bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparative Study on the Alternative Ankle Brachial Index (ABI) Method Versus the Traditional ABI Method Among Screened Patients: A 1-year Retrospective Review
Authors: Chan Keith Andrew L , Alcazar Jeremy Anne A , Buaya Carlo Andrew A , L. Gallardo Elaine 
Published: July 2024

BACKGROUND: Peripheral artery disease (PAD) of the lower extremities is a chronically progressive disorder characterized by the presence of arterial occlusion. Screening for PAD by the Ankle–Brachial Index (ABI) is recommended and traditionally computed using the higher ankle pressure divided by the higher brachial pressure. Alternative methods that utilize the lower pressure of the pressures have been proposed with the premise of reclassifying a greater number of at-risk individuals.

METHODS: This study is a retrospective analysis. Data from inpatients screened for ABI from March 1, 2018, to March 31, 2019, were included. All ABIs were computed via traditional methods, with all abnormal ABIs (<0.9) grouped accordingly (ABI A). The remaining patients were then retested using the alternative method, and those with abnormal ABIs were then grouped (ABI B). The remaining patients were designated to have normal ABIs. Patients assessed as outpatients and those with incomplete clinical information or with ABIs of greater than 1.4 were excluded. Differences among the clinical parameters among groups were analyzed via t test or χ2 test (P < 0.05).

RESULTS: A total of 226 patients were analyzed. Through traditional ABI computation, 18 patients (7.96%) had abnormal values. The remainder had ABIs computed via the alternative method, with an additional 15 patients (6.64%) having abnormal ABIs, with a significantly higher percentage of patients having abnormal ABIs with the traditional versus alternative methods (7.96% vs 14.6%). Patients with abnormal ABIs were significantly older (p = 0.003, p = 0.061), with patients traditionally screened having higher cholesterol (p = 0.015). All other demographic and clinical characteristics were similar among all groups.

CONCLUSION: The alternative ABI method detects a significantly higher number of patients compared with the traditional method; apart from age and cholesterol, there exist no significant differences in clinical characteristics among the groups, emphasizing the need for diligent ABI screening for PAD.

KEYWORDS: Ankle Brachial Index; Alternative Method ABI; ABI Computation
One Artery to Rule it All: A Case of 30-year-old Male with Single Coronary Artery
Authors: Banluta Andre Russell F , Buensuceso Jill , Cornel Mylene , Lim Bernadette Semilla , Macabeo Renelene 
Published: July 2024

Single coronary artery (SCA) is a rare congenital anomaly in which there is an isolated coronary artery that arises from a single coronary ostium and provides coronary blood supply to the entire myocardium. SCA is classified based on Lipton Classification which includes the origin, branching pattern and course. We aim to present a rare case of congenital anomaly that presented with atypical symptoms and to discuss the features and classification of a single coronary artery. This is a case of a 30-year-old Filipino, male, known type 1 diabetes mellitus came in with diarrhea and vomiting, which later had severe abdominal pain. A consideration of Mesenteric ischemia was entertained due to abdominal pain not compatible with physical exam findings. He then underwent CT angiogram of the abdomen which was unremarkable, so a consideration of atypical presentation of chest pain was considered since patient is diabetic hence he underwent CT coronary angiogram and was noted to have SCA as an incidental finding.
Cost of Hospitalization for Acute Coronary Syndrome in the Philippines
Authors: Mendoza Victor L 
Published: July 2024

INTRODUCTION: Acute coronary syndrome (ACS), specifically myocardial infarction, accounted for approximately 41% of deaths due to coronary artery disease in 2013. A large number of Filipinos are affected by ACS; thus, it is important to determine its hospitalization cost. The study objectives were to (1) define the hospital care pathways for ACS; (2) determine the resources used; (3) estimate the hospitalization cost for uncomplicated ACS; and (4) determine the difference between the estimated hospitalization cost and the coverage provided by the Philippine Health Insurance Corporation (Philhealth).

METHODS: A cost analysis study was done. Mixed qualitative and quantitative data collection tools consisted of consultations with local cardiologists, key informant interviews, and self administered survey forms. Sensitivity analysis was performed through scenario analysis.

RESULTS: The ACS hospital care pathway was derived after consultative meetings with invasive and noninvasive cardiologists. Using this pathway, the resources used for ACS hospitalization were identified, and the total hospitalization costs were calculated. For medical treatment alone, the costs were approximately Philippine peso (₱) 67,000 to ₱90,000, whereas for medical treatment with percutaneous coronary intervention (PCI), the costs were approximately ₱265,000 to ₱425,500. In comparison, Philhealth’s maximum coverage for ACS with PCI is ₱39,750.

CONCLUSION: There is variation in the ACS hospitalization cost, depending on the management strategy used and the type of hospital where a patient is confined. Medical plus reperfusion with PCI increases the cost four to five times when compared with medical treatment alone. Huge out-of-pocket expense is demonstrated because of the large discrepancy between the actual hospitalization costs to Philhealth’s ACS coverage.

KEYWORDS: acute coronary syndrome, cost analysis, Philhealth
Atrial Fibrillation Following Coronary Artery Bypass Surgery in Medical Center Manila
Authors: Dayo Alfred Matthew , Reyes Michael Joseph 
Published: July 2024

BACKGROUND: Atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery may lead to prolonged hospital stay and increased morbidity and mortality. Identifying people at risk may help in the management and improve the outcome of patients undergoing this procedure.

OBJECTIVES: The aims of this were to determine the incidence of AF in patients who underwent CABG surgery in ManilaMed–Medical Center Manila and whether certain factors were associated with developing AF in patients who underwent the procedure.

METHODS: This was a single-center, retrospective, cross-sectional study wherein adult patients who underwent CABG, without previous AF, were included.

RESULTS: Among patients included in the study, 29 developed AF, with an incidence of 27.62%. Patients who had AF after CABG were, on average, older (65.79 vs 59.29 years, P = 0.002); had dyslipidemia (72% vs 47%, P = 0.021), a higher average left atrial volume index (LAVI) (26.72 vs. 23.45, P = 0.038), an LAVI greater than 34 mL/m2 (24% vs 3%, P = 0.002), and an episode of previous stroke (28% vs 11%, P = 0.038); and had been taking diuretics (28% vs 9%, P = 0.027) but had a lower prevalence of having diabetes (41% vs 66%, P = 0.023).

CONCLUSION: Atrial fibrillation remains to be a frequent arrhythmia after CABG occurring in 28% of patients who had CABG. It may occur in older patients, patients with dyslipidemia, patients with a large left atrium, patients who had a previous stroke, and patients taking diuretics. On the other hand, the odds of a diabetic patient developing AF after CABG are low.

KEYWORDS: Cardiac Biomarkers, Chest CT, COVID-19, CT Severity, NT-proBNP, Troponin I
Lutembacher Syndrome in a 35-Year-Old Filipino Woman: A Case Report
Authors: Reynoso Arch Anthony , Sibal Josephus , Magno Jose Donato , Medina Angelito , Reblando Myrna , Perez Melissa 
Published: July 2024

INTRODUCTION: Lutembacher syndrome (LS) is an uncommon cardiac abnormality characterized by any association of a congenital or iatrogenic atrial septal defect (ASD) and a congenital or acquired mitral stenosis (MS). The hemodynamic effects of this syndrome are a result of the interplay between the relative effects of the ASD and MS.

CASE REPORT: A 35-year-old woman presented to the cardiology clinic with a 1-month history of easy fatigability, exertional dyspnea, and productive cough with whitish phlegm. She has no edema, orthopnea, paroxysmal nocturnal dyspnea, or fever. Two weeks before admission, she developed palpitation and still with persistence of symptoms. She sought consultation and was prescribed with clopidogrel 75 mg one tablet once a day, sildenafil 100 mg one tablet once a day, and verapamil 40 mg one tablet once a day, which provided relief. She has no history of hypertension, diabetes, cerebrovascular disease, coronary artery disease, or thyroid or renal disease. She is a nonsmoker and an occasional alcoholic drinker.

On general physical examination, blood pressure was 120/80 mm Hg; cardiac rate, 72 beats per minute; and respiratory rate, 20 cycles per minute. She was afebrile and had distended jugular veins with rales at the left lung base. Abdominal examination revealed neither organomegaly nor shifting dullness. There was neither cyanosis nor pedal edema.
PSE/PHA Interim Guidelines for Enhanced Quality and Safety at the Echocardiography Laboratory amidst Emerging Infections: Recommendations from the Task Force on Quality and Safety during Echocardiography of the Philippine Society of Echocardiography, Inc. and the Philippine Heart Association Council on Echocardiographys
Authors: Magno Jose Donato A , Cornel Mylene U , Sumalpong Jehan Karen G , Pua Emmet Vi Ladlad , Jumangit Joyce S , Ubaldo Rylan Jasper , Nunez Jonnie Bote , Carpo Patrick R , Gamponia Aurora Muriel S , Flores Viannely Berywn F , Senga Aileen C , Uy Celia Catherine C , Bantala-Supnet Kristine Hashim , Rillera-Posadas Karla Rhea G , Santos Romeo J , Lazaro Victor L , Rogelio Gregorio G , Obillos Stephanie Martha O , Valencia Ofelia N , Go Loewe O , Alimurung Benjamin N , Ramirez-Ragasa Rosemarie , Reyes Eugene B , Sibal Josephus R , Del Rosario Jose Jonas D , Fernandez Ma. Bridget D , S. Supe Myla Gloria , Tucay Edwin S 
Published: July 2024

Quality and safety go hand in hand in the practice of echocardiography. This fact becomes increasingly relevant amidst the pandemic that poses a number of extraordinary challenges to the healthcare community. The field of cardiovascular ultrasonography is no exception, as physicians, sonographers and allied health professionals carry out their tasks in the backdrop of a more intimate patient setting. The Philippine Society of Echocardiography, recognizing its key leadership role not only in the country but in the Asia-Pacific region, teamed up with the Philippine Heart Association Council on Echocardiography and the heads and training officers of various cardiovascular laboratories and training centers in the country to come up with a summary of best practices that are intended to elevate quality and infection control in echocardiography.

KEYWORDS: echocardiography, cardiovascular laboratory, quality, safety, infection control
Relationship of Left Atrial Volume Index with Exercise Functional Capacity among Post-Percutaneous Coronary Intervention Patients
Authors: Darunday-Patiño Irene , Supe Myla 
Published: July 2024

INTRODUCTION: Recent evidence highlighted the importance of increased left atrial volume index (LAVI) as a powerful predictor of mortality after acute myocardial infarction (AMI). This study aimed to investigate whether LAVI correlates with the level of functional capacity assessed by treadmill exercise test using metabolic equivalents (METS).

METHODS: Twenty-four patients with AMI who underwent percutaneous coronary intervention (PCI) were included in this study. Two-dimensional echocardiography done after PCI were reviewed and the following parameters were obtained: left atrial size, LAVI and left ventricular ejection fraction (LVEF). At least two weeks post-PCI, patients underwent symptom-limited treadmill exercise test using the National Institute for Health (NIH)/NEPTET protocol. Pearson product moment correlation was used to determine the linear correlation between LAVI and exercise capacity measured by METS score.

RESULTS: Majority of the patients were male with a mean age of 49.5 years. Majority were hypertensive, overweight and were current smokers. The mean ejection fraction (56.0 + 1.0) was preserved while the mean LAVI (21.3 + 5.8) was within normal ranges. The median METS achieved patients was 7.5. Pearson product moment correlation showed that there was no correlation between LAVI and exercise capacity measured by METS score.

CONCLUSION: There is no correlation between LAVI and exercise capacity measured by metabolic equivalents (METS) among post-PCI for myocardial infarction patients.

KEYWORDS: left atrial volume index; functional exercise capacity; post-percutaneous coronary intervention
Role of ST2 in Predicting Major Adverse Cardiovascular Events in Acute Coronary Syndrome Patients who Underwent Percutaneous Coronary Intervention
Authors: Bacani Jason Roy , Estacio Ronaldo H , Sui James Ho Khe 
Published: July 2024

The Gensini scoring system is an objective method to determine the severity of coronary artery disease (CAD) according to angiographic findings and was noted to be independently associated with in-hospital mortality in ST-Elevation Myocardial Infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). This was a single-center cross-sectional study which included 56 participants who were diagnosed with acute coronary syndrome and underwent coronary angiogram and percutaneous coronary intervention. ST2 Levels were determined and Gensini scoring for severity of CAD was done. A cut-off value 71 ng/ml was established to be a good predictor of outcomes with a sensitivity of 81.3% and specificity of 75% (LR+ 3.680 LR - 0.256 AUC 0.811). Patients with elevated ST2 levels on admission had increased major adverse cardiovascular events within 1-year follow up, which included death (p=0.128), worsening heart failure (p=0.015), arrhythmia (p=0.041) and worsening angina (p=0.128). Likewise, they had increased Gensini scores (p=0.025), equating to more severe coronary anatomy, more number of vessels involved and most had incomplete revascularization.

CONCLUSION: Higher ST2 levels at presentation predisposes to higher risk of developing future adverse events. Taking into account a combination of traditional risk factors, angiography-based scores, and traditional or novel biomarkers such as ST2 could lead to improved prediction of events in this cohort with coronary artery disease.

KEYWORDS: ST2, coronary artery disease, acute coronary syndrome, percutaneous coronary intervention, risk stratification, Gensini score
Clinical and Echocardiographic Outcomes of Tricuspid Regurgitation After Percutaneous Transmitral Commissurotomy: Prospective Cohort
Authors: Toledano Bryan Rene F , Jaluage-Villanueva Maria Johanna , Lacson Sharon Marisse 
Published: July 2024

PURPOSE: The gap in evidence in the management of multivalvular lesions can be addressed by providing more data on clinical and echocardiographic outcomes after percutaneous transmitral commissurotomy (PTMC) in patients with concomitant significant tricuspid regurgitation (TR) at baseline.

METHODS: This is a single-center cohort study of adult Filipinos 19 years or older, admitted between January 2019 and October 2020 due to severe mitral stenosis with moderate to severe TR subjected to PTMC. The outcome post-PTMC was divided into 2 groups: significant TR, which included the progression of moderate to severe TR or persistence of severe TR, and insignificant TR group, which included those with mild TR, regression of moderate to mild TR, severe to moderate, or persistence of moderate TR. The clinical and echocardiographic parameters of these groups were compared at baseline, at 24 hours, 1 month, and 6 months postprocedure. The numerical data between significant and nonsignificant TR were compared using nonparametric Mann–Whitney U test and categorical data using the χ2 test.

RESULTS: Thirty-eight patients with significant mitral stenosis and TR post-PTMC were analyzed. At 24 hours post-PTMC, the significant TR group had significantly higher right atrial volume index (42.3 vs 26.1, P = 0.004), right ventricular dimension (RVD) mid (3.81 vs 2.92, P = 0.001), systolic pulmonary arterial pressure (60.5 vs 38.5, P = 0.003), and right ventricular outflow tract (2.8 vs 2.2, P = 0.001) and lower mitral valve (MV) planimetry (1.25 vs 1.58, P = 0.009). At 1 month, RVD mid (3.4 vs 2.8, P = 0.02) and tricuspid valve (TV) annulus (3.35 vs 2.76, P = 0.10) were significantly higher in the significant TR group. At 6 months, right atrial volume index (59 vs 24.7, P = 0.001), RVD mid (4 vs 2.73, P = 0.006), and TV annulus (4.5 vs 2.67, P = 0.001) were significantly higher in the significant TR group. The insignificant TR group on the sixth month had significantly improved functional class New York Heart Association I (32 vs 5 P = 0.019).

CONCLUSION: Percutaneous transmitral commissurotomy improved functional class and echocardiographic parameters of systolic pulmonary arterial pressure, MV planimetry, and MV gradient on short-term follow-up on both groups of TR. The majority of outcomes after the procedure had insignificant TR. However, those with significant TR had higher RVD mid and TV annulus from 24 hours to 6 months when compared with the insignificant TR group.

KEYWORDS: rheumatic heart disease, mitral stenosis, percutaneous transmitral commissurotomy, tricuspid regurgitation
Epidemiologic Burden of Hospitalization Among Adult Filipinos with Supraventricular Tachycardia Requiring Radiofrequency Ablation
Authors: Santos April Ann A. Bermudez-delos , Agbayani Michael-Joseph F , C. Fadreguilan Erdie , Gabriel Eden A , Tumanan-Mendoza Bernadette A , Mendoza Victor L , Pestaño Noemi S , David Gladys Ruth S , Punzalan Felix Eduardo R , Gervacio Giselle G , Segundo Luigi Pierre S , De Las Llagas Carlos E , Lagamayo Magdalena J 
Published: July 2024

INTRODUCTION: Radiofrequency catheter ablation (RFA) is an interventional cardiac electrophysiologic procedure that uses heat energy for definitive management of supraventricular tachycardias. It is a class I recommendation for chronic management of most supraventricular arrhythmias. No local data exist in the incidence hospitalization for SVT and utilization of RFA for this condition. The study aimed to obtain the prevalence of hospitalization of patients with supraventricular tachycardias where RFA is utilized, including the patients’ demographic profile, length of hospitalization, and mortality rate.

METHODOLOGY: Philippine Health Insurance Corporation claims for hospitalization from January 1, 2017, to December 31, 2018, were reviewed. Data analysis was done using median and interquartile range for continuous data, and frequency and percentage distribution for categorical data.

RESULTS: There were 1121 and 1149 claims for hospitalization for SVTs (atrial paroxysmal tachycardia, atrioventricular paroxysmal tachycardia, nodal paroxysmal tachycardia, and junctional tachycardia) in 2017 and 2018, respectively. This represents four hospitalization claims for SVT per 10,000 of the total PHIC claims. The majority of patients were female with median age of 52 years. Only 25 and 19 patients underwent radiofrequency ablation in 2017 and 2018, respectively. The majority of these patients were male and younger with a median age of 31 years. No mortality was recorded among patients admitted for catheter ablation.

CONCLUSION: In 2017 and 2018, hospitalization claims for SVT requiring catheter ablation were 0.04% (four hospitalization claims for SVT per 10,000 of the total claims) in both years. The majority of patients were admitted with pharmacologic therapy on discharge with very low utilization of radiofrequency ablation for long-term management.

KEYWORDS: arrhythmia, supraventricular tachycardia, radiofrequency ablation, prevalence, hospitalization
Predictive Value of Liver Stiffness Using FIB-4 Index in Mortality of Heart Failure Patients (Philippine Heart Failure Registry)
Authors: Benitez Victor Jonathan S , Cantre Jennifer , De Guzman Arnold 
Published: July 2024

BACKGROUND: Heart failure has an in-hospital mortality of 8.2% in the Philippines. The chronic passive congestion caused by heart failure is known to cause liver stiffness, which is proven using ultrasound elastography (US). However, US is not readily available in the Philippines; hence, a scoring system, the FIB-4 index, may have a prognostic value in patient with heart failure. This study aimed to establish the utility of the FIB-4 index as an independent risk factor of mortality in heart failure patients.

METHODS: This was a prospective study that included heart failure patients diagnosed using the Framingham criteria and enrolled in the Philippine Heart Failure Registry. FIB-4 index was computed for each patient and classified as having minimal FIB-4 index (<1.45); moderate (1.46 to 3.25) or advanced (>3.25). Regression analysis was performed to determine the association of FIB-4 index to mortality rate.

RESULTS: Of the 523 patients included in the study, majority were males (59.27%), newly diagnosed with heart failure (54.50%) and had no previous hospitalization (44.9%). Paroxysmal nocturnal dyspnea (82.41%) was the most common major criteria and dyspnea on exertion (88.10%) was the most common minor criteria present. Most complained of dyspnea (59%) on admission. The most common primary etiology of heart failure was hypertensive heart disease (30%). Regression analysis showed a five-fold increased risk of mortality (p=0.0001, 95% CI 2.1–11.7) in patient with FIB-4 index value >3.25, which increased to a 14-fold increase in risk after adjustment for covariates (p=0.0001, 95% CI 3.4–55.63), compared with patients with minimal to moderate FIB-4 index value.

CONCLUSION: Chronic passive congestion of the liver from heart failure leads to liver stiffness and those patients with advanced FIB-4 index value have a 14 times higher risk of mortality compared to those with minimal to moderate FIB-4 index value.
Analisis Keputusan Memilih Bermain I ZONE di Tebing Tinggi Ditinjau Dari Harga dan Promosi
Authors: Fitrianingsih Fitrianingsih , Nublah Zulpianda , Puspitasari Devy Mawarnie 
Published: July 2024

The aim of this research are to analyze the effect of priceand promotion on the decision to choose.This research is quatitative with a research sample of 96 parents of consumers who choose to play at I Zone. Collecting data using a questionnaire with data analysis using SPSS. The results of the anakysis show that the price has no significant effect on the decision to choose, promotion has significant effect on the decision to choose, and the price and promotion simultaneously have a significant effect on the decision to choose.