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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) ACI (Acta Cardiologia Indonesiana) Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education
Gharini, Putrika Prastuti Ratna
Department Of Cardiology And Vascular Medicine, Faculty Of Medicine Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Prognostic Factor of Soluble ST2 Serum on 90 Days-Major Cardiovascular Events in ST-Elevation Acute Myocardial Infarction Patients with Reperfusion Therapy Pamrayogi Hutomo; Anggoro Budi Hartopo; Indah Sukmasari; Ira Puspitawati; Putrika Prastuti Ratna Gharini; Budi Yuli Setianto
ACI (Acta Cardiologia Indonesiana) Vol 3, No 1 (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.29680

Abstract

Background: Soluble ST2 (sST2) is released by strained myocardial. High baseline sST2 levels have been shown to be a predictor of mortality and heart failure in STEMI patients within 30 days and within 1 year, but its effect on medium-term events has not been widely investigated. Aims: To assess the prognostic factor of sST2 levels during admission with major cardiovascular events in the form of cardiovascular death and heart failure due to left ventricular dysfunction within 90 days of observation. Methods: A retrospective cohort study was conducted on STEMI patients with an onset of ≤ 24 hours undergoing reperfusion therapy from April 2014 - June 2015 in Dr. Sardjito General Hospital, Yogyakarta, Indonesia. The sST2 sample of venous blood was performed at admission. Primary outcomes for this analysis included cardiovascular death and congestive heart failure (CHF) through 90 days of follow-up. Assessment of major cardiovascular events was based on medical record data. Bivariate analysis were conducted on demographic and clinical factors related to sST2 and major cardiovascular events. A multivariate analysis was then conducted to determine the independent factors that influenced the emergence of major cardiovascular events. Results: Of the 107 patients who met the subject criteria, there were 33 (30.8%) subjects withmajor cardiovascular events and 74 subjects (69.2%) without major cardiovascular events in 90 days of observation. Of the 33 subjects with major cardiovascular events, there were 10 subjects (9.3%) died and 23 subjects (21.5%) with heart failure. The sST2 levels did not have a significant relationship with the incidence of mortality (p=0.617), heart failure (p=1.000), orboth combined (p = 1.000) in 90 days of observation. Conclusion: High serum sST2 levels during admission in STEMI patients who had undergonereperfusion therapy were not associated with increased incidence of major cardiovascular events (either the incidence of mortality or heart failure alone or both combined) in 90 days observation. 
3 Dimensional Printing in Cardiology: Innovation for Modern Education and Clinical Implementation Putrika Prastuti Ratna Gharini; Herianto Herianto; Nur Arfian; Ferdinandus Bayu Satria; Nur Amin
ACI (Acta Cardiologia Indonesiana) Vol 4, No 2 (2018)
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.40855

Abstract

Medical uses of three-dimension (3D) printing have advantages for many importances, such as tissue and organ fabrication, creation of prosthetics, and model structural anatomy. Visualization of 3-dimensional structure of heart for the importance of examination, management or education is not fully comprehensive describe toward the complexity of anatomical structure and also toward the illustration of medical procedure. The aim of this study was to identify the potential application of heart’s 3D printing for the enhancement of case understanding for doctor, medical students or residents and also for patient and its family. A normal model of heart is used in this research to stimulate next 3D object in cardiology area.We retrieved data from patients’ CT scan performed in Gadjah Mada University Hospital, Yogyakarta from December 2017 to March 2018. Our focus is on normal heart anatomy. Data from CT scan results are exported into Digital Imaging and Communications format (DICOM), then dimension measurement and threshold segmentation are performed using Mimics Medical 20.0 (Materialise) application. Finally the file must be exported into STL format due to final process to cut the desirable parts using Mesh editing application. After the final model has been done, then it will be printed by fuse deposition method to make a 3D object.The making and implementing 3D printingof heart model has many advantages for medical education especially for the doctor, medical students or residents and also for the patient and its family to be more aware on the condition of the heart. This study may stimulate another trial of using this technique into several heart abnormalities
Is Plaque Rupture Always Responsible in Acute Coronary Syndrome? Putrika Prastuti Ratna Gharini
ACI (Acta Cardiologia Indonesiana) Vol 5, No 1 (P) (2019): Proceedings Jogja Cardiology Update 2019 (JCU2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (624.674 KB) | DOI: 10.22146/aci.47681

Abstract

The majority cause of myocardial infarction is the atherothrombotic event, mainly cause by plaque rupture. Since the 20th century, it was found that the plaque rupture was not the solely condition responsible for the acute coronary syndrome. With the invention of more sensitive myocardial biomarker, a series of guideline was written as guideline for the definition of myocardial infarction. This review discuss about the consensus in the Universal Definition of  Myocardial Infarction.
Relationship of P Terminal Force V1 on Electrocardiogram with Left Atrial Function in Chronic Kidney Failure Patients on Hemodialysis Kartika Apshanti; Putrika Prastuti Ratna Gharini; Hasanah Mumpuni
ACI (Acta Cardiologia Indonesiana) Vol 5, No 2 (2019)
Publisher : Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (678.712 KB) | DOI: 10.22146/aci.50216

Abstract

Background: Chronic kidney failure is a worldwide public health problem.Cardiovascular disease is a common complication and the main cause of mortality in this population.Impaired left atrial function is an early marker of cardiovascular involvement and a prognostic factor that correlated with mortality in chronic kidney disease patients. We aimto investigate the relationship between P terminal force V1 (PTFV1), an ECG parameter, with left atrial function in chronic kidney failure patients on hemodialysis.Method: This cross sectional study was done in chronic kidney failure patients on hemodialysis in Dr. Sardjito General Hospital Jogjakarta. Electrocardiogram and echocardiography were done after hemodialysis procedure. P terminal force V1 was measured by multiplying amplitude and duration of negative deflection of terminal P wave in V1. Abnormal PTFV1 was defined as PTFV1 value ≥ 40 mm.msec. Left atrial function was measured using left atrial peak global longitudinal strain (LA PGLS).Results: This study was done in 71 patients with mean age 50 years old. Forty three subjects (61%) were men. Sixty four subjects (90%) had hypertension. Forty four subjects (62%) had abnormal PTFV1 on ECG. Mean LA PGLS was 24.89 ± 8.23%. No significant correlation was found between PTFV1 value with LA PGLS (r= -0.178; p=0.138). By multivariate analysis, left ventricular ejection fraction, left atrial diameter and hemodialysis duration (in months) were variables that independently correlated with LA PGLS. In subanalysis, amplitude of negative deflection of terminal P wave in V1 was significantly correlated with LA PGLS(r= -0.257, p= 0.031).Conclusions: This study reveals no correlation between P terminal force V1 and left atrial function in chronic kidney failure patients on routine hemodialysis. There is significant correlation between amplitude of negative deflection of terminal P wave in V1 with LA PGLS.
DEVELOPMENT OF MOBILE ECG APPLICATION TO IMPROVE ECG INTERPRETATION SKILLS OF GENERAL PRACTITIONERS AND MEDICAL STUDENTS Rizki Amalia Gumilang; Anis Fuad; Vita Arfiana Nurul Fatimah; Shofuro Hasana; Orisativa Kokasih; Putrika Prastuti Ratna Gharini
Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 10, No 3 (2021): November
Publisher : Asosiasi Institusi Pendidikan Kedokteran Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jpki.62977

Abstract

ABSTRACT Background: Electrocardiogram (ECG) has become a crucial examination in the management of cardiac emergencies. Accordingly, improvement of ECG interpretation skills is mandatory for general practitioners as the front-liners in emergency cases. The Mobile ECG application was developed as mobile learning media to facilitate continuing improvement of ECG interpretation skills.Aims: This study aimed to investigate the impact of the Mobile ECG application toward ECG interpretation skills of general practitioners and medical students and evaluate its usability.Methods: A pilot quasi-experimental study was conducted in a 1-week timeframe using webinar and the Mobile ECG application. Subjects were recruited through consecutive sampling. They met the following criteria: 1) registered as general practitioners or medical students, 2) completed the basic ECG pre and post-tests, and 3) agreed to participate in the study. The Mobile ECG is a web-based application which consists of modules, quizzes, and gallery of ECG interpretations. Pre and post-test analysis and system usability scale (SUS) questionnaire were used to evaluate the impact and usability of the application.Results: A total of 252 subjects were recruited and 80.2% were general practitioners. There was a significant increase in post-test scores compared to pre-test (p=0.000) for all subjects. General practitioners significantly gained more score increment than medical students (1.08 vs 0.16, p=0.001). Based on the SUS score of 67.5, the application was marginally accepted by the users.Conclusion: To conclude, the implementation of the Mobile ECG application did improve basic ECG interpretation skills. According to the SUS score, this application still needs improvement.
Pulmonary vascular resistance/systemic vascular resistance (PVR/SVR) ratio changes after sildenafil therapy in uncorrected congenital heart disease-associated pulmonary arterial hypertension Evita Devi Noor Rahmawati; Putrika Prastuti Ratna Gharini; Anggoro Budi Hartopo; Lucia Kris Dinarti; Dyah Wulan Anggrahini
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202305

Abstract

Pulmonary vascular resistance (PVR) to systemic vascular resistance (SVR) ratio is a prognostic predictor in congenital heart disease (CHD)-associated pulmonary arterial hypertension (PAH) after defect correction. Sildenafil, widely used as a PAH drug, can decrease PVR with minimal or without changes in SVR, resulting in decreased PVR/SVR ratio after treatment. However, there is limited evidence that PVR/SVR ratio reduced after sildenafil therapy in uncorrected CHD-associated PAH patients. This study aimed to investigate the decreasing of the PVR/SVR ratio after ≥ 1-year oral sildenafil therapy in adult uncorrected CHD-associated PAH. A total of 30 uncorrectable CHD-associated PAH subjects derived from the COHARD-PH registry were included in this study. Right heart catheterization (RHC) was performed during the first visit and further evaluations were conducted after ≥1-year oral sildenafil therapy. The PVR/SVR ratio at the baseline and after the evaluation was collected. The primary outcome of this study was the changes in PVR/SVR ratio from baseline to evaluated RHC. Characteristic analysis of subjects with decreased PVR or PVR/SVR ratio was perforemd as the secondary outcome. The mean PVR and SVR were not different from baseline and evaluated RHC (15.98± 10.67 vs. 18.38±13.93 WU, p=0.206 and 36.65±13.99 vs. 39.34±15.46 WU, p=0.262). There was no significant difference in the baseline PVR/SVR ratio and the evaluated PVR/SVR ratio after ≥1-year sildenafil therapy (0.48 ±0.32 vs. 0.49±0.36; p=0.882). As much as 15 subjects (50%) experienced decreased PVR/SVR ratio. However, there was no significant difference in the characteristics, including age, Eisenmenger syndrome, type of shunts, baseline PVR, PAH-specific treatment, and baseline NT-proBNP level (p>0.05). In conclusion, sildenafil therapy does not change PVR/SVR ratio in adults with uncorrected CHD-associated PAH.
Co-Authors Anggoro Budi Hartopo Anggoro Budi Hartopo Anggrahini, Dyah Wulan Anis Fuad Budi Yuli Setianto Evita Devi Noor Rahmawati Ferdinandus Bayu Satria Gumilang, Rizki Amalia Hasanah Mumpuni Herianto Herianto Indah Sukmasari Ira Puspitawati Kartika Apshanti Krisdinarti, Lucia Nur Amin Nur Arfian Orisativa Kokasih Pamrayogi Hutomo Shofuro Hasana Vita Arfiana Nurul Fatimah