Indeks Massa Ventrikel Kiri dengan Disfungsi Diastole pada Pasien Konsentrik Penyakit Jantung Hipertensi

Chaerul Achmad, Erwan Martanto, Toni Mustahsani Aprami, Augustine Purnomowati, R. Reni Farenia Soedjana Ningrat, Mega Febrianora

Abstract


Hipertrofi ventrikel kiri ditunjukkan secara objektif dengan peningkatan indeks massa ventrikel kiri (IMVK). Peningkatan massa ventrikel kiri dan dilatasi jantung ruang adalah parameter untuk penyakit jantung hipertensi (PJH). Remodeling jantung ini mengubah fungsi jantung yang mengakibatkan disfungsi diastolik. Penelitian ini bertujuan menemukan korelasi antara IMVK dan disfungsi diastolik pada pasien PJH konsentrik. Terdapat 49 pasien PJH konsentrik. Dari 49 pasien, 43 pasien dilibatkan, 15 laki-laki (35%) dan 28 perempuan (65%) memenuhi kriteria inklusi. Penelitian dilakukan di Cardiac Centre RSUP Dr. Hasan Sadikin Bandung periode 1 Oktober 2014–15 February 2015. Pemeriksaan tinggi dan berat badan menggunakan alat SMIC ZT 120. Pemeriksaan ekokardiografi standar dilakukan dan fungsi diastolik dinilai dengan pemeriksaan E/e' menggunakan mesin ekokardiografi Vivid 7. Usia rata-rata subjek adalah 56,56 tahun dan indeks massa tubuh rata-rata adalah 25,96 kg/m2. Tekanan darah sistole rata-rata 145,51 (SD 21,969) mmHg dan diastole rata-rata 85,13 (SD 10,227) mmHg. Frekuensi denyut jantung rata-rata 74,07 kali/menit. Fraksi ejeksi rata-rata 73,02. Obat yang secara teratur diminum oleh subjek angiotensin-converting enzyme inhibitor pada 17 orang (40%), calcium channel blocker 19 orang (44%), beta-blocker 15 orang (35%), angiotensin II reseptor blocker 9 orang (21%), dan diuretik 4 orang (9%). Nilai IMVK rata-rata 130,36 (SD 21,077) g/m2. Nilai E/e' rata-rata 10,56 (SD 2,761). Hasil penelitian menunjukkan tidak ada hubungan yang signifikan antara IMVK dan derajat disfungsi diastolik (p=0,73). Data IMVK dan derajat tingkat disfungsi diastolik terdistribusi normal. Simpulan, tidak terdapat hubungan antara IMVK dan disfungsi diastolik pada pasien PJH jenis konsentrik.


LEFT VENTICULAR MASS INDEX WITH DIASTOLIC DYSFUNCTION IN HYPERTENSIVE HEART DISEASE PATIENTS

Left ventricular hypertrophy was shown with increased left ventricular mass index (LVMI). Increased left ventricular mass and cardiac chamber dilatation are parameters for hypertensive heart disease (HHD). This cardiac remodeling causes changes in heart function resulting in diastolic dysfunction. This study aimed to find the correlation between LVMI and diastolic dysfunction in patients with concentric HHD. We enrolled 49 patients with concentric HHD in Cardiac Centre RSUP Dr. Hasan Sadikin Bandung during 1 October 2014 to 15 February 2015, whom 43 met the inclusion criteria, 15 males (35%) and 28 females (65%). The subjects of study height and weight measured using SMIC tool ZT 120. The standard echocardiography examination was performed and diastolic function was assessed by examination of the E/e' using echocardiography machine Vivid 7. The average age of the subjects was 56.56 years with body mass index of 25.96 kg/m2. The average of systolic blood pressure and diastolic blood pressure were 145.51 (SD 21.969) and 85.13 (SD 10.227) mmHg respectivelly. The average frequency of heart beats was 74.07 bpm and average ejection fraction was 73.02. Drugs regularly consumed by subjects according to the percentage were: angiotensin-converting enzyme inhibitor {17 (40%)}, calcium channel blocker {19 (44%)}, beta-blocker {15 (35%)}, angiotensin II receptor blocker {9 (21%)}, and diuretics {4 (9%)}. The average value of LVMI was 130.36 (SD 21.077) g/m2 and the average value of E/e' was 10.56 (SD 2.761). The result show that there was no significant correlation between LVMI and the degree of diastolic dysfunction (p=0.73). The data LVMI and the degree of diastolic dysfunction levels were normally distributed. In conclusion, there is no correlation between LVMI and diastolic dysfunction in patients with HHD concentric type.


Keywords


Diastolic dysfunction; disfungsi diastolik; hipertensi; hypertension; hipertrofi ventrikel kiri; hypertensive heart disease; indeks massa ventrikel kiri, left ventricular hypertrophy; LV mass index; penyakit jantung hipertensi

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DOI: https://doi.org/10.29313/gmhc.v5i1.2194

pISSN 2301-9123 | eISSN 2460-5441


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