Braghmandaru Adhi Bhaskara
Department of Cardiology and Vascular Medicine Faculty of Medicine Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia

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Interval TpTe Diagnostic Value in Diastolic Dysfunction of Patients with Hypertension Rano Irmawan; Braghmandaru Adhi Bhaskara; Hasanah Mumpuni; Nahar Taufiq
ACI (Acta Cardiologia Indonesiana) Vol 3, No 2 (2017)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.33547

Abstract

Introduction: Diastolic dysfunction has been shown to be associated with an increase in mortality rates in both normal and decreased systolic function. In patients with hypertension, there is elongation of transmural repolarization dispersion in left ventricular, which will cause heart diastolic relaxation disorders. The elongation of the transmural repolarization dispersion is indicated by the increase of the TpTe interval. We conducted this study to fnd out whether the TpTe interval had a good diagnostic value in detecting diastolic dysfunction in patients with hypertension.Methods: This is an analytic observational research using cross sectional design on hypertensive patients in whom echocardiography was performed. The study conducted in February 2017 until March 2017 in Dr. Sarjito general hospital Yogyakarta. Electrocardiography examination was taken after the patient was performed echocardiography. The TpTe interval was calculated using the ‘tail’ method at lead V5. Diastolic dysfunction was established using echocardiographywith the ASE / EAE 2016 algorithm.Results: Of the 112 patients met the criteria of the study subjects. The cut-off value for TpTe was 103.97 m.s., based R.O.C curve analysis. TpTe interval ≥ 103.97 m.s. had a moderate diagnostic value for detecting diastolic dysfunction with 73% accuracy, 83% sensitivity, 64% specifcity, 22% positive predictive value, and 97% negative predictive value. There were 66 (58.9%) subjectswith TpTe interval <103.97 m.s. and 46 subjects (41.1%) with TpTe interval ≥103.97 m.s. There were 12 subjects (10.7%) with diastolic dysfunction. Bivariate and multivariate analyzes showed no demographic and clinical factors that independently affected the TpTe interval.Conclusion: The TpTe interval ≥ 103.97 m.s. had a moderate diagnostic value for detecting diastolic dysfunction in patients with hypertension
Diagnostic Values of P-Wave Dispersion to Detect Diastolic Function in Patient with Hypertension Braghmandaru Adhi Bhaskara; Rano Irmawan; Lucia Kris Dinarti; Hasanah Mumpuni
ACI (Acta Cardiologia Indonesiana) Vol 3, No 2 (2017)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/aci.33574

Abstract

Background: Hypertension is one of the main causes of cardiovascular disease. Patients with hypertension have increase risk of heart failure compared to populations with normal blood pressure. Clinical evidence shows diastolic dysfunction (DD) can lead to heart failure. Diagnostic of DD with echocardiography is important but access to echocardiography machines is limited compared to electrocardiography (ECG). ECG research correlates P-wave dispersion (PWD) with DD. The aim of this study is to determine the value of PWD to diagnose DD in patients with hypertension.Methods: A cross sectional study was conducted in patients with hypertension at Dr. Sardjito Hospital. Patients received echocardiography, ECG, blood pressure measurement and data recording. The diastolic dysfunction was determined based on 2016 ASE/EACVI criteria. We conducted ROC analysis to determine the cut-off point of P-wave dispersion and the area under the curve (AUC) value, and bivariate analysis on demographic and clinical factors related to PWD. Multivariate analysis was performed to determine the independent factors affecting PWD.Results: 113 patients met the criteria of the study subjects, with 47 men (37.2%), mean age 58.32±11.17 years. Thirteen (11.5%) subjects had DD and 37 subjects (32.7%) with increased PWD. Results showed increased PWD above 71.4 m.s with AUC 76.2%, sensitivity 75%, specifcity 72.2%, positive predictive value 33.3%, negative predictive value 96%, and accuracy of 72.5% in diagnosing DD.Conclusion: This is the frst study to examine the diagnostic value of PWD to detect diastolic function based on 2016 ASE/EACVI criteria. We found PWD above cut-off point 71.4 m.s has a moderate diagnostic value for detecting DD in patients with hypertension.