CORRELATION BETWEEN MITRAL STENOSIS SEVERITY AND MEAN PULMONARY ARTERY PRESSURE OF THE PATIENTS IN DR. SARDJITO GENERAL HOSPITAL

YOGA ARDITYA, dr. Erika Maharani, Sp.JP(K); dr. Anggoro Budi Hartopo, Sp.PD, Sp.JP, M.Sc, Ph.D

2018 | Skripsi | S1 KEDOKTERAN

INTISARI Latar belakang: Mitral stenosis adalah suatu kondisi di mana terjadi penebalan dan imobilitas dari katup mitral, fusi dan penebalan korda tendinea menghasilkan obstruksi mekanik yang menghambat aliran darah dari atrium kiri ke ventrikel kiri. Ini akan menyebabkan peningkatan tekanan di atrium kiri dan jika prosesnya kronis, dapat menyebabkan hipertensi pulmonal. Mitral stenosis dapat didiagnosis dengan ekokardiografi. Seseorang dapat memperkirakan tingkat keparahan hipertensi pulmonal dengan menghitung rumus tekanan arteri pulmonalis rata-rata menggunakan data PVAT. Tujuan: Untuk mengetahui hubungan antara tingkat keparahan mitral stenosis dengan rata-rata tekanan arteri pulmonalis pada pasien di rumah sakit umum pusat Dr. Sardjito. Metode: Sampel diambil dengan metode consecutive sampling dari data registrasi pasien mitral stenosis di Kantor Penelitian Kardiologi di RSUP Dr. Sardjito, Yogyakarta. Investigasi dalam bentuk ekokardiografi dilakukan sebelumnya di Pusat Jantung Terpadu RSUP Dr. Sardjito. Data yang diperoleh dianalisis dengan uji korelasi Spearman. Hasil: Berdasarkan jenis kelamin subjek diketahui bahwa 36 (80%) subjek adalah perempuan dan 9 (20%) adalah laki-laki. Berdasarkan usia subjek diketahui bahwa usia rata-rata subjek adalah 46,78 tahun. Regurgitasi mitral ditemukan pada semua subjek, dengan 18 (40%) subjek mengalami regurgitasi mitral ringan dan 27 (60%) mengalami regurgitasi mitral sedang hingga berat. Hipertensi ditemukan pada 7 (15,6%) subyek dan tidak dalam 38 (84,4%) dari total subyek. Demam reumatoid pada masa kanak-kanak yang ditemukan pada 8 (17,8%) subyek dan tidak di 37 (82,2%) dari total subyek. Diabetes mellitus ditemukan dalam 4 (9%) subyek dan tidak di 41 (91%) dari subyek total. Berdasarkan uji korelasi Spearman antara data MVA dan mPAP ditemukan korelasi negatif, dibuktikan dengan nilai koefisien korelasi -0.178. Nilai p dari data adalah 0,242, yang berarti korelasi tidak signifikan secara statistik. Kesimpulan: Ada korelasi, meskipun tidak signifikan secara statistik, antara tingkat keparahan mitral stenosis dengan rata-rata tekanan arteri pulmonalis pasien di rumah sakit umum pusat Dr. Sardjito.

ABSTRACT Background: Mitral stenosis is a condition where there is a thickening and immobility of the mitral valve, fusion and thickening of the tendinea chord result in mechanical obstruction that inhibits blood flow from the left atrium to the left ventricle. This will cause increased pressure in the left atrium and if the process is chronic, it can cause pulmonary hypertension. Mitral stenosis can be diagnosed with echocardiography. One can estimate the severity of the pulmonary hypertension by calculate the mean pulmonary artery pressure formula using the PVAT data. Objective: To determine the correlation between the severity of mitral stenosis and mean pulmonary artery pressure of the patients in Dr. Sardjito general hospital. Method: Samples are taken with consecutive sampling method from the mitral stenosis patient registry data in the Cardiology Research Office in Dr. Sardjito hospital, Yogyakarta. Investigations in the form of echocardiography were done beforehand at the Integrated Heart Center of Dr. Sardjito hospital. The obtained data is analyzed with Spearman correlation test. Result: Based on the sex of the subjects it is known that 36 (80%) of the subjects are females and 9 (20%) are males. Based on the age of the subjects it is known that the average age of the subjects was 46.78 years old. The mitral regurgitation was found in all of the subjects, with 18 (40%) of the subjects had mild mitral regurgitation and 27 (60%) had moderate to severe mitral regurgitation. Hypertension presented in 7 (15.6%) subjects and did not present in 38 (84.4%) of the total subjects. Rheumatoid fever in childhood presented in 8 (17.8%) subjects and did not present in 37 (82.2%) of the total subjects.. Diabetes mellitus presented in 4 (9%) subjects and did not present in 41 (91%) of the total subjects. Based on the Spearman correlation test between the data of MVA and mPAP the negative correlation is found, proven by the correlation coefficient value of -0.178. The p value of the data is 0.242, which means the correlation is not statistically significant. Conclusion: There is a correlation, although not statistically significant, between the severity of mitral stenosis with mean pulmonary artery pressure of the patients in Dr. Sardjito general hospital.

Kata Kunci : Mitral stenosis, rata-rata tekanan arteri pulmonalis / Mitral stenosis, mean pulmonary artery pressure