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Martha JW, Prameswari HS, Munita FF, Kusumawardhani NY, Hasan M, Astuti A, Mulyani NN, Agustina H, Sari MT. A multidisciplinary approach of a patient with pheochromocytoma presenting as recurrent acute fulminant myocarditis: A rare case report and comprehensive review of literature. Curr Probl Cardiol 2024; 49:102521. [PMID: 38492617 DOI: 10.1016/j.cpcardiol.2024.102521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/13/2024] [Indexed: 03/18/2024]
Abstract
Fulminant myocarditis (FM) is a rare illness characterized by abrupt and severe widespread cardiac inflammation, which frequently results in mortality due to cardiogenic shock, ventricular arrhythmias, or multiorgan system failure. Pheochromocytoma is an uncommon and difficult-to-diagnose cause of FM, and it is associated with a significant risk of recurrent acute myocarditis. There is, however, little information on reoccurring acute FM. Herein, we report a rare case of recurrent acute FM due to pheochromocytoma. We present the case of a 22-year-old woman who was admitted to our hospital three days previously with acute dyspnea. Five months prior, the patient was diagnosed with post-acute myocarditis, and a massive tumor on the right adrenal gland was discovered, which lead to pheochromocytoma diagnosis. In this present admission, following the exclusion of infection, autoimmune, and metabolic derangements, pheochromocytoma was presumed to be the reason for the recurrence and more severe acute FM during the current hospitalization. The patient responded favorably to high-dose steroids combined with heart failure therapy regimens. To detect recurrent acute myocarditis related to pheochromocytoma, a multidisciplinary approach was used, including several laboratory biomarkers and imaging findings. Following pheochromocytoma removal and biopsy, the patient recovered satisfactorily. Our findings may provide beneficial contributions to the literature as pheochromocytoma is an uncommon but important cause of recurrent acute myocarditis. A multidisciplinary approach is essential in identifying acute FM and determining the underlying causes of this malady.
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Affiliation(s)
- Januar Wibawa Martha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University-Dr Hasan Sadikin Hospital, Jalan Prof Eyckman 38, Bandung, West Java 40161, Indonesia.
| | - Hawani Sasmaya Prameswari
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University-Dr Hasan Sadikin Hospital, Jalan Prof Eyckman 38, Bandung, West Java 40161, Indonesia
| | - Fatihatul Firdaus Munita
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University-Dr Hasan Sadikin Hospital, Jalan Prof Eyckman 38, Bandung, West Java 40161, Indonesia
| | - Nuraini Yasmin Kusumawardhani
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University-Dr Hasan Sadikin Hospital, Jalan Prof Eyckman 38, Bandung, West Java 40161, Indonesia; Department of Internal Medicine, Faculty of Medicine, Padjadjaran University-Dr Hasan Sadikin Hospital, Bandung, West Java, Indonesia
| | - Melawati Hasan
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University-Dr Hasan Sadikin Hospital, Jalan Prof Eyckman 38, Bandung, West Java 40161, Indonesia
| | - Astri Astuti
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University-Dr Hasan Sadikin Hospital, Jalan Prof Eyckman 38, Bandung, West Java 40161, Indonesia
| | - Nanny Natalia Mulyani
- Department of Internal Medicine, Faculty of Medicine, Padjadjaran University-Dr Hasan Sadikin Hospital, Bandung, West Java, Indonesia
| | - Hasrayati Agustina
- Department of Pathological Anatomy, Faculty of Medicine, Padjadjaran University-Dr Hasan Sadikin Hospital, Bandung, West Java, Indonesia
| | - Minsy Titi Sari
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University-Dr Hasan Sadikin Hospital, Jalan Prof Eyckman 38, Bandung, West Java 40161, Indonesia
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Prameswari HS, Dewi TI, Hasan M, Martanto E, Astuti A, Saboe A, Cool CJ. Clinical Presentation and 6-Month Outcomes of Patients with Peripartum Cardiomyopathy in Indonesia. Int J Gen Med 2024; 17:1073-1083. [PMID: 38529099 PMCID: PMC10962360 DOI: 10.2147/ijgm.s447214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/28/2024] [Indexed: 03/27/2024] Open
Abstract
Background Due to the rarity of peripartum cardiomyopathy (PPCM) globally, baseline characteristic data for PPCM patients are still scarce. Therefore, this study aims to determine the baseline characteristics and 6-month outcomes of PPCM patients in Indonesia. Methods From January 2014 to December 2021, all PPCM patients aged ≥18 years who were admitted to Dr. Hasan Sadikin General Hospital in Bandung, Indonesia, participated in this single-center, prospective cohort study. All patients were re-evaluated within 6 months of PPCM diagnosis. Results A total of 138 patients with PPCM were admitted to Dr. Hasan Sadikin General Hospital in Bandung. The mean age of all patients was 30.4 ± 6.4 years old. Approximately 60% patients were multipara and had preeclampsia. All guideline-directed medical therapy for heart failure was received by most patients, excluding mineralocorticoid receptor antagonists (25.2%) and bromocriptine (14.1%). The neonatal mortality rate was 5.1%. Among those who survived, 61.2% had normal weight, 31.8% had low birth weight, and 7% had very low birth weight. At the 6-month follow-up, 6.7% of the patients died, 63.3% recovered, and 1.9% were rehospitalized. Conclusion The present study found a high incidence of PPCM in Indonesia. Our patients frequently had preeclampsia, which contributed to the higher rate of miscarriage and low birth weight. Our liberal use of beta-blockers and ACEi/ARB may have contributed to the higher 6-month recovery rate than that in other countries.
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Affiliation(s)
- Hawani Sasmaya Prameswari
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
| | - Triwedya Indra Dewi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
| | - Melawati Hasan
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
| | - Erwan Martanto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
| | - Astri Astuti
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
| | - Aninka Saboe
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
| | - Charlotte Johanna Cool
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
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Ng CT, Tan LL, Sohn IS, Gonzalez Bonilla H, Oka T, Yinchoncharoen T, Chang WT, Chong JH, Cruz Tan MK, Cruz RR, Astuti A, Agarwala V, Chien V, Youn JC, Tong J, Herrmann J. Advancing Cardio-Oncology in Asia. Korean Circ J 2023; 53:69-91. [PMID: 36792558 PMCID: PMC9932224 DOI: 10.4070/kcj.2022.0255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/25/2022] [Indexed: 11/25/2022] Open
Abstract
Cardio-oncology is an emerging multi-disciplinary field, which aims to reduce morbidity and mortality of cancer patients by preventing and managing cancer treatment-related cardiovascular toxicities. With the exponential growth in cancer and cardiovascular diseases in Asia, there is an emerging need for cardio-oncology awareness among physicians and country-specific cardio-oncology initiatives. In this state-of-the-art review, we sought to describe the burden of cancer and cardiovascular disease in Asia, a region with rich cultural and socio-economic diversity. From describing the uniqueness and challenges (such as socio-economic disparity, ethnical and racial diversity, and limited training opportunities) in establishing cardio-oncology in Asia, and outlining ways to overcome any barriers, this article aims to help advance the field of cardio-oncology in Asia.
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Affiliation(s)
- Choon Ta Ng
- Department of Cardiovascular Medicine, Mayo Clinic Rochester, Rochester, MN, USA
- Department of Cardiology, National Heart Centre Singapore, Singapore.
| | - Li Ling Tan
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Il Suk Sohn
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | | | - Toru Oka
- Onco-Cardiology Unit, Department of Internal Medicine, Saitama Cancer Center, Saitama, Japan
| | | | - Wei-Ting Chang
- Division of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Jun Hua Chong
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | | | - Rochelle Regina Cruz
- Department of Cardiology, Cardinal Santos Medical Center, Metro Manila, The Philippines
| | - Astri Astuti
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Vivek Agarwala
- Department of Medical Oncology and Haemato-Oncology, Narayana Superspeciality Hospital and Cancer Institute, Howrah, India
| | - Van Chien
- Department of Cardiology, National Heart Institute, Hanoi, Vietnam
| | - Jong-Chan Youn
- Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jieli Tong
- Department of Cardiology, Tan Tock Seng Hospital, Singapore
| | - Joerg Herrmann
- Department of Cardiovascular Medicine, Mayo Clinic Rochester, Rochester, MN, USA.
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Cool CJ, Fathini F, Adams I, Saboe A, Kusumawardhani NY, Astuti A, Yahya AF. Eisenmenger syndrome with left main compression syndrome: a case report. BMC Cardiovasc Disord 2022; 22:89. [PMID: 35247981 PMCID: PMC8898490 DOI: 10.1186/s12872-022-02524-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Left main coronary artery disease secondary to pulmonary artery compression related to Eisenmenger syndrome is an under-suspected condition that can cause fatal outcomes if left untreated. It presents with typical angina but is frequently mistaken for pulmonary hypertension (PH) symptoms. It is now recognized as one of the few important causes of angina in PH. Case presentation A 37-year-old man with a history of unoperated atrial septal defect and Eisenmenger syndrome came to the outpatient department with a chief complaint of angina on exertion. Electrocardiogram showed regular sinus rhythm with right axis deviation, right ventricular hypertrophy, deep T-wave inversion in inferior and anterior leads suggestive of ischemia or strain, and incomplete right bundle branch block. Cardiac CT showed compression of the left main coronary artery due to a dilated main pulmonary artery. Therefore, this patient was diagnosed with Eisenmenger syndrome with left main compression due to dilated pulmonary artery. He was treated successfully with IVUS-guided stent implantation. The patient experienced marked improvement in regular activities, with no recurrence of angina symptoms. Angiography 3 months after the procedure revealed good patency of the stent, without significant stenosis. Conclusions Left main coronary artery compression is a complication that should be suspected in patients with Eisenmenger syndrome presenting with angina symptoms. Non-invasive modalities are recommended for diagnostic evaluation, but the gold-standard technique remains coronary angiography. The best treatment is not well-established, with either myocardial revascularization or PH treatment, but a left main coronary artery stenting procedure is considered an ideal emergent treatment to provide a better quality of life for patients in this condition.
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Sumantra IG, Astuti A, Martanto E, Sihite TA, Maman Abdurahman R, Iqbal M, Rizki Akbar M, Martha JW. OR65. The Effect of Carvedilol on Subclinical Left Ventricular Dysfunction after Chemotherapy of FAC Regimen in Breast Cancer Patients : An Experimental Study. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartjsupp/suab122.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Breast cancer survivors potentially develop cardiotoxicity after FAC regiment administration. Carvedilol may provide antioxidant, antiapoptotic, and myocyte-calcium regulation effects in chemotherapy. This study aimed to evaluate cardioprotective effects of Carvedilol towards preventing subclinical left ventricular dysfunction (SLVD) in breast cancer patients following FAC chemotherapy.
Methods
The study was a prospective open-label and Quasi-Experimental. We divided the patients receiving the FAC chemotherapy from September 2018 until May 2019 into intervention (IG) and control groups (CG). The IG received Carvedilol 6.25 mg b.i.d. up titrated every three weeks until the tolerated dose. We evaluated the left ventricular GLS changes and the incidence of SLVD (GLS reduction ≥15% and GLS >-18%) at 24 weeks after the FAC regimen initiation.
Result
Eighty-one women were enrolled in the study; 31 of them were the IG. There were no significant GLS changes during and after FAC completion in the IG, while the CG showed contradictive. At the end of follow-up, the delta GLS reduction was lower in the IG 0.7 (95% CI – 0.60,3.60) than the CG 3.00 (95% CI – 2.16,4.19), p = 0.035. The GLS percentage reduction showed similar results with 3.6% and 14.29% in the IG and CG respectively with p = 0.05. The incidence rate of SLVD (GLS reduction ≥15% and GLS >-18%) in IG was lower; 41.9% and 25.8%, while in the CG was 58% and 48%.
Conclusion
Carvedilol may have a cardioprotective effect by preventing the GLS reduction and reducing the incidence of SLVD in women with breast cancer after a complete cycle of FAC regimen.
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Affiliation(s)
- I Gede Sumantra
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Indonesia; Departement of Surgical Oncology, Universitas Padjadjaran, Bandung, Indonesia
| | - Astri Astuti
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Indonesia; Departement of Surgical Oncology, Universitas Padjadjaran, Bandung, Indonesia
| | - Erwan Martanto
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Indonesia; Departement of Surgical Oncology, Universitas Padjadjaran, Bandung, Indonesia
| | - Teddy A Sihite
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Indonesia; Departement of Surgical Oncology, Universitas Padjadjaran, Bandung, Indonesia
| | - R Maman Abdurahman
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Indonesia; Departement of Surgical Oncology, Universitas Padjadjaran, Bandung, Indonesia
| | - Mohammad Iqbal
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Indonesia; Departement of Surgical Oncology, Universitas Padjadjaran, Bandung, Indonesia
| | - M Rizki Akbar
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Indonesia; Departement of Surgical Oncology, Universitas Padjadjaran, Bandung, Indonesia
| | - Januar W Martha
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Indonesia; Departement of Surgical Oncology, Universitas Padjadjaran, Bandung, Indonesia
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Astuti A, Kartamihardja AHA, Ilhamy MA, Fahlavi MD, Kusumawardhani NY, Hasan M, Hamijoyo L. Myocardial dissection complicating left sinus of Valsalva aneurysm in silent takayasu arteritis. BMC Cardiovasc Disord 2021; 21:464. [PMID: 34565345 PMCID: PMC8474797 DOI: 10.1186/s12872-021-02271-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 09/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myocardial dissection (MD) in a left sinus of Valsalva aneurysm (LSVA) is a rare condition that may lead to a fatal complication. Determining the MD etiology is challenging because of various possibilities ranging from congenital to acquired diseases. Here, we discuss an approach for determining the etiology of MD complicating LSVA in Takayasu arteritis (TA) and its treatment. CASE PRESENTATION A 41-year-old man presented with dyspnea on heavy activities and a history of consciousness loss at the age of 24 years. He was diagnosed with dilated cardiomyopathy and MD complicating LSVA in TA based on combined clinical and pathognomonic diagnostic criteria of TA evaluated using vascular Doppler and computed tomography angiography of the aorta. The patient refused to undergo surgery and received an optimal dose of chronic heart failure therapy, a high-dose steroid, and azathioprine. The patient experienced some improvements in clinical condition, functional outcome, and inflammatory markers at 1-year follow-up. CONCLUSIONS Clinical criteria and various imaging modalities may be used to determine the etiology of MD complicating LSVA in silent TA. As an alternative to surgery, the optimal medical treatment might result in a satisfactory outcome.
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Affiliation(s)
- Astri Astuti
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Jl. Pasteur no.38, Bandung, West Java, Indonesia.
| | - Achmad Hafiedz Azis Kartamihardja
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Jl. Pasteur no.38, Bandung, West Java, Indonesia
| | - Muhammad Adniel Ilhamy
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Jl. Pasteur no.38, Bandung, West Java, Indonesia
| | - Muhammad Dinnar Fahlavi
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Jl. Pasteur no.38, Bandung, West Java, Indonesia
| | - Nuraini Yasmin Kusumawardhani
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Jl. Pasteur no.38, Bandung, West Java, Indonesia
| | - Melawati Hasan
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Jl. Pasteur no.38, Bandung, West Java, Indonesia
| | - Laniyati Hamijoyo
- Division of Rheumatology, Department of Internal Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
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Astuti A, Erwinanto E, Akbar MR, Martanto E, Badudu DF. Global and Regional Longitudinal Strain Reduction in Breast Cancer Patients After First Chemotherapy Cycle With Fluorouracil, Adriamycin, and Cyclophosphamide Regimen. Cardiol Res 2021; 12:238-243. [PMID: 34349865 PMCID: PMC8297038 DOI: 10.14740/cr1229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/04/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Chemotherapy with fluorouracil, adriamycin, and cyclophosphamide (FAC) regimen in breast cancer patients may cause myocardial injury and necrosis, thereby attenuating global and regional longitudinal strain (GLS and RLS). It is unclear whether the first chemotherapy cycle would cause GLS and RLS reduction and which segment would be most affected by the chemotherapy. The purpose of the study was to investigate the effect of the first chemotherapy cycle on GLS and RLS reduction. METHODS This was a prospective single-center cohort study of patients with breast cancer who underwent the first chemotherapy cycle with a FAC regiment. The GLS and RLS were measured using speckle tracking echocardiography and left ventricular ejection fraction (LVEF) measured with Simpson's biplane. The echocardiography was performed before and 3 weeks after the first chemotherapy cycle. We compared the value of GLS, RLS, and LVEF before and after chemotherapy using paired t-test analysis. RESULTS Thirty-six breast cancer patients were enrolled in the study. The GLS and RLS were reduced significantly at 3 weeks compared to baseline. The RLS of the basal anteroseptal, basal anterolateral, mid anterolateral, mid inferolateral, and all apical segments declined significantly from baseline. The largest RLS decline was detected in the apicoanterior segment. The post-chemotherapy GLS but not LVEF was significantly lower than that before treatment. CONCLUSION The GLS and RLS of patients who underwent first cycle chemotherapy with FAC declined significantly than that before treatment, especially at the apicoanterior segment. LVEF was not altered after first cycle chemotherapy.
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Affiliation(s)
- Astri Astuti
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Jl. Pasteur No. 38, Bandung 40161, Indonesia
| | - Erwinanto Erwinanto
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Jl. Pasteur No. 38, Bandung 40161, Indonesia
| | - Muhammad Rizki Akbar
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Jl. Pasteur No. 38, Bandung 40161, Indonesia
| | - Erwan Martanto
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Jl. Pasteur No. 38, Bandung 40161, Indonesia
| | - Dharmayanti Fransisca Badudu
- Department of Surgery, Oncology Division, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Dr. Hasan Sadikin General Hospital, Jl. Pasteur No. 38, Bandung 40161, Indonesia
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Wibowo A, Pranata R, Astuti A, Tiksnadi BB, Martanto E, Martha JW, Purnomowati A, Akbar MR. Left and right ventricular longitudinal strains are associated with poor outcome in COVID-19: a systematic review and meta-analysis. J Intensive Care 2021; 9:9. [PMID: 33436101 PMCID: PMC7802997 DOI: 10.1186/s40560-020-00519-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/25/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis aimed to assess whether ventricular longitudinal strain can be used as a prognostication tool in patients with coronavirus disease 2019 (COVID-19). METHODS Systematic literature searches of PubMed, Embase, and EuropePMC databases were performed on 16 November 2020. Left ventricular global longitudinal strain (LV-GLS) refers to LV contraction measurement using the speckle tracking-based method refers to the mean of strain values of the RV free wall (three segments) measured using echocardiography. The main outcome was poor outcome, defined as a composite of mortality and severe COVID-19. RESULTS Seven studies comprising of 612 patients were included in meta-analysis. Six studies have mortality as their outcome, and 1 study has severity as their outcome. Patients with poor outcome have lower LV-GLS (SMD 1.15 (0.57, 1.72), p < 0.001; I2 70.4%). Each 1% decrease in LV-GLS was associated with 1.4x increased risk of poor outcome (OR 1.37 (1.12, 1.67), p = 0.002; I2 48.8%). Patients with poor outcome have lower RV-LS (SMD 1.18 (0.91, 1.45), p < 0.001; I2 0%). Each 1% decrease in RV-LS was associated with 1.3x increased risk of poor outcome (OR 1.25 (1.15, 1.35), p < 0.001; I2 11.8%). Subgroup analysis showed that for every 1% decrease in LV-GLS and RV-LS is increased mortality with OR of 1.30 (1.12, 1.50) and OR of 1.24 (1.14, 1.35), respectively. CONCLUSION This study shows that lower LV-GLS and RV-LS measurements were associated with poor outcome in patients with COVID-19. TRIAL REGISTRATION PROSPERO CRD42020221144.
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Affiliation(s)
- Arief Wibowo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Jalan Professor Eyckman No.38, Pasteur, Bandung, Jawa Barat 40161 Indonesia
| | - Raymond Pranata
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Jalan Professor Eyckman No.38, Pasteur, Bandung, Jawa Barat 40161 Indonesia
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Astri Astuti
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Jalan Professor Eyckman No.38, Pasteur, Bandung, Jawa Barat 40161 Indonesia
| | - Badai Bhatara Tiksnadi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Jalan Professor Eyckman No.38, Pasteur, Bandung, Jawa Barat 40161 Indonesia
| | - Erwan Martanto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Jalan Professor Eyckman No.38, Pasteur, Bandung, Jawa Barat 40161 Indonesia
| | - Januar Wibawa Martha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Jalan Professor Eyckman No.38, Pasteur, Bandung, Jawa Barat 40161 Indonesia
| | - Augustine Purnomowati
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Jalan Professor Eyckman No.38, Pasteur, Bandung, Jawa Barat 40161 Indonesia
| | - Mohammad Rizki Akbar
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Jalan Professor Eyckman No.38, Pasteur, Bandung, Jawa Barat 40161 Indonesia
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Iqbal M, Victory V, Astuti A, Febrianora M, Karwiky G, Achmad C, Akbar MR. Cardiotoxicity by Anthracycline Regimen Chemotherapy Prolonged T Peak to T End Interval. Cardiol Res 2020; 11:305-310. [PMID: 32849965 PMCID: PMC7430896 DOI: 10.14740/cr1052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/12/2020] [Indexed: 11/21/2022] Open
Abstract
Background Myocardial necrosis may occur due to anthracycline (doxorubicin/adriamycin) chemotherapy usage. Furthermore, myocardial necrosis can affect the heterogeneity of heart conduction system and lead to repolarization abnormalities. The aim of this study was to investigate the effect of cardiotoxicity caused by anthracycline to repolarization abnormalities measured by T peak to T end (TpTe) interval. Methods This was a single center prospective cohort study with linear regression from October 2018 to May 2019. The subjects of the study were breast cancer patients after completing administration of chemotherapy with fluorouracil, adriamycin and cyclophosphamide (FAC) regimen (containing anthracycline) for 6 months. Myocardial necrosis was assessed by high sensitive (hs)-troponin I, and the heterogeneity of repolarization was measured by TpTe interval. Results This study involved 25 breast cancer patients after chemotherapy in the 6-month FAC regimen. The mean age is 46 ± 7 years, and the cumulative dose of anthracycline is 591 ± 52 mg/m2. The mean level of hs-troponin I is 90.5 ± 44.7 ng/L and the TpTe interval is 108.2 ± 10 ms. The results of linear regression analysis showed a positive correlation between hs-troponin I and TpTe interval (r: 0.421, P: 0.036) after controlling for one confounding variable (cumulative dose of anthracycline). Conclusions Cardiotoxicity caused by accumulative dose of anthracycline may lead to myocardial necrosis which was shown by elevated hs-troponin I levels. This process may lead to heterogeneity conduction system that affect the repolarization phase of cardiac cycle which was shown by increased TpTe interval.
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Affiliation(s)
- Mohammad Iqbal
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Jalan Eyckman 38, Bandung 40161, Indonesia
| | - Viky Victory
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Jalan Eyckman 38, Bandung 40161, Indonesia
| | - Astri Astuti
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Jalan Eyckman 38, Bandung 40161, Indonesia
| | - Mega Febrianora
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Jalan Eyckman 38, Bandung 40161, Indonesia
| | - Giky Karwiky
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Jalan Eyckman 38, Bandung 40161, Indonesia
| | - Chaerul Achmad
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Jalan Eyckman 38, Bandung 40161, Indonesia
| | - Mohammad Rizki Akbar
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Jalan Eyckman 38, Bandung 40161, Indonesia
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Priyadarshini R, Hamzah A, Astuti A. Growth performance and biomass production of Eleusine indica and Rorippa sylvestris on heavy metal contaminated soil after biochar application. J Degrade Min Land Manage 2020. [DOI: 10.15243/jdmlm.2020.074.2287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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