Gambaran Geometri Ventrikel Kiri pada Pasien Hipertensi yang Menjalani Ekokardiografi di RSUD Al-Ihsan Bandung Tahun 2018–2019

Putri Wulandari, Badai Bhatara Tiksnadi, Tony S. Djajakusumah

Abstract


Hipertensi dapat menginduksi perubahan struktur dan fungsi jantung sebagai hypertension mediated organ damage (HMOD). Gejala subklinis HMOD tersering adalah left ventricle hypertrophy (LVH) yang merupakan salah satu geometri ventrikel kiri. Tujuan penelitian ini mengetahui gambaran geometri ventrikel kiri pada pasien hipertensi yang menjalani ekokardiografi. Penelitian deskriptif ini dilakukan secara potong lintang dengan metode total samplingmenggunakan data rekam medik dan hasil ekokardiografi pasien hipertensi di RSUD Al-Ihsan Bandung pada bulan Januari 2018–Desember 2019 yang memenuhi kriteria inklusi sebanyak 123 sampel. Gambaran geometri ditentukan dengan penghitungan tebal dinding relatif dan indeks massa ventrikel kiri. Hasil penelitian menunjukkan bahwa karakteristik pasien hipertensi mayoritas perempuan (66,7%), usia 45–64 tahun dan >65 tahun (89,4%), serta obesitas (49,6%). Gambaran geometri ventrikel kiri yang didapat adalah LVH konsentrik (40%), LVH eksentrik (33%), normal geometri (18%), dan konsentrik remodeling (9%). Simpulan, geometri ventrikel kiri pasien hipertensi mayoritas telah mengalami LVH dengan tipe terbanyak LVH konsentrik. LVH konsentrik cenderung terjadi pada pasien dengan karakteristik usia >65 tahun, perempuan, dan obesitas. LVH eksentrik cenderung terjadi pada pasien dengan komorbid penyakit arteri koroner, penyakit katup jantung, penurunan ejeksi fraksi, dan diabetes melitus tipe II. Geometri konsentrik remodeling dan geometri normal tidak pernah dominan sebagai tipe geometri terbanyak pada pasien hipertensi yang diteliti.


DESCRIPTION OF LEFT VENTRICLE GEOMETRY IN HYPERTENSION PATIENTS WHO UNDERTAKING ECHOCARDIOGRAPHY AT AL-IHSAN HOSPITAL BANDUNG IN 2018–2019

Hypertension can induce changes in structures and functions of the heart as hypertension mediated organ damage (HMOD). The most common subclinical symptoms of HMOD are left ventricular hypertrophy (LVH) as one of the left ventricle geometries. This study aims to determine the description of left ventricle geometry in hypertension patients undertaking echocardiography. This descriptive study was conducted with cross-sectional and total sampling methods using medical record data and the echocardiography result of hypertension patients at Al-Ihsan Hospital Bandung in January 2018–December 2019 who met the inclusion criteria of 123 samples. The description of geometry was determined by the calculation of relative wall thickness and left ventricular mass index. The results showed that the majority characteristics of hypertension patients were women (66.7%), age 45-64 years and >65 years (89.4%), and obese (49.6%). Geometric patterns of the left ventricle obtained were concentric LVH (40%), eccentric LVH (33%), normal geometry (18%), and concentric remodeling (9%). In conclusion, the left ventricle geometry of hypertension patients majority has experienced LVH, with the most pattern is concentric LVH. Concentric LVH tends to occur in patients with characteristics age >65 years, women, and obesity. Eccentric LVH tends to occur in patients with comorbid coronary artery diseases, valvular heart diseases, reduction ejection fraction, and type II diabetes mellitus. The concentric remodeling and normal geometry were never dominant as the most common geometry pattern in the hypertension patients studied.


Keywords


Concentric LVH; concentric remodeling; eccentric LVH; geometri ventrikel kiri; hipertensi; hypertension; konsentrik remodeling; left ventricular geometry; LVH eksentrik; LVH konsentrik

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References


Wu CY, Hu HY, Chou YJ, Huang N, Chou YC, Li CP. High blood pressure and all-cause and cardiovascular disease mortalities in community-dwelling older adults. Medical (Baltimore). 2015;94(47):e2160.

World Health Organization. Hypertension [Internet]. Geneva: WHO; 2020 [diunduh 19 Januari 2020]. Tersedia dari: https://www.who.int/news-room/fact-sheets/detail/hypertension.

Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia. Hipertensi si pembunuh senyap [Internet]. Jakarta: Kemenkes RI; 2014 [diunduh 20 Desember 2020]. Tersedia dari: https://pusdatin.kemkes.go.id/resources/download/pusdatin/infodatin/infodatin-hipertensi-si-pembunuh-senyap.pdf.

Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia. Laporan nasional Riskesdas 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan; 2019.

Kementerian Kesehatan Republik Indonesia. Profil kesehatan Indonesia tahun 2018. Jakarta: Kemenkes RI; 2019.

Dinas Kesehatan Provinsi Jawa Barat. Profil kesehatan Provinsi Jawa Barat tahun 2017. Bandung: Dinas Kesehatan Provinsi Jawa Barat; 2018.

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, dkk. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018;39(33):3021–104.

Nadar SK, Tayebjee MH, Messerli F, Lip GY. Target organ damage in hypertension: pathophysiology and implications for drug therapy. Curr Pharm Des. 2006;12(13):1581–92.

Gaasch WH, Zile MR. Left ventricular structural remodeling in health and disease: with special emphasis on volume, mass, and geometry. J Am Coll Cardiol. 2011;58(17):1733–40.

Kuroda K, Kato TS, Amano A. Hypertensive cardiomyopathy: a clinical approach and literature review. World J Hypertens. 2015;5(2):41–52.

Wulandari K, Yasmin AAADA, Wibhuti IBR. Gambaran ekokardiografi ventrikel kiri pasien hipertensi di Puskesmas Kubu II Kecamatan Tianyar Kabupaten Karangasem. Medicina (Denpasar). 2019;50(1):36–40.

Marwick TH, Gillebert TC, Aurigemma G, Chirinos J, Derumeaux G, Galderisi M, dkk. Recommendations on the use of echocardiography in adult hypertension: a report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE). Eur Heart J Cardiovasc Imaging. 2015;16(6):577–605.

Gjesdal O, Bluemke DA, Lima JA. Cardiac remodeling at the population level—risk factors, screening, and outcomes. Nat Rev Cardiol. 2011;8(12):673–85.

Janardhanan R, Kramer CM. Imaging in hypertensive heart disease. Expert Rev Cardiovasc Ther. 2011;9(2):199–209.

Devereux RB, Pickering TG, Alderman MH, Chien S, Borer JS, Laragh JH. Left ventricular hypertrophy in hypertension. Prevalence and relationship to pathophysiologic variables. Hypertension. 1987;9(2 Pt 2):II53–60.

Isa M. Patterns of left ventricular hypertrophy and geometry in newly diagnosed hypertensive adults in Northern Nigerians. J Diabetes Endocrinol. 2010;1(1):1–5.

Papademetriou V. Geometric patterns of left ventricular hypertrophy: is geometry alone to be blamed? Hellenic J Cardiol. 2017;58(2):143–5.

Tadic M, Cuspidi C, Grassi G. The influence of sex on left ventricular remodeling in arterial hypertension. Heart Fail Rev. 2019;24(6):905–14.

Piro M, Della Bona RD, Abbate A, Biasucci LM, Crea F. Sex-related differences in myocardial remodeling. J Am Coll Cardiol. 2010;55(11):1057–65.

Cuspidi C, Facchetti R, Bombelli M, Tadic M, Sala C, Grassi G, dkk. High normal blood pressure and left ventricular hypertrophy echocardiographic findings from the PAMELA population. Hypertension. 2019;73(3):612–9.

de Simone G, Izzo R, De Luca N, Gerdts E. Left ventricular geometry in obesity: is it what we expect? Nutr Metab Cardiovasc Dis. 2013;23(10):905–12.

Nadruz W. Myocardial remodeling in hypertension. J Hum Hypertens. 2014;29(1):1–6.

Zabalgoitia M, Berning J, Koren MJ, Støylen A, Nieminen MS, Dahlöf B, dkk. Impact of coronary artery disease on left ventricular systolic function and geometry in hypertensive patients with left ventricular hypertrophy (the LIFE study). Am J Cardiol. 2001;88(6):646–50.

Uçar H, Gür M, Börekçi A, Yıldırım A, Baykan AO, Yüksel Kalkan G, dkk. Relationship between extent and complexity of coronary artery disease and different left ventricular geometric patterns in patients with coronary artery disease and hypertension. Anatol J Cardiol. 2015;15(10):789–94.

Baumgartner H, Hung J, Bermejo J, Chambers JB, Evangelista A, Griffin BP, dkk. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. Eur J Echocardiogr. 2009;10(1):1–25.

Dawson A, Morris AD, Struthers AD. The epidemiology of left ventricular hypertrophy in type 2 diabetes mellitus. Diabetologia. 2005;48(10):1971–9.




DOI: https://doi.org/10.29313/jiks.v3i2.7433

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