Korelasi Keparahan Penyakit Jantung Koroner dengan Dispersi QT pada Pasien Obstructive Sleep Apnea (OSA)

Rasmijon Rasmijon, Muhammad Yamin, Syahrial M. Hutauruk, Cleopas Martin Rumende

Abstract

Pendahuluan. Penyakit jantung koroner (PJK) dan obstructive sleep apnea (OSA) merupakan dua masalah kesehatan yang umum dan kompleks. Keduanya memiliki risiko tinggi terjadinya kematian jantung mendadak (KJM). Dispersi QT (QTd) pada elektrogram merupakan ukuran heterogenitas repolarisasi miokardial yang mampu memprediksi kejadian aritmia ventrikular yang menjadi penyebab KJM. Selama ini, belum ada publikasi mengenai hubungan keparahan PJK dengan QTd  pada pasien OSA di Indonesia.

Metode. Dilakukan studi potong lintang pada 29 pasien PJK yang disertai OSA selama tahun 2015 yang telah menjalani korangiografi dan polisomnografi dengan dispersi QT dari hasil rekaman jantung di Rumah Sakit Cipto Mangunkusumo, Jakarta. Dispersi QT (QTd) didapat dari selisih QT terkoreksi (QTc) maksimum dengan QTc minimum.  Keparahan PJK dinilai dengan skor Gensini yang didapat dari hasil rekaman korangiografi di cathlab.

Hasil. Didapatkan median skor Gensini 10 (rentang 1-112). Rerata QTc maks 459,76 mdet (simpang baku [SB] 41,39 mdet), rerata QTc min 386,72 mdet (SB 31,61 mdet), dan median QTd 56 mdet (rentang 14-201 mdet).  Uji korelasi Spearman menunjukkan adanya korelasi positif lemah antara skor Gensini dengan QTd (r = 0,494; p = 0,006).

Simpulan. Keparahan PJK berdasarkan skor Gensini yang disertai OSA berkorelasi positif lemah dengan QTd.

Kata Kunci: OSA, Penyakit jantung koroner, QTd, QTc maksimum, QT minimum, Skor gensini

 

Correlation Between the Severity of Coronary Heart Disease and QT Dispersion in Patients with Obstructive Sleep Apnea

Introduction. Coronary heart disease (CHD) and obstructive sleep apnea (OSA) are common and complex clinical problems. Both have a high risk of sudden cardiac death (SCD). QT dispersion (QTd) in electrogram is a measure of heterogeneity of myocardial repolarization that can predict the occurrence of ventricular arrhythmias that cause SCD QTd is a predictor of ventricular arrhythmias and sudden cardiac death. So far, there is no publication about the severity relationship CHD with QTd in OSA patients in Indonesia.

Methods. A cross-sectional study was conducted on twenty-nine CHD patients accompanied OSA in 2015 who had undergone coronary angiography and polysomnography against the QT dispersion by electrocardiography in Cipto Mangunkusumo Hospital, Jakarta. QTd obtained from maximum QTc difference with minimum QTc. The severity of CHD was assessed by the Gensini score obtained from the recording of coronary angiography in the cath lab.

Results. The median value of Gensini score was 10 (range 1-112). Mean value of QTc max and QTc min were 459.76 ms (standard deviation [SD] 41.39 ms) and 386.72 ms (SD 31.61), respectively. Meanwhile, the median value of QTd was 56 ms (range 14-201 ms). The Spearman correlation test showed a weak positive correlation between Gensini score and QTd (r = 0.464; p value = 0.006).

Conclusion. The severity of coronary heart disease by Gensini score is weakly correlated with QT dispersion.


Keywords

Coronary heart disease, Gensini score, QTd, maximum QTc, minimum QT, OSA

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