged 1 month - 12 years who visited the Outpatient Pediatric Cardiology Clinic at Haji Adam Malik General Hospital, Medan, North Sumatera. Inclusion criteria from history and physical examination were recurrent acute respiratory illness (ARI), poor nutritional status, failure to thrive, cardiac murmurs, and/or a history of cyanosis. Results Seventy children underwent NADAS screening, of whom 60 had CHD. In the <5-year age group, 63.3% had heart disease. All patients had poor nutritional status, both CHD and non-CHD patients. All CHD patients had an abnormal electrocardiogram (ECG), while 88.33% had a history of recurrent ARI, 80% had abnormal chest x-ray, and 55% had abnormal S2 heart sound on auscultation. A grade 3 or higher systolic murmur was found in 78.33% of patients who had CHD. There were 55 children who had a NADAS score of 3 or higher, of which 53 children with CHD and 2 children non CHD (1 of the 2 children non CHD showed only 3 minor criteria of the NADAS score and had infantile fibrosarcoma). The other 15 children had a NADAS score of less than 3 with 7 children with CHD and 8 children without CHD. Conclusion The NADAS criteria can be used as a screening test to diagnose disease in children suspected of having CHD for cut-off score at 3 (1 major + 2 minor), with 87.14% accuracy, 88.33% sensitivity, 80% specificity, and 0.883 AUC value.