bluuebunny/crossref_metadata_2025_split huggingface dataset:
OR55. Risk Factor For Mortality Of Patients Waiting For Elective Coronary Artery Bypass Graft Surgery
Authors: Perdana A , Sobirin M A , Nugroho Suhartono M A 
Published: April 2022

Abstract

Background and Aims
Insufficient capacity for cardiac surgery results in extensive waiting time of patients requiring coronary artery bypass grafting (CABG). Previous studies have reported a consequence of an increased risk of mortality while waiting for CABG. Identification of mortality rates and risk factors for mortality is important in patients waiting for CABG.

Methods and results
This retrospective cohort study was done on patients awaiting for elective CABG in dr. Kariadi General Hospital from January 2018 to December 2020. Identification of risk factors that associated with mortality was done on patients who were waiting CABG using logistic regression methods. There were 162 patients fulfilling the criteria, with a mean waiting time for an operation of 9.8 months. While waiting for CABG surgery, 32 (19.7%) patients died of any cause. Independent risk factors for death while waiting for CABG included : left ventricular ejection fraction &lt; 45% (OR 4.75; 95% CI 1.76-12.78; p = 0.002), left main disease (OR 4.12; 95% CI 1.50-11.27; p = 0.006), serum creatinin &gt; 1.5 mg/dl (OR 3.71; 95% CI 1.41-9.74; p = 0.008), and number of coronary artery disease risk factor &gt; 3 (OR 3.34; 95% CI 1.24-8.99; p = 0.017).

Conclusions
Long waiting lists for CABG is associated with high mortality rate which is influenced by left ventricular ejection fraction &lt; 45%, left main disease, serum creatinin &gt; 1.5 mg/dl, and number of coronary artery disease risk factor &gt; 3.
OR67. The Effects of Electric Cigarette Smoke and Conventional Cigarette Smoke Exposure on the Increase of Atherogenic Marker: Leptin Receptor (mRNA-ObR) and Aortic Calcification in Mice
Authors: Putri N L P D A , Wiryawan N , Aryadana W , Widiana I G R , Arijana I G K N , Dewangga I M S Y 
Published: April 2022

Abstract

Aims
The effect of e-cigarettes on atherosclerosis is still a matter of debate. One method that can be used as atherogenic process marker is the expression of Leptin receptors (mRNA-ObR) and aortic calcification. The aim of this study was to compare Leptin receptors (mRNA-ObR) expression and aortic calcification in mice exposed to conventional cigarettes and e-cigarettes.

Methods and Results
Thirty samples of mice were randomly divided into control group, conventional cigarette exposure group, and e-cigarette exposure group. After 2 months of treatment using a modified smoking chamber, a surgical procedure was performed to remove aortic tissue. This procedure was followed by histopathological examination to discover aortic calcification, and RT-PCR examination to see the expression of mRNA-ObR. The results of post hoc analysis showed that control group and conventional cigarette exposure group had differences in mRNA-ObR expression and aortic calcification [0.030 (0.090-0.046) fg/µl vs 0.332 (0.990-0.537) fg/µl, p = 0.000, in mRNA ObR; and 0.130 ± 0.719% vs 1.678 ± 0.696%, p = 0.000, in aortic calcification], as well as control group and e-cigarette exposure group [0.030 (0.090-0.046) fg/µl vs 0.376 (0.218-0.464) fg/µl, p = 0.000, in mRNA ObR and 0.130±0.719% vs 1.493±0.496%, p = 0.000, in aortic calcification]. Meanwhile, the group with e-cigarette exposure and group with conventional cigarette exposure didn’t show any differences [0.376 (0.218-0.464) fg/µl vs 0.332 (0.990-0.537) fg/µl, p = 0.568, in mRNA ObR and 1.493 ± 0.496% vs 1.678 ± 0.696%, p = 0.889, in aortic calcification].

Conclusion
There were no differences in Leptin receptor (mRNA-ObR) expression and aortic calcification in conventional cigarettes and e-cigarettes exposure groups.
OR73. The Relationship Between Echocardiographic Parameters and Chronotropic Incompetence in Patients with Cardiovascular Disease at Sanglah General Hospital, Bali
Authors: Jagannatha G N P , Pradnyana I W A S , Kamardi S , Yasmin A A A D A 
Published: April 2022

Abstract

Background and Aims
Patients with cardiovascular disease commonly have chronotropic incompetence which may be associated with cardiac remodelling and increased LV filling pressure. This study aimed to determine the association between echocardiography findings and chronotropic incompetence (CI) among patients with cardiovascular disease.

Method and Results
This was a cross-sectional study that included 136 medical records of patients with cardiovascular disease underwent treadmill stress test (TST) and echocardiography examination at outpatient cardiology clinic, Sanglah General Hospital from 2018 until 2020. Chronotropic incompetence was defined as maximum heart rate that can’t reach 85% age-predicted maximum heart rate. Data was analyzed using SPSS version 21. Mann-Whitney U test was used to evaluate the association between echocardiography findings such as ejection fraction (EF), left ventricular internal dimension end-diastolic (LVIDd), LVIDd index (LVIDdi), left ventricular mass, E/E’ ratio, left atrial volume index (LAVI) and CI. Among 136 subjects of this study, the mean age was 54.7 years, 71.3% were male and 37.5% were obese. Patients with CI were found to had lower LVIDd (42.8+0.89 vs 45.2+0.72, p = 0.029), lower LVIDi (24.6+0.37 vs 25.5+ 0.31, p = 0.025), higher left ventricular mass (175.6+3.27 vs 125.1+2.63, p &lt; 0.001), higher E/E’ ratio (17.3+0.29 vs 13+0.35, p &lt; 0.001), and higher LAVI (47+1.98 vs 31.6+1.09, p &lt; 0.001) compared with patients without CI.

Conclusion
Patients with cardiovascular disease commonly have chronotropic incompetence that could be detected by TST examination, which may be partly predicted by echocardiographic parameters that are associated with cardiac remodelling and increased LV filling pressure.
OR74. The relationship between hypertension and homocysteine level in patients with peripheral arterial disease in mataram city
Authors: Rialdi M A , Yanna I , Herpan S H , Catarina B 
Published: April 2022

Abstract

Aims
Peripheral arterial disease (PAD) is a disorder or narrowing of the peripheral arteries, especially in the lower extremities due to atherosclerosis. Hyperhomocysteinemia is an independent factor in the formation of atherosclerosis. Hypertension is associated with hyperhomocysteinemia and the incidence of atherosclerosis. Data regarding plasma homocysteine levels in PAP patients with hypertension are limited. Therefore, this study aimed to investigate the comparation between hypertension and plasma homocysteine levels in PAD patients in Mataram City.

Method and Result
This research is a cross sectional study conducted at Siti Hajar Islamic Hospital Mataram City. The number of samples in this study was 42 samples. The study sample was a PAP subject with hypertension and an ankle brachial index (ABI) score of &lt; 0.90. The results of this study were homocysteine levels in PAP patients with hypertension and PAP patients with non-hypertension. Analyze data using unpaired T test. Forty-two PAP patients participated in the study, with 32 samples (76.1%) female and average age 56.07 years. The average level of homocysteine in PAP patients with hypertension (6.13±0.56 μmol/L) was significantly higher than homocysteine levels in PAP patients with non-hypertension (5.18±1.14 μmol/L) (p = 0.002). Gender, age, DM history and ABI score are not associated with PAP and hypertension.

Conclusion
There were significant differences between average homocysteine levels in the PAP subject group with hypertension and non-hypertension.
OR79. Validation of EuroSCORE II, Ambler score and Harapan Kita Score as Predictor of In Hospital Mortality in Patients Underwent Heart Valve Surgery
Authors: Asmuni M , Soesanto A M , Kurniawati Y , Zahara R , Dwiputra B , Rossimarina V 
Published: April 2022

Abstract

Aims
Preoperative risk prediction models have important role in heart valve surgery management. Changing in patient characteristics and surgical facilities over time, might affect the predicting value of those scoring system. This study aimed to compare the validation of EuroSCORE II, Ambler score and Harapan Kita score in predicting in hospital mortality at patients underwent heart valve surgery

Methods
Cohort restrospective study was performed at 416 patients who underwent heart valve surgery from November 2018 to December 2019. Data was taken from the medical records by consecutive sampling method. The calibration and discrimination value of EuroSCORE II, Ambler score and Harapan Kita score were obtained.

Results
Observed in hospital mortality was 6.7%. EuroSCORE II, Ambler score and Harapan Kita score have good calibration (Hosmer-Lemeshow test p = 0.065, p = 0.233 and p = 0.314). The discriminative value of these three scores predicting in hospital mortality for EuroScore II AUC 0.763 (95% CI; 0.660-0.867), Ambler score AUC 0.748 (95% CI; 0.655-0.841) and Harapan Kita score AUC 0.694 (95% CI; 0.584-0.804)

Conclusion
EuroSCORE II, Ambler score and Harapan Kita score have fairly good validation. Those scoring system have good calibration with Harapan Kita score calibration relatively better than EuroSCORE and Ambler score, meanwhile Harapan Kita score has less discrimination value than EuroScore II and Ambler score.
M5. Effect of Macitentan on pulmonary vascular resistance index in patients with congenital heart disease-pulmonary arterial hypertension: a meta-analysis
Authors: Wijaya M P , Wijaya K M , Sutarmini S A N Y 
Published: April 2022

Abstract

Background and Aims
Macitentan is a novel dual endothelin receptor antagonist which proven effective as treatment in adults with pulmonary arterial hypertension.

Methods and Results
We performed a systematic search from inception until May 31, 2021, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines comparing PVRi baseline and after Macitentan 10mg and selected studies according to our pre-defined inclusion and exclusion criteria. Two reviewers extracted data into the predefined tables in the Microsoft Excel (Microsoft Corp., New Mexico, US) sheet. We used RevMan software to perform a meta-analysis and draw Forest plots. We used a random effects model to estimate risk ratios. A two-sided p-value of ≤ 0.05 was considered statistically significant. A total of three randomized control trials (RCTs) with 325 patients were included in our analysis. Macitentan 10mg a day showed moderately associated with lower PVRi compare with baseline value (SMD: -0.72) and statistically significant (p = 0.002; 95% CI=-1.18-(-0.25)).

Conclusion
Macitentan was developed by modifying the structure of Bosentan in order to increase the efficacy and safety. Macitentan has slower receptor dissociation kinetics and longer duration of action which allows once-daily dosing. The safety profile of Macitentan appears to be superior with respect to hepatic safety and edema than other therapy such as Bosentan and Ambrisentan, respectively. Macitentan is a promising drug to treat pulmonary hypertension which is well tolerated and associated with improvements.
M13. Stenting of right ventricular outflow tract as palliation for patient with right ventricular outflow tract obstruction with ventricular shunt physiology: a systematic review and meta-analysis
Authors: Ulfiarakhma D , Ardining H , Prakoso R 
Published: April 2022

Abstract

Aims
Right ventricular outflow tract (RVOT) stenting is emerging as an effective alternative to surgical palliation in selected patients. We aim to assess the outcome of RVOT stenting in patients suffered from RVOT obstruction with ventricular shunt physiology such as tetralogy of Fallot (ToF) and other type of lesions, also to compare its clinical outcomes with modified Blalock-Taussig shunt (mBTS) procedure.

Method and Results
A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. We systematically searched the relevant studies from date of inception to June 2021. Outcomes of interest were pulmonary artery (PA) growth and oxygen saturation after palliation. Eleven retrospective studies (384 patients) were included for qualitative analysis, and four studies (193 patients) were eligible for meta-analysis. From our study, RVOT stenting can be accomplished safely and effectively in severe cyanosis or high risk patients with ToF physiology. Right PA z-score and oxygen saturation post RVOT stenting was significantly higher compared with post mBTS (MD 0.50; 95% CI 0.06 – 0.93, p = 0.03 and MD 3.46; 95% CI 1.42 – 5.49, p = 0.0009 respectively). Our analysis shows no significant difference of left PA z-score after palliation between two groups (MD -0.05; 95% CI -0.89 – 0.79, p = 0.90).

Conclusion
RVOT stenting effectively improves oxygen saturation and promotes proper pulmonary artery growth in patients with ToF physiology. The larger and randomized-controlled studies are required to better evaluate the efficacy of RVOT stenting and its superiority compared to mBTS.
M17. The usefulness of brain natriuretic peptide measurement in pediatric patients with cardiovascular disease: a systematic review and meta-analysis
Authors: Ardining H , Ulfiarakhma D , Prakoso R 
Published: April 2022

Abstract

Background and Aims
The use of brain natriuretic peptide (BNP), a common cardiac biomarker, has traditionally been limited to adult populations for heart failure assessment. In children, less is known about the diagnostic value of BNP. Emerging evidence suggests they might be useful in diagnosis of children with cardiovascular disease. We aim to evaluate the use of BNP in children with cardiovascular disease.

Methods and Results
We performed a systematic review of literatures on online databases for studies evaluating level of BNP in children with cardiovascular disease from inception to July 26, 2021. A total number of 8 studies comprising 1304 patients were included in the meta-analysis. All articles included in the meta-analysis had high quality according to the GRADE approach. From our analysis, higher BNP was found in patients with congenital heart disease (CHD) compared with healthy subjects (SMD 2.88 [0.21-5.56], p = 0.03; I2 99%). Higher BNP was also found in children with heart failure (HF) compared with patients without HF (SMD 1.21 [0.73-1.69], p &lt; 0.0001; I2 0%), and higher in CHD patients with pulmonary hypertension (PH) compared with CHD patients without PH (SMD 1.76 [0.02-3.51], p = 0.05; I2 95%).

Conclusion
Significantly higher level of BNP was found in CHD patients, CHD-PH, and HF patients. Therefore, BNP measurement might be used for screening of CHD, PH in CHD populations and HF in pediatric populations. Further study is required to determine diagnostic accuracies and cut-offs within age groups.
C5. Acute limb ischemia in COVID-19 patient: a case report
Authors: Kristianti S , Lizarda A 
Published: April 2022

Abstract

Background
Spread of coronavirus has led to the coronavirus disease (COVID-19) pandemic and resulting in new challenges. COVID-19 can cause thrombotic complications such as acute limb ischemia (ALI). This complication may increase the risk of morbidity and mortality in COVID-19 patient. A high index of suspicion should be maintained for ALI in COVID-19 patient, which is a vascular emergency.

Case Description
A-53 year old male presented to the emergency department with acute left leg pain and shortness of breath since two days before admission. Physical examination revealed heart rate of 120x/min, blood pressure 130/100 mmHg, and oxygen saturation 96%. The patient had bilateral crackles on lung auscultation and absent left dorsalis pedis pulse. His left foot was discoloured, cold to the touch, and mottled in appearance. He had elevated D-dimer. Chest x-ray showed bilateral hazy infiltrates. COVID-19 was diagnosed on the basis of RT-PCR testing. He received antibiotic, antiviral, and enoxaparin. Unfortunately, he underwent amputation procedure.

Discussion
COVID-19 has been associated with systemic effects resulting in cardiovascular, hematologic, neurologic, immunologic, and renal complications. Arterial thrombosis is an important consideration in COVID-19 patient associated with systemic inflammatory response, hypercoagulable states, and endothelial injury. ALI can occur during in-hospital evolution of COVID-19 infection or they can be admitted to the hospital for this vascular condition with mild or no respiratory symptoms. Some patients are able to achieve revascularization with observation or medical and/or surgical intervention, but other patients succumb to either amputation or death.
C30. Clinical Decision Making in Intermediate Coronary Stenosis: Role of Fractional Flow Reserve
Authors: Kusnadi S , Nugraha M T 
Published: April 2022

Abstract

Background
Coronary stenosis can be managed by percutaneous coronary intervention (PCI). However, it has limitation by producing only 2D images of the actual 3D vascular lumen. It is necessary to assess the functional significance of stenosis with fractional flow reserve (FFR).

Case Summary
There are two patients in this case. The first patient was a 52-year-old man with typical chest pain, with a history of PCI in LAD 2 years earlier. Echocardiography revealed regional wall motion abnormality (RWMA) with reduced left ventricular ejection fraction (LVEF) of 30-40%. PCI with FFR guidance was performed. Previous stent in osteal-distal LAD was patent. In the distal LAD, a stenosis of 60-70% was obtained with FFR of 0.81. In distal LCX, 50-60% stenosis was also obtained with FFR of 0.91. No stent was implanted then. The second patient was a 59-year-old man with typical chest pain. The patient had been stented in proximal-mid LAD and LCX-OM a year earlier. Echocardiography showed RWMA with LVEF of 51-54%. LAD and LCX stents were patent. A 70-80% stenosis was found in both mid and distal RCA. FFR was done in the mid-RCA with result of 0.57, so stent was placed in the mid RCA. FFR at distal RCA was 0.31 so that the stent was also placed in the distal RCA. Both showed good results.

Discussion
Physiologic assessment is important before deciding to revascularize. FFR-guided PCI is expected to better guide us in managing intermediate coronary stenosis.
C38. Diagnosis and Management of Atrial Septal Defects (ASD) and Pulmonary Hypertension (PH) in Pregnancy
Authors: Sari Anna P , Krevani C K , Karani Y , Kino  
Published: April 2022

Abstract

Background
Atrial Septal Defect (ASD) is a congenital heart disease that is often found in adulthood, including women in pregnancy. Women with ASD are at greater risk for cardiovascular complications during pregnancy especially with Pulmonary Hypertension (PH), so comprehensive management is essential for this case.

Case Summary
A 31-year-old woman with gravida 32-33 weeks complaint of shortness of breath increasing since 3 days before entering the hospital with central cyanosis, clubbing finger, peripheral oxygen saturation 74%, from auscultation showed hardened P2 sound, indistinct wide fixed split, grade 3/6 systolic murmur. Echocardiography showed ASD with High Probability PH (Pulmonary Hypertension). The patient treated with furosemide 2x20 mg, sildenafil 3x12.5 mg, 3x20 mcg berraprost. The pregnancy was electively terminated with cesarean delivery and also got tubectomy. After 18 days of treatment in hospital, patient was discharged with stable and good condition. The patient was planned for right heart catheterization from outpatient clinic.

Discussion
Based on Guidline ESC on the management of Cardiovascular disease during Pregnancy in 2011, patients with ASD-PH are included in class IV WHO classification, where are contraindicated for pregnancy. If the pregnancy continues, recommended for patients to control regularly to the cardiologists and obstetricians during pregnancy, delivery and the puerperium.
From literature, cesarean delivery is recommended for pregnant women with Pulmonary Hypertension (including Eisenmenger's Syndrome). Special attention and comprehensive management are required for pregnant patients with ASD-PH. The choice of intervention method and some medical therapy in this patient must also be considered.
C49. Hybrid Procedure in A Patient with Multiple Aortic Dissections and Marfan Syndrome: A Case Report
Authors: Taofan T , Gill R S D , Wartono D A , Adiarto S 
Published: April 2022

Abstract

Background
Aortic dissection is a tear in the inner layer of the aortic wall, which allows blood to enter into the wall of the aorta, creating a new passage for blood, known as the false lumen. The indications for surgical approach in aortic dissections Stanford A and DeBakey I and II are widely recognised and accepted, but little is known that in certain cases of Stanford A, DeBakey type I or type II aortic dissection patients who meet the eligibility criteria, endovascular repair can be performed.

Case Illustration
A 36-year-old woman came with a chief complaint of acute stabbed pain, she was known to have Concomitant DeBakey type II and IIIb aortic dissection, severe aortic regurgitation, and Marfan Syndrome. Because of her condition, we decided to conduct an open surgical repair with Bentall Procedure that was planned to be followed by an elective thoracic endovascular aortic repair (TEVAR). The Bentall procedure was a success and the patient’s clinical condition improved each day.

Conclusion
In concomitant DeBakey type II and IIIb aortic dissection cases, especially in those who have an underlying condition such as Marfan Syndrome, the Bentall procedure is the treatment of choice. In conditions when surgical procedure cannot be done, a hybrid approach of open surgery and TEVAR may provide a valuable alternative for patients.
C55. Intramyocardial dissecting hematoma, a rare complication after myocardial infarction : a case report
Authors: Kaputrin N , Rahimah A F , Rizal A 
Published: April 2022

Abstract

Background
Intramyocardial dissecting hematoma (IDH) is a rare complication of myocardial infarction (MI) that contribute to high morbidity and mortality rate. There is scarce information in literature and hence management uncertainties. Additionally, coronary reperfusion results on the occurrence of IDH is still poorly understood.

Case Summary
A 49-year-old man with a previous anterior wall MI 3 months before without revascularization, presented with a recent onset of New York Heart Association (NYHA) functional class IV heart failure. Echocardiographic diagnosis of IDH was based on the presence of a neocavity with an endomyocardial border extending from the LV mid inferoseptal wall to the apical segments, corroborated with cardiac magnetic resonance (CMR). Coronary angiography showed severe three-vessel disease. The patient underwent staged complete revascularization and kept on optimal medical management. With non-surgical treatment, the patient remained clinically stable and showed a gradual improvement. Repeated echocardiography up to one year after the initial diagnosis demonstrated regression of the haematoma.

Discussion
An unusual form of myocardial rupture that can complicate acute myocardial infarction is IDH. The diagnosis can be missed in some cases. Transthoracic echocardiography may allow diagnosing and evaluating IDH at the bedside. Controversy exists regarding whether surgical repair or conservative treatment is the best option for this condition. The appropriate management should be individualized. Conservative treatment in clinically stable patients suffering from IDH following MI and coronary intervention can be a feasible option.