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Biomedical subjects

Sarwono Waspadji

Publications and source records attributed to Sarwono Waspadji.

8 recordsLinked to original sources

Multi-country study on the prevalence and clinical features of peripheral arterial disease in Asian type 2 diabetes patients at high risk of atherosclerosis.

OBJECTIVE: PAD-SEARCH was the first international study to investigate the prevalence of peripheral arterial disease (PAD) in Asian type 2 diabetic patients and to demonstrate the relationships between putative risk factors and PAD. SUBJECTS AND METHODS: In total 6625 type 2 diabetic patients aged 50 and older were enrolled and determined ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) in Korea, China, Taiwan, Hong Kong, Indonesia, Thailand and the Philippines. RESULTS: Mean patient age was 63.7+/-8.2 years and mean duration of diabetes was 10.3+/-8.0 years. One thousand one hundred and seventy-two (17.7%) subjects were diagnosed as PAD by ABI (< or =0.9). PAD subjects had a significantly longer duration of diabetes, hypertension, higher HbA1c, and a significantly lower mean BMI than non-PAD subjects. In terms of lipid profiles, triglyceride was the only significant variable. Notably, mean ABI and baPWV in females were significantly poorer than age matched males in subjects with a normal ABI. However, mean ABI and baPWV in males were significantly poorer than in age matched females in subjects with PAD. CONCLUSIONS: These findings suggest that PAD is a common complication in Asian type 2 diabetic patients. Therefore, PAD screening and treatment should be emphasized for Asian diabetic patients with high risk factors.

Age Distribution↗

Correlation between cortisol levels and myocardial infarction mortality among intensive coronary care unit patients during first seven days in hospital.

AIM: To measure cortisol level, its relationship with myocardial infarction, and to determine the correlation of elevated cortisol levels with the outcome of myocardial infarction. METHODS: This study was designed as a pre and post study. The diagnosis of myocardial infarction was established based on the WHO criteria. The patients were followed for seven days. Blood specimens were collected on day 1, 3, 5 and 7. RESULTS: Thirty six patients with myocardial infarction were studied. Four patients (11.1%) died and 32 patients (88.9%) survived. Nineteen patients (52.7%) had large infarcts and 23 patients (63.9%) had myocardial complications. The deceased patient's cortisol level differed significantly from those tht survived (65.68 + 29.07 vs 21350 + 15.82 microg/dl, p < 0.05). The groups with large infarcts and myocardial infarct complications had higher cortisol levels, but the difference was not significant compared with the group with small infarcts and patients without complications. Six patients (16.6%) who received thrombolytic therapy had significantly lower cortisol levels as compared to patients without thrombolytic therapy. The duration of elevation cortisol elevation in the deceased patient was longer than that among those who survived. Similar findings were also true for those with large infarcts when compared to those with small infarcts, as well as myocardial infarct patients with complications when compared to those without. However, the duration of cortisol elevation was shorter among patients who received thrombolytic therapy. CONCLUSION: Cortisol level can be used as a prognostic marker for myocardial mortality.

Acute Disease↗

Left ventricular diastolic dysfunction in obese women.

AIM: To determine the direct effect of obesity on echocardiographic indices of diastolic left ventricular function METHODS: 44 obese (BMI > or =25 kg/m2) and 45 normal weight women were studied. They had no other pathological conditions. Echocardiographic indices of diastolic function were obtained, and dysfunction was assumed when at least two values differed by > or =2 SD from the normal weight group. RESULTS: In obese subjects, the values of maximum velocity of active mitral filling (A) were increased and pulmonary diastolic velocity was decreased significantly (p< 0,01); all other diastolic variables were unchanged. Subclinical diastolic dysfunction tend to be more prevalent among obese subjects but it was not significantly different from non obese (p= 0.11), being present in nine obese (20.5%) and 4 normal (8.9%) subjects. CONCLUSION: Subclinical left ventricular diastolic dysfunction is present in obese women.

Adult↗

The correlation between insulin resistance and left ventricular systolic function in obese women.

AIM: To determine the correlation between insulin resistance and left ventricular systolic function in obese women. METHODS: 44 obese (BMI > or =25 kg/m2) and 45 normal weight women were studied. They had no other pathological conditions. Echocardiograms were undertaken in our echocardiographic laboratory following standard methods. The homeostasis model was used to assess insulin resistance (HOMA IR). RESULTS: Ejection fraction (p =0.22) and fractional shortening (p= 0.58) were not difference between obese women and the normal group. There was no correlation between insulin resistance and left ventricular systolic function. CONCLUSION: There was no correlation between insulin resistance and left ventricular ejection fraction.

Adolescent↗

Correlation between left ventricular mass and visceral fat thickness in obese women.

AIM: This study was aimed to measure left ventricular mass, which partly determines the function of the left ventricle, in obese women. METHODS: The total number of study subjects was 90, which consisted of 45 obese women (BMI >or= 25 Kg/m2) and 45 non-obese women (BMI < 25 Kg/m2) as control group. They were evaluated by M mode echocardiography and abdominal CT to measure visceral fat, blood pressure, insulin resistance and waist circumference. Correlation was assessed for both groups. RESULTS: There were significant differences in the left ventricular mass of the obese and non-obese group (P= 0.000), systolic blood pressure (P = 0.000), diastolic blood pressure (P = 0.006), waist circumference (P = 0.000), visceral fat (P = 0.000), and HOMA-IR (P = 0.000). With bivariant analysis, it is concluded that there are significant correlations between left ventricular mass and visceral fat (r = 0.67, P = 0.000); between BMI and left ventricular mass (r = 0.67, P = 0.000); between waist circumference and left ventricular mass (r = 0.72, P = 0.000); and also between HOMA-IR and left ventricular mass (r = 0.57, P = 0.000). CONCLUSION: There are significant correlations between increased left ventricular mass and visceral fat, BMI, waist circumference and HOMA-IR among Indonesian women. So far, this study has shown a correlation between obesity and high cardiovascular risk.

Adult↗