Page 51 - Abstract Book KONIKA 18

Cardiology

O-CAR-003
Signs and Symptoms Differences between Oral and Injection Routes
as Secondary Prophylaxis in Rheumatic Fever and Rheumatic Heart Disease

Fiqi Isnaini Nurul Hikmah, Dyahris Koentartiwi, Renny Suwarniaty
Department of Child Health, Faculty of Medicine, Universitas Brawijaya/Saiful Anwar Hospital,
Malang, East Java, Indonesia

Abstract
Background Secondary prophylaxis with benzathine penicillin (BBP) is used to prevent RF and RHD
progression. The use of erythromycin was recommended as an alternative treatment. In the beginning of
2021, there was lack of BBP and erythromycin was then used as an alternative. Objective This study aims
to evaluate the signs and symptoms in RF and RHD patients administered with BBP and erythromycin in
Saiful Anwar Hospital. Methods This is an observational analytic study conducted in the Saiful Anwar
Hospital (July 2021). The subjects were pediatric patients with RF and RHD (2-18 years old), receiving
erythromycin for 5 months and had a prior history of BBP injection. We compared the sign and symptom
differences during the two different treatment types with chi-squared test (SPSS v.23). Results There were 32
RF and RHD patients undertaking routine health control monthly (20 patients with BBP injection switching
to erythromycin). The number of patients included in this study was 20 (6 males and 14 females). The mean
age was 12.45 (SD 2.14) years. The mean duration of the disease was 2.77 (0.5 to 9.5) years. There were
6 of the 20 patients who did not routinely take erythromycin, with 5 patients suffering from fatigue, joint
pain, and fever. We found that there was no significant difference in the signs and symptoms during BBP
and erythromycin (P =0.053). Conclusion There was no significant difference in the signs and symptoms
presenting in RF and RHD patients receiving erythromycin in comparison to BBP.
Keywords: rheumatic fever; rheumatic heart disease; benzathine penicillin; erythromycin; secondary
prophylaxis

O-CAR-004
The Role of Speckle Tracking Echocardiography in Detecting Asymptomatic
Ventricular Dysfunction in Children with Major Thalassemia

2
1
M. Ikhsan Nurkholis , Mulyadi M. Djer , Pustika Amalia , Pramita Gayatri
2
2
1
Department of Child Health, Faculty of Medicine Universitas Hasanuddin, Makassar, South Sulawesi and
2
Faculty of Medicine Universitas Indonesia, Jakarta , Indonesia
Abstract
Background End-stage heart failure due to iron overload cardiomyopathy are the major cause of mortality
in thalassemia major (TM) patients, but many patients remain asymptomatic until the late stage. Detection
of ventricular dysfunction using conventional echocardiography often misses the early signs of ventricular
dysfunction. Objective To investigate the role of speckle tracking echocardiography (STE) in detecting
asymptomatic ventricular dysfunction in TM patients. Methods A diagnostic test of STE was conducted
in detecting ventricular dysfunction in children with TM. Multivariate analysis assessed the relationship
between age, duration of transfusion, ferritin levels, transferrin saturation and ventricular dysfunction.
Results Only ferritin levels were proven to play a role in the incidence for left ventricular diastolic dysfunction
and systolic dysfunction, with the cut off point of ferritin levels associated with ventricular dysfunction was
5624 ng/mL with a fairly good AUC value 0.702% (95%CI 0.553 to 0.852). Diastolic dysfunction assessed
by STE has a moderate sensitivity of 61% and a low specificity of 46%. Meanwhile, the incidence of systolic
dysfunction has a high sensitivity of 91% and a moderate specificity of 66%. Conclusion Ferritin has been
shown to be a significant factor in the incidence of ventricular dysfunction with cut-off point value of 5624
ng/ml. Speckle tracking echocardiography can detect left ventricular diastolic and systolic dysfunction in
patients with normal LVEF.
Keywords: thalassemia major; ventricular dysfunction; Speckle tracking echocardiography

KONIKA XVIII Abstract Book 5