Nilai Diagnostik Left Ventricular Early Inflow-Outflow Index dalam Menentukan Derajat Keparahan Mitral Regurgitasi

Vera, Yulia (2017) Nilai Diagnostik Left Ventricular Early Inflow-Outflow Index dalam Menentukan Derajat Keparahan Mitral Regurgitasi. Masters thesis, Universitas Andalas.

Preview	Text (cover dan abstrak) coverabstrakwmpdf.pdf - Published Version Download (494kB) | Preview
Preview	Text (BAB I) BAB I.pdf - Published Version Download (291kB) | Preview
Preview	Text (BAB VI Kesimpulan) BAB VI.pdf - Published Version Download (264kB) | Preview
Preview	Text (Daftar Pustaka) DAFTAR PUSTAKA.pdf - Published Version Download (276kB) | Preview
	Text (Tesis Fulltext) tesis fulltext.pdf - Published Version Restricted to Repository staff only Download (16MB)

Abstract

ABSTRAK Nama : Vera Yulia Program Studi : Ilmu Penyakit Jantung dan Pembuluh Darah Judul : Nilai diagnostik Left Early Ventricular Inflow-Outflow Index dalam menentukan derajat keparahan Mitral Regurgitasi. Latar Belakang: Penentuan derajat keparahan MR sangat penting terkait dengan prognosis dan tatalaksana terhadap penyakit tersebut. Sampai saat ini, belum ditemukan alat baku emas untuk kuantifikasi keparahan mitral regurgitasi (MR) pada pemeriksaan ekokardiografi. Pedoman American Society of Echocardiography (ASE) menguraikan sejumlah parameter yang terintegrasi menggunakan color dan spectral Doppler serta pengukuran anatomik. Left Ventricular Early Inflow Outflow Index (LVEIO Index) diajukan sebagai salah satu pengukuran MR dengan menghilangkan kesalahan geometris yang terdapat pada pengukuran menggunakan metode volume regurgitasi. Dengan demikian LVEIO index dianggap dapat menjadi salah satu metode yang sederhana, mudah serta akurat dalam menentukan derajat keparahan MR. Metode Penelitian: Penelitian ini merupakan suatu penelitian uji diagnostik dengan desain potong lintang. Subjek penelitian adalah semua pasien mitral regurgitasi organik yang dilakukan pemeriksaan ekokardiografi untuk diukur LVEIO index serta parameter lain berdasarkan rekomendasi ASE. Uji diagnostik digunakan untuk mengetahui sensitifitas dan spesifisitas dari LVEIO index. Hasil Penelitian: Dari 49 pasien MR terdapat 23 pasien MR severe, dan 26 pasien MR non severe. Proporsi jenis kelamin hampir sama pada kedua kelompok dengan rentang usia 56 sampai 61 tahun serta etiologi MR adalah MR degeneratif. Pada pemeriksaan ekokardiografi rerata fraksi ejeksi 634,2% pada MR severe dan 643,9% pada MR non severe dengan peningkatan LAVI, MPAP, E-wave, VC, EROA dan LVEIO index yang bertambah sesuai beratnya keparahan MR (LAVI; 67±18,2 vs 40±14,2 ml/m2, MPAP; 28±12,8 vs 20±12,6 mmHg, E-wave 1,50,3 vs 10,2 m/s, VC 0,80,3 vs 0,50,1 cm, EROA 0,40,1 vs 0,20,1cm2, LVEIO 92,4 vs 51,8). Berdasarkan uji diagnostik, LVEIO index pada penderita MR organik memiliki sensitivitas 86%, spesifisitas 84%, dan akurasi 89%. Kesimpulan: LVEIO index dapat diusulkan sebagai pemeriksaan non invasif yang relatif sederhana dan mudah dalam menentukan derajat keparahan MR. Kata Kunci: LVEIO index , derajat keparahan MR. � ABSTRACT Name : Vera Yulia Study program : Cardiology and Vascular Medicine Title : Diagnostic value of Left Ventricular Early Inflow-Outflow Index in determining severity of mitral regurgitation. Background: Determining severity of MR is very important, related with prognosis and management of the disease. There is no gold standard currently exist for quantification of mitral regurgitation (MR) severity using echocardiography. American Society of Echocardiography (ASE) guidelines recommend several parameters based on integrative criteria using color and spectral Doppler and anatomic measurement. Left Ventricular Early Inflow Outflow Index (LVEIO Index) was proposed as one parameter to assess the severity of MR by omitting geometric error from regurgitant volume method. Thus, LVEIO index offer a simple, easy and accurate measurement in determining the severity of MR. Method: This study was a diagnostic test research with cross-sectional design. The subjects were all patients with organic mitral regurgitation who underwent echocardiography examination to measure severity of MR using the LVEIO index as well as other parameters measurements based on parameters of ASE guidelines. Diagnostic test was used to determine the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of LVEIO index. Result: Of 49 patients included in this study, there were 23 severe MR and 26 non severe MR. The proportion of gender almost similar between two groups with an age range from 56 to 61 years and the most common etiology finding was degenerative MR. Echocardiography examination showed the ejection fraction in severe MR was 634,2% and 643,9% in non severe MR. The value of LAVI, MPAP, E-wave, VC, EROA and LVEIO index increased parallel with severity of the MR (LAVI; 67±18,2 vs 40±14,2 ml/m2, MPAP; 28±12,8 vs 20±12,6 mmHg, E-wave 1,50,3 vs 10,2 m/s, VC 0,80,3 vs 0,50,1 cm, EROA 0,40,1 vs 0,20,1cm2, LVEIO 92,4 vs 51,8). The sensitivity, specificity, and accuracy of LVEIO index for diagnosis of severe MR were 86%, 84%, and 89%, respectively. Conclusion: LVEIO can be proposed as a relatively simple, easy and accurate method in determining the severity of MR Keyword: LVEIO index, severity of MR

Actions (login required)

View Item