bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reversible myocardial ischaemia caused by ectopic left circumflex coronary artery: a case report
Authors: Sillanmäki Saara , Istomina Maria , Husso Annastiina , Hedman Marja 
Published: April 2022

Abstract

Background
Coronary artery anomalies (CAAs) are congenital disorders associated with variable manifestations and pathophysiological mechanisms. Anomalies can be asymptomatic or cause chest pain, myocardial infarction, or even sudden cardiac death.

Case summary
We describe a 34-year-old man with a history of a single episode of chest pain. An ectopic origin on the part of the left circumflex (LCX) coronary artery from the proximal right coronary artery (RCA) was evident upon coronary computed tomography angiography. A positron emission tomography perfusion study revealed a stress-induced perfusion defect in the anomalous LCX territory (infero-posterior wall). The patient experienced dyspnoea and ST-segment depression in electrocardiography, suggestive of myocardial ischaemia during the maximal bicycle ergometer stress test. No mechanical compression or stenosis was seen upon invasive coronary angiography. The left ventricular perfusion normalized after the initiation of beta-blocker medication.

Discussion
Patients with CAAs especially benefit from a multimodality assessment of the vascular territories. In our case, the myocardial perfusion of the infero-posterior wall normalized after treatment with beta-blockers. This may be due to increased coronary vasodilation capacity and myocardial flow reserve, as well as reduced oxygen consumption. Beta-blockers may represent a viable option in low-symptomatic CAA patients with perfusion defect and no ostial stenosis or compression.
OR3. Admission blood glucose and ischemic time are associated with successful fibrinolysis in combined assessment of ST-segment resolution, myocardial infarction flow grade, and myocardial perfusion grade
Authors: Rusnanta F , Rohman M Saifur , Prasetya I , Rizal A , Kurnianingsih N 
Published: April 2022

Abstract

Background and Aims
Fibrinolytic therapy (FT) is the alternative recommendation in patients with ST-segment elevation myocardial infarction (STEMI) if primary percutaneous coronary intervention (PCI) could not be perfomed timely at initial presentation. Successful revascularization of occluded infarct-related coronary arteries depends on complex mechanisms of hemodynamic, clinical, biochemical, and mechanical parameters. This study aimed to find out predictors of complete reperfusion after FT based on Thrombolysis in Myocardial Infarction (TIMI) 3 flow, Myocardial Blush Grade (MBG) 3, and ST-segment resolution.

Method and Results
This retrospective study was held in Saiful Anwar, Malang Hospital during 2017-2021, including total of 142 patients. All patients received FT and coronary angiographic evaluation post-FT. Those were divided into 3 groups, which included R0,1 (0/1 highest measure of reperfusion), R2 (2 highest measures of reperfusion), and R3 (3 highest measures of reperfusion). Admission blood glucose (ABG) (OR 0.99 [95%CI -0.16;-0.001]; p = 0.025), ischemic time (OR 0.82 [95%CI -0.491;-0.137]; p = 0.001), and triglycerides (OR 0.98 [95%CI 0.23;-0.006]; p = 0.001) were negatively correlated to the complete restoration of reperfusion (R3). ABG&lt;140 mg/dL (AUC 0.701 [95%CI 0.612-0.790]; p = 0.000) and ischemic time&lt;5 hours (AUC 0.742 [95%CI 0.645-0.839]; p = 0.000) were significant predictors for R ≥ 2. Coronary characteristics were not related to measure of reperfusion (p = 0.25).

Conclusion
ABG&lt;140 mg/dL and ischemic time&lt;5 hours are important predictors of successful reperfusion post FT (R ≥ 2), along with triglycerides. Early assessment of patients who are likely to have low parameter reperfusion (R &lt; 2) would help promptly preparing for primary PCI.
OR7. Validation study: Association between aortoseptal angulation on echocardiography with the origin of outflow tract ventricular arrhythmias
Authors: Saputra Charles , Raharjo Sunu Budhi , Kuncoro Ario Soeryo , Soesanto Amiliana Mardiani , Rudiktyo Estu , Hermanto Dony Yugo , Yuniadi Yoga , Hanafy Dicky Armein , Ariani Rina 
Published: April 2022

Abstract

Background
Radiofrequency ablation (RFA) has become therapeutic modality with high success rate for outflow tract ventricular arrhythmia (OTVA). Determining the origin of OTVA before ablation is important to choose the appropriate approach, avoiding multiple complications, and saving fluoroscopy time. ECG-based criteria is a method that has been widely used to predict the origin of OTVA, but it oftenly has inconsistent diagnostic value. Previous study showed that aortoseptal angulation by echocardiography might be beneficial to predict the origin of OTVA. We need to validate the result in a prospective manner.

Objective
To validate the association between aortoseptal angulation measurements by echocardiography and OTVA origin.

Methods
A validation of diagnostic study involving patients VTs/PVCs with the ECG’s morphology of LBBB and inferior axis who underwent RFA therapy. An echocardiography examination was held before RFA therapy. Aortoseptal angulation is measured on parasternal long axis (PLAX)view to measure the angle between the aortic root and interventricular septum. The origin of OTVA was determined by mapping during RFA.

Results
There were 41 subjects with a mean age of 44.7±12.6 years. Majority of subjects were patients with right OTVA (n = 34, 82.9%). The mean aortoseptal angulation of the left OTVA 127.2±2.8 was significantly smaller than the right OTVA 136.7±5.7(p &lt; 0.001). An angle below 129.2o has 71.4% sensitivity and 85.29% specificity to predict an LVOT origin.

Conclusion
This validation study proved that aortoseptal angulation measurement by echocardiography &lt;129,2o is a valid diagnostic tool to differentiate left OTVA origin with OR 10,1.
OR8. Appropriateness of percutaneous coronary intervention procedure in Indonesia
Authors: Hadisoemarto P F , Tarsidin N F , Ariska L , Wandira R D , Tiksnadi B B , Masytoh L S , Dany F , Sastroasmoro S 
Published: April 2022

Abstract

Background and Aims
There is a possibility of the high variability of the appropriateness of PCI performed in Indonesia. It is assumed that appropriate PCI tends to have clinical outcomes than other categories. This study aimed to evaluate the appropriateness of the percutaneous coronary intervention (PCI) procedure in Indonesia.

Method and Results
We assigned appropriateness ratings to 214 acute coronary syndromes (ACS) and 191 stable ischemic heart disease (SIHD) records that underwent PCI in four hospitals from 2017 - 2018. The included hospitals consist of one public and three private hospitals, two cardiovascular centers, and two general hospitals with the most performed PCI procedures on 2016 - 2018 and accessible to the researchers. The PCI appropriateness was adjudicated using 2016/2017 ACC/AHA guidelines of the Appropriate Use of Care (AUC) for coronary revascularization in ACS and SIHD. The results were categorized into “appropriate”, “maybe appropriate”, and “rarely appropriate”.
The result from this study demonstrated that in ACS patients, 76.0% and 24.0% of PCI were appropriate” and “maybe appropriate”. While, in SHID patients, 68.7%, 28.7%, and 2.6% of PCI were “appropriate”, “maybe appropriate”, and “rarely appropriate”. In ACS patients, “appropriate” PCI is more commonly found in ST-elevation myocardial infarction (STEMI) cases (62.6%). In SIHD patients, 54.0% and 46.0% of left-main diseases patients underwent “maybe appropriate” and “rarely appropriate” PCI.

Conclusion
The majority of PCI performed in ACS and SIHD patients from the studied hospitals are “appropriate”.
OR15. Cell Surface Markers on Adipose-Derived Mesenchymal Stem Cells: Isolation, Culture, and Identification for Translational Success
Authors: Sativa Oryza , Nugraha Ricardo Adrian , Arjani Kandita , Hasan Muhammad Rifqi Djamal , Pikir Budi Susetyo , Dharmadjati Budi Baktijasa , Oktaviono Yudi Her 
Published: April 2022

Abstract

Aims
The purpose of this study is determining that each part of adipose tissue will generate stem cells with similar adipose-derived mesenchymal stem cells (AMSCs) characteristic and specific cell-surface markers, thus there is no waster product of part adipose tissue in regenerative medicine.

Methods
An invitro experimental study, used approximately 20 grams of human subcutaneous adipose tissue were isolated and processed, until stromal vascular factor (SVF) and creamy supernatant separated. Both substances then divided into single filtration group and double filtration group consecutively. Each group and control group were sextuplicate before further analysis using immunocytochemistry. Single and double filter of AMSCs were applied to the subsequent experiments. AMSCs were observed under a microscope, the growth curves of the cells were assessed using a cell counting kit‑8 assay and the membrane expression of cell surface antigens, including cluster of differentiation (CD) 34, CD45, CD90, and CD105 were detected by immunocytochemistry.

Results
Flow cytometry demonstrated that the cells were highly positive for fourth cell surface markers. CD34 and CD45 expressions were detected in control group, and gradually decreased among another groups whereas lack of CD45 expression were consistent on other remaining groups. The expression of CD90 and CD105 were visibly increased significantly from control group to fourth group.

Conclusion
This study demonstrated that either SVF and/or supernatant generates fibroblastic-like cells and surface markers expression that matched the MSCs criteria. Therefore, all parts of adipose tissue are an appealing alternative of stem cell source regardless of culture method chosen.
OR18. Combination of ramiprilat and human umbilical cord blood-mesenchymal stem cells derived secretome increase endothelial progenitor cells migration
Authors: Isaridha I A , Oktaviono Y H , Lefi A , Sandra F , Subagjo A 
Published: April 2022

Abstract

Background and Aims
Stem cells therapy has been studied in the cardiovascular field, but the limitations in terms of survival and risk of rejection make cell-free therapy with secretome worth considering. This study aims to identify the effect of human umbilical cord blood mesenchymal stem cells (hUCB-MSCs) derived secretome, ramiprilat, and combination of both on endothelial progenitor cells (EPCs) migration.

Methods and Results
EPCs were collected from mononuclear cells (MNCs) of the peripheral blood of chronic coronary syndrome patient using density gradient centrifugation method, then cultured in Stemline II medium (Sigma Aldrich, USA). Secretom was made by taking the supernatant from the hUCB-MSCs cell line culture media that had been centrifuged. Cultured EPCs was divided into control group, treatment with 10 µmol Ramiprilat, various concentrations of hUCB-MSCs-derived secretome (2%, 10%, and 20%) and combination of 10 µmol Ramiprilat and each concentration of secretome. EPCs migration was assessed using Boyden chamber assay. Results showed that ramiprilat and all doses of secretome increased EPCs migration compared to the control group (p &lt; 0.001). Secretome 20% had higher EPCs migration than ramiprilat (51.00±5.15 vs 33.80±2.49, p &lt; 0.001), and the combination of ramiprilat and secretome 20% showed the highest number of migrated EPCs among all groups.

Conclusion
hUCB-MSCs-derived secretome and ramiprilat increase EPCs migration. The combination of those two substances furtherly increased the migrated cells. hUCB-MSCs-derived secretome has the potential as a cell-free cardiovascular treatment for coronary artery disease patients.
OR19. Correlation between Circadian Variation of Idiopathic Ventricular Arrhytmia and Left Ventricular Intrinsic Systolic Function assessed by Speckle Tracking Echocardiography
Authors: Nugroho Bhayu Hanggadhi , Raharjo Sunu Budhi , Andriantoro Hananto , Lelya Olfi , Dwiputra Bambang , Sukmawan Renan 
Published: April 2022

Abstract

Aims
To investigate the correlation between circadian variation of idiopathic ventricular arrhytmia (IVA) and left ventricular (LV) intrinsic systolic function.

Methods
This cross sectional study included 67 patients with IVA originated from ventricular outflow tract. All patients underwent 24-hour Holter monitoring and speckle tracking echocardiography examinations. The circadian variation of IVA burden and global longitudinal strain (GLS) were determined and statistical analysis was conducted to evaluate their correlation.

Results
A total 31 patients (46.3%) had impaired LV systolic function by GLS (-15.1% + 1.8% vs -21.3% + 2.0%; p = &lt;0.001) with less variation in circadian PVC distribution (coefficient of variation 6 hourly 26.8% + 15.6 vs 52.0 % + 28.2%; p = &lt;0.00). Impaired LV systolic function was found in 31 patients (46.3%) with less variation in circadian IVA distribution (coefficient of variation/CoV 6 hourly 26.8%+15.6) compared to patients with normal LV systolic function (CoV: 52.0%+28.2%; p = &lt;0.001). Multivariate analysis showed that less variation in circadian PVC distribution [CoV&lt;35%) is correlated with LV dysfunction (OR = 3.89, 95%CI 1.09-13.80, p = 0.036). Other independent factors were episode of non-sustained VT (OR = 14.4, 95%CI=2.36-88.55, p = 0.008), IVA burden &gt;9% (OR = 6.81, 95%CI 1.35-34.41, p = 0.020), and male gender (OR = 14.4, CI 95%=2.02-101.1, p = 0.004).

Conclusion
This study is the first to show that lack of circadian variation of IVA is associated with impaired LV systolic function by GLS. The finding of this study suggested that chronotherapy of antiarrhytmia medication may prevent the development of LV dysfunction.
OR22. Correlation Between the New York Heart Association Functional Class with depression in Heart Failure patients: A Cross sectional study
Authors: Arifin Y , Saifur Rohman M , Tjahjono C T , Sargowo D , Rahimah A F 
Published: April 2022

Abstract

Background
The prevalence of heart failure (HF) continues to increase and presents as one of the most financially burdensome diseases. The prevalence of depression in HF patients was higher than in general populations. Depression was known to increase the rehospitalization, cost, and mortality of HF patients. This study aimed to find the correlation between the New York Heart Association (NYHA) Functional Class in HF patients with the incidence of depression.

Method and Result
This cross-sectional study recruited 342 patients diagnosed with HF previously for more than 3 months at Dr. Saiful Anwar General Hospital from December 2016 to March 2021. Each patient was interviewed for their demographic and clinical data and assessed for depression with Montgomery-Asberg Depression Rating Scale Indonesian version. We used Spearman coefficients to evaluate the correlations between variables. Patients were predominantly male with ACE-i/ARB and beta-blockers treatment. Age ranged from 22 to 87 years old. The median baseline of the left ventricular ejection fraction (LVEF) was 52 (42-60) %. Baseline characteristics among the depression and non-depression groups demonstrated no significant difference (p &gt; 0.05). There were significant correlations between NYHA Class and marital status (p &lt; 0.05) with depression. We performed log regression for the confounding. The result was NYHA Class significantly with depression and NYHA Class also have effects on the depression.

Conclusion
In HF patients, NYHA Class was significantly correlated with depression.
OR23. Correlation of Right Ventricular Systolic Function by Right Ventricular Global Longitudinal Strain in Rheumatic Mitral Stenosis compared to Mitral Regurgitation before and after Intervention
Authors: Kesumawardani E S , Ketaren A P , Ardini T W , Akbar N Z , Hasan H 
Published: April 2022

Abstract

Background and Aims
Right ventricle systolic dysfunction develop prior to the onset of clinical systemic congestion; thus, early detection is beneficial for both diagnostic and therapeutic value. We aim to asses changes of Right Ventricular Global Longitudinal Strain (RVGLS) in rheumatic mitral valve disease, and assess correlation between Right Ventricular Systolic Pressure (RVSP) and RVGLS before and after intervention.

Methods and Results
Our study consisted of 21 patients with an established diagnosis of significant MS or MR and normal RV function, who were admitted for either Balloon Mitral Valvulotomy (BMV) or Mitral Valve Replacement (MVR). 2D echocardiography and measurement of RVGLS was obtained from RV-focused A4CH view. Patients were divided into 2 groups: (1) significant MS consists of 11 patients, (2) significant MR consists of 10 patients. Prior to intervention, MS group had significantly lower RVGLS compared to MR group (-11.64 vs. -18.29; p = 0.001). After MVR, the RVGLS of MS group was significantly increased compared to MR group (MS -11.64 to -15.59, p = 0.001 vs. MR -18.29 to -19.39, p = 0.069). Both MS and MR groups showed significant negative correlation between RVSP and RVGLS before and after intervention (r=-0.642; p = 0.002; r=-0.670; p = 0.001).

Conclusion
Pre-intervention with a background normal RV function, RVGLS was impaired significantly in MS group compared to MR group. Post intervention RVGLS improved significantly in MS group compared to MR group. Both groups showed significant negative correlation between RVSP and RVGLS before and after intervention.
OR26. Dedifferentiated Fat Cells versus Adipose Derived Mesenchymal Stem Cells Experimental Study about Adipose-derived Stem Cells for Cardiomyocyte Precursor using Traditional and Insert Culture
Authors: Sativa O , Nugraha R A , Pikir B S , Dharmadjati B B , Oktaviono Y O 
Published: April 2022

Abstract

Background and Aims
The discovery of dedifferentiated fat cell (DFAT) raises the question, are AMSC and DFAT the same type of mesenchymal stem cell (MSC)? We aim to analyze the immunocytochemistry (ICC) profile of both cells and the correlation between different methods with different passage to GATA-4 and cTnT expression in vitro.

Methods and Results
Human subcutaneous-fat tissue was isolated and divided into, first group, using single filtration by 100 µm cell strainer and second group using double filtration with addition of 70 µm strainer after the 100 µm. Cell obtained from both groups were labeled AMSC and DFAT respectively. Prior to passaging, CD34, CD45, CD90, and CD105 were analyze by ICC. After passaging, passage 1 and 4 was exposed to Gibco PSC Cardiomyocyte Differentiation Kit for 21 days. Colonies from days 7, -14, and -21 were analyze by ICC for GATA-4 and cTnT expression. Post hoc analysis shown that there is no significance difference in MSC markers expression between groups. There were significance differences in GATA-4 expression on all observation days, which decreased significantly from the 14th to the 21st day. Statistic significancy also found on cTnT expression, with a significant increase from day 14 to day 21. The filter variable consistently has a significant effect on the quantity of GATA-4 and cTnT expressions.

Conclusion
The study shows that different culture methods, presumably the use of filters, will have a significant effect on the differentiation of AMSC and DFAT into cardiomyocytes.
OR27. Depression, Anxiety, and Stress in Chronic Heart Failure patient
Authors: Rafidhinar R , Pramudyo M 
Published: April 2022

Abstract

Background
Heart failure is a progressive health problem with high mortality and morbidity rates, associated with a significant reduction in the quality of life (QoL)1,2,3. Heart failure greatly affects the physiological condition of the patient, such as depression, anxiety, and stress4,5. This study aimed to determine the prevalence of depression, anxiety, and stress symptoms in chronic heart failure patients.

Method & Results
A descriptive study was conducted from outpatients at the Heart Failure Clinic at Hasan Sadikin Hospital Bandung in June 2021, which screened for Depression, Anxiety, and/or Stress using the Depression, Anxiety, Stress Scale-21 (DASS-21) questionnaire. The descriptive analysis of this study showed several patients had depression and anxiety following chronic heart failure. This study comprised 20 patients consisting of female (45%), and male (55%). 7 patients (35%) had psychological problems (Depression, Anxiety, and/or stress). 4 patients (20%) had depression symptoms, which consists of 3 patients (80%) had mild depression and 1 patient (20%) had moderate depression. 6 patients (30%) had anxiety symptoms, 4 patients (80%) diagnosed with mild anxiety and 2 patients (20%) diagnosed with moderate anxiety. And there were no patients classified with stress.

Discussion
Based on these findings, patients with chronic heart failure were prone to have psychological problems such as depression and anxiety. We recommend the screening should be routinely performed, with appropriate referral pathways to psychiatrists. Further research is needed to improve detection and develop effective treatments for these disorders in HF patients.
OR33. Elevated d-dimer in predicting all-cause in-hospital mortality of coronavirus disease 2019 in kediri general hospital
Authors: Niazta N A , Nisa N K , Nuraini P E , Sulistyono W , Prasetyo S U , Haq M D K 
Published: April 2022

Abstract

Aims
COVID-19 has infected the world on a wide spectrum, from mild to severe and causing death. As of January 1st 2021, global case fatality rate (CFR) was 2.2 % due to COVID-19. CFR in Kediri district is 7.7 %, higher than Nasional CFR which is only 3 %. A huge number of COVID-19 patients who had increased D-dimer level. This study aimed to determine the association of D-dimer with all-cause in-hospital mortality in COVID-19 patients.

Method and Result
This was a retrospective single center cross sectional study. A total of 185 COVID-19 patients aged &gt;18 years old and confirmed positive by RT-PCR were hospitalized at Kediri General Hospital since March to December 2020 met the inclusion criteria. Pregnant women and patients with incomplete records were excluded. In our research, optimal cut off point D-dimer was 2.5 µg/ml. The association of predictive factors for all-cause in-hospital mortality. Data were analysed by Chi-square and followed by logistic regression backward LR method. During hospitalization, 45 patients (24.3%) were died. Elevated D-dimer ≥ 2.5 µg/ml was statistically significant associated with all-cause in-hospital mortality (adjusted OR 95%CI = 3.46 [1.41 – 8.49], p = 0.007), with a sensitivity of 82.1% and a specificity of 42.2% (AUC, 0.628; 95% CI, 0.527 – 0.728).

Conclusion
Elevated D-dimer level were associated statistically significant with all-cause in-hospital mortality. In our study, optimal cut of point D-dimer value was 2.5 µg/ml.