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All Journal Journal of Tropical Life Science : International Journal of Theoretical, Experimental, and Applied Life Sciences Heart Science Journal
Renny Suwarniaty
Department Of Pediatric, Faculty Of Medicine, Universitas Brawijaya, Malang, Indonesia.
Agriculture, Biological Sciences & Forestry Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology

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Poor Adherence to Secondary Prophylaxis is Associated with More Severe Rheumatic Valve in Pediatric Patients: A Cross-Sectional Study Taufieq Ridlo Makhmud; Mohammad Saifur Rohman; Renny Suwarniaty; Djanggan Sargowo; Faris Wahyu Nugroho; Annisa Hasanah; Bambang Kusbandono; Citra Tarannita; Ratih Kusuma Wardani; Sasmojo Widito; Heny Martini
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.409 KB) | DOI: 10.21776/ub.hsj.2020.001.01.4

Abstract

Background : Rheumatic heart disease (RHD) contributed to a large number of proportion amoung cardiovascular problems in developing county, especially Indonesia. Secondary prophylaxis method using intramuscular injection of Benzathin Penicillin-G (BPG) has been known as the most effective strategy in the prevention of RHD. However, whether this prevention method also resulting in prevention of disease severity in Indonesian patients remained to be examined.Objectives : This study aimed to assess the difference of rheumatic valve severity in Indonesian pediatric patients between adequate and poor adherence to secondary prophylaxis by using intramuscular BPG injection.Methods : This cross-sectional study was conducted at Pediatric Cardiology Department of Saiful Anwar General Hospital from November 2018 to June 2019. Patients with documented history of RHD were included. Frequency of intramuscular BPG injection during the last one year was recorded. Adherence was measured using the proportion of days covered (PDC) and adequate adherence was defined as PDC ≥0.90. The severity of RHD was assessed based on the severity of the mitral and / or aortic valve using echocardiography. Bivariate analysis and multivariate logistic regression analysis was used to identify characteristics associated with rheumatic valve severity.Results : A significant difference of rheumatic mitral and/or aortic valve severity was observed between adequate adherence compared to poor adherence group (p = 0.016). Rheumatic mitral and/or aortic valve were found to be more severe in patients who has one or more episode of ARF recurrence (p = 0.003). Multivariate logistic regression analysis demonstrated that adherence to secondary prophylaxis within the last 1 year has the strongest influence on the severity of rheumatic mitral and/or aortic valve (p = 0.049; OR 7.20).Conclusion : The adherence to secondary prophylaxis has the strongest related the rheumatic valve severity compared to other factors.
Prominently Increased of Mannose Binding Lectin (MBL) and Myeloperoxidase (MPO) Levels in Severe Valve Regurgitation and Heart Failure of Rheumatic Heart Disease Rachmania Putri; Renny Suwarniaty; Loeki Enggar Fitri; Susanto Nugroho; Mohammad Saifur Rahman
Journal of Tropical Life Science Vol. 7 No. 2 (2017)
Publisher : Journal of Tropical Life Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jtls.07.02.04

Abstract

Rheumatic heart disease (RHD) is mediated by an abnormal immunological response following a Streptococcus pyogenes infection that induces a disturbance of oxidants and antioxidants balances. Mannose-binding lectin (MBL) binds to N-acetylglucosamine, a molecule present on the Streptococcus cell wall and human heart valves. There is a disturbance of oxidant and antioxidant balance in rheumatic disease. Myeloperoxidase (MPO) is a marker of oxidative stress and inflammation. This study was aimed to determine the correlation of MBL and MPO levels and severity of valvular regurgitation and heart failure (HF) in RHD patients. A case-control study was conduct using human peripheral blood samples from 32 children aged 6 to 14 years old. The subjects were divided into two groups: 16 RHD patients included in the case group and 16 healthy children as a control group. The level of MBL and MPO was investigated using ELISA method. There were significant differences on MBL and MPO level between patient and control group. The level of MBL and MPO were significantly increased in RHD group, especially on severe valvular regurgitation. There was a strong correlation between MBL and MPO levels and the severity of valvular regurgitation (r = 0.94 and r = 0.88). The least significant diff-erence (LSD) analysis showed that significant difference occurs in the severe heart failure group. Our research revealed that the MBL and MPO levels in pediatric RHD patients were significantly higher than in healthy children. The MBL and MPO levels were significantly correlated with the severity of valvular regurgitation and heart failure.
Co-Authors Annisa Hasanah Bambang Kusbandono Citra Tarannita Djanggan Sargowo Faris Wahyu Nugroho Heny Martini Loeki Enggar Fitri Mohammad Saifur Rahman Mohammad Saifur Rohman Rachmania Putri Ratih Kusuma Wardani Sasmojo Widito Susanto Nugroho Taufieq Ridlo Makhmud