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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Background: Improved functional capacity (FC) and inflammatory marker reduction is a good prognostic factor in post-revascularization cardiac patients. However, there is still limited study investigated association of functional capacity and inflammatory marker after cardiac rehabilitation program. We studied the effects of cardiac rehabilitation (CR) program in the improvement of FC and high-sensitive-C Reactive Protein (hs-CRP) reduction and association between those variables. Methods: This was quasi experimental study in post-revascularization CAD patients who attended phase II CR program at CR gymnasium, Dr. Hasan Sadikin General Hospital, Bandung, from October 2014 to May 2015. The CR program included additional education sessions and consistently strict program intensity on 50-80% heart rate reserve based on formula and Borg scale 11 to 15. Functional capacity and hs-CRP were measured before and after the program. Functional capacity was assessed by maximal treadmill test through indirect VO 2 max measurement. Results: A total of 37 patients aged 56.05±7.3 years old were analyzed in this study. They consisted mainly of men (81.1%) which 78.4% of them underwent percutaneous coronary intervention (PCI). Our study revealed significant FC improvement after completion of this newly-modified CR program from an average of 6.76 to 8.68 METs (28.4%) ( p<0.001). Hs-CRP reduction was also occurred from mean of 0.49 mg/L to 0.20 mg/L (59.2%) of log hs-CRP level (p= 0.005). Linear regression analysis showed the improvement of fitness was associated with baseline FC (p<0.001) and reduction of hs-CRP was associated with baseline hs-CRP (p<0.001), and not influenced by age, gender, ejection fraction and type of procedure. There is moderate correlation (r s = 0.636, p<0.001) between functional capacity improvement and hs-CRP reduction. Each 1 METs improvement can reduce 9.317 mg/L of transformed hs-CRP level (p=0.006, 95%CI 2.942,15.693). Conclusions: CR program significantly increased functional capacity and reduce hs-CRP level in post-revascularization CAD patient, and more prominent in a patient with low baseline functional capacity and high hs-CRP level. Functional capacity improvement and hs-CRP reduction were moderately correlated. INTISARILatar belakang: Peningkatan kapasitas fungsional dan penurunan penanda inflamasi merupakan suatu faktor prognostik yang baik pada pasien pasca revaskularisasi jantung. Namun studi mengenai hubungan antara kapasitas fungsional dan penanda inflamasi masih terbatas. Penelitian ini bertujuan mempelajari pengaruh program rehabilitasi jantung terhadap perbaikan kapasitas funsional dan penurunan highsensitive-C Reactive Protein (hs-CRP) serta asosiasi di antara kedua variable tersebut. Metode: Studi eksperimental-kuasi dilakukan pada pasien penderita penyakit arteri koroner pasca revaskularisasi yang menjalani program rehabilitasi jantung fase II di pusat kebugaran rehabilitasi jantung, Rumah Sakit Umum Pusat Dr. Hasan Sadikin, Bandung dari Bulan Oktober 2014 sampai Mei 2015. Program baru...

Kualitas hidup dan prognosis pasien dengan penyakit kardiovaskular merupakan hal yang penting dan direkomendasikan untuk dievaluasi, salah satunya melalui pengukuran kapasitas fungsional. Uji jalan 6 menit (UJ6M) merupakan sebuah metode non-invasif sederhana dan reliabel untuk mengukur kapasitas fungsional yang sebelumnya telah banyak diaplikasikan pada penderita penyakit paru-paru dan gagal jantung. Saat ini, penggunaannya terus dikembangkan, salah satunya pada pasien pasca Sindrom Koroner Akut (SKA). Uji jalan 6 menit (UJ6M) dapat dilakukan secara dini, selain berguna untuk menentukan jenis aktivitas dan latihan di rumah untuk pasien, juga dapat memberikan prediksi morbiditas dan mortalitas pada kasus sindrom koroner akut tertentu. Walaupun studi prognostik mengenai UJ6M pada pasien pasca SKA masih terbatas, pasien dengan jarak tempuh UJ6M yang lebih rendah dapat dipertimbangkan memiliki risiko terjadinya kejadian jantung yang tidak diinginkan yang lebih tinggi di kemudian hari.

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Background: In patients with acute coronary syndrome (ACS), the role of admission blood pressure (BP) on outcomes remains inconclusive.Objective: This study aimed to investigate the association between admission BP and various outcomes in patients hospitalized for ACS. Method:In this cross-sectional study, 279 patients who admitted with ACS to Kediri District Hospital and Bogor General Hospital between January and June 2020 were included. Data were analyzed using SPSS software v25.Result: There was association between hypertension status on admission and diagnosis; there were more hypertensive patients with non-ST segment elevation (NSTE) ACS compared to ST segment elevation (STE) ACS diagnosis (p=0.002); and signifi cant difference on admission systolic BP between STE-ACS and NSTE-ACS patients (p<0.00001). Patients who died during hospitalization had signifi cantly lower admission systolic BP compared to survived patients (p=0.001). Patients with reduced ejection fraction (EF) on follow-up echocardiography had signifi cantly lower admission systolic BP compared to patients with normal EF (p=0.014). Patients with diastolic dysfunction on follow-up echocardiography had signifi cantly higher admission systolic BP compared to patients without diastolic dysfunction (p=0.009). No signifi cant difference on length of stay between hypertensive and non-hypertensive patients (p=0.416). Conclusion:Lower admission systolic BP was associated with increased inhospital mortality and reduced EF, while higher systolic BP was associated with diastolic dysfunction.

Background: Cardiovascular disease has very high morbidity and mortality, therefore, prevention of this disease becomes a national priority in the health programs. Health cadres, as an agent in community primary prevention, should have a good health condition. This study aimed to describe the cardiovascular risk profile in health cadresin Jatinangor, West Java. Methods: This was a cross-sectional study, conducted in Cilayung Village, Jatinangor, in September 2018. Consecutive sampling was performed on 20 health cadres aged 25 -64 years old who did not have previous cardiovascular events such as coronary heart disease or stroke. Clinical data were collected consisting of blood pressure, body mass index (BMI), random blood glucose, history of diabetes mellitus, physical activity and active smoking habits. Cardiovascular risk was assessed using Jakarta cardiovascular scores and European Relative Risk Score. Results: Only 17 of 20 health cadres fulfilled the inclusion criteria with a systolic and diastolic blood pressure of 133.5±27.8 mmHg and 81.1±14.8 mmHg, respectively, and BMI of 27.4±5.3 kg/m2.The risk of cardiovascular disease in healthy cadres was at low (47.1%), moderate (41.2%) and high risk (11.7%). The average of the European Relative Risk score was 1.88±0.9. BMI >30 has a 40% high risk of cardiovascular disease. Conclusions: Most of the health cadres in Jatinangor, West Java have a low and moderate risk of cardiovascular disease, even though there is a small percentage that is at a high risk. The awareness for prevention and management programs for risk factors needs to be raised among health cadres.

Conclusion:This study shows that most patients experience a decrease in blood pressure immediately after exercise. Men tend to have increasing blood pressure compared to women. However, other classic cardiovascular risk factors were not associated with the changes.