Heart Science Journal
Vol 2, No 2 (2021): Dealing with Vascular Disease

Profile of Pediatric Rheumatic Heart Disease Patients with Mitral Regurgitation Receiving Angiotensin-Converting Enzyme Inhibitor in dr. Saiful Anwar General Hospital Malang

Faris Wahyu Nugroho (Brawijaya Cardiovascular Research Center, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia)
Muhammad Saifur Rohman (Brawijaya Cardiovascular Research Center, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia Department of Cardiology and Vascular Medicine, Medical Faculty of Universitas Brawijaya – dr. Sai)
Ardian Rizal (Department of Cardiology and Vascular Medicine, Medical Faculty of Universitas Brawijaya – dr. Saiful Anwar General Hospital, Malang, East Java – Indonesia)
Heny Martini (Department of Cardiology and Vascular Medicine, Medical Faculty of Universitas Brawijaya – dr. Saiful Anwar General Hospital, Malang, East Java – Indonesia)
Indra Prasetya (Department of Cardiology and Vascular Medicine, Medical Faculty of Universitas Brawijaya – dr. Saiful Anwar General Hospital, Malang, East Java – Indonesia)
Taufieq Ridlo Makhmud (Brawijaya Cardiovascular Research Center, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia)



Article Info

Publish Date
29 Apr 2021

Abstract

AbstractBackground : Rheumatic heart disease (RHD) remains the leading cause of heart failure in children worldwide. Long-term consequences and sequelae of acute rheumatic fever may further contributes to isolated mitral regurgitation (MR), unless promptly treated, may develop to extensive fibrosis and calcification leading to mitral stenosis.  ACE inhibitor through reverse remodeling mechanisms may encounter secondary LV changes due to rheumatic MR. Studies in the field of RHD remain limited, particularly in Indonesia. Method : This observational descriptive study recruited 69 pediatric patients diagnosed with RHD who went to Pediatric Cardiology Clinic of dr. Saiful Anwar General Hospital during November 2018 to June 2019. A total of 22 patients were excluded due to incomplete data or showing no MR during echocardiography. The remaining samples (47 patients) were divided into two groups i.e: captopril and no captopril group. Data regarding profile of baseline characteristics, parameter of LV remodeling (dimension, mass and geometry), and grading of MR  were collected then tabulated using descriptive statistical analysis. Results : In general, from total 47 of sample population, female sex was found to predominate (68%), with mean age of 12.1 years and body mass index (BMI) 17.2 kg/m2. Proportion of distribution among captopril and no captopril group demonstrated no significant difference (p>0.05). Captopril group revealed younger age, higher BMI and longer time of initial RHD diagnosis compared to no captopril group. Evaluation of LV remodeling parameter demonstrated that captopril group had smaller LVIDd, lower LVMI, higher fractional shortening (FS) and higher LVEF. LVPWd dan RWT were found to be relatively similar among both groups. Evaluation of MR grade revealed that captopril group showed lower value of MR VC, MR EROA and MR regurgitant volume. Conclusion : Profile of pediatric RHD patients with MR who had been receiving captopril for at least 12 months in dr. Saiful Anwar General Hospital during period of 2018-2019 demonstrated younger age, higher BMI, smaller LVIDd, lower LVMI, lower MR grade, higher FS and higher LVEF compared to patients who had not. Keywords: rheumatic heart disease, mitral regurgitation, ACE inhibitor, captopril, left ventricle remodeling

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Journal Info

Abbrev

heartscience

Publisher

Subject

Health Professions Immunology & microbiology Medicine & Pharmacology

Description

HEART SCIENCE is the official open access journal of Brawijaya Cardiovascular Research Center, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. The journal publishes articles three times per year in January, May, and September. The ...