Korelasi Antara Jumlah Cd4 Dengan Global Longitudinal Strain Ventrikel Kiri Pada Penderita Human Immunodeficiency Virus

  • Yanuar Surya Pratama Bagian Jantung dan Pembuluh Darah, Fakultas Kedokteran Universitas Diponegoro
  • Andita Chairunnisa Bagian Jantung dan Pembuluh Darah, Fakultas Kedokteran Universitas Diponegoro - RSUP Dr. Kariadi Semarang
  • Udin Bahrudin Bagian Jantung dan Pembuluh Darah, Fakultas Kedokteran Universitas Diponegoro - RSUP Dr. Kariadi Semarang
  • Ilham Uddin Bagian Jantung dan Pembuluh Darah, Fakultas Kedokteran Universitas Diponegoro - RSUP Dr. Kariadi Semarang
  • Mochamad Arif Nugroho Bagian Jantung dan Pembuluh Darah, Fakultas Kedokteran Universitas Diponegoro - RSUP Dr. Kariadi Semarang
  • Muchlis Achsan Udji Sofro Bagian Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Diponegoro - RSUP Dr. Kariadi Semarang
  • Tri Nur Kristina Bagian Mikorbiologi, Fakultas Kedokteran Universitas Diponegoro

Abstract

Latar Belakang: Jumlah CD4 merupakan parameter penting pada penderita HIV dan berhubungan dengan peningkatan risiko disfungsi sistolik. Hingga saat ini, korelasi antara jumlah CD4 dengan parameter global longitudinal strain (GLS) sebagai indikator fungsi sistolik subklinis masih belum jelas.

Metode: Penelitian ini merupakan studi observasional dengan metode belah lintang. GLS ventrikel kiri diperiksa menggunakan ekokardiografi dua dimensi. Jumlah CD4 baseline dan nadir diperoleh dari rekam medis sedangkan jumlah CD4 aktual dan CD4 percentage (CD4%) diperiksa menggunakan metode flow cytometry.

Hasil: Total 37 pasien HIV asimptomatik mengikuti penelitian dengan rerata umur 31,95± 7,54 tahun dan median durasi penggunaan ARV adalah 34 bulan. Median CD4 baseline dan CD4 nadir adalah 272 sel/uL dan 223 sel/uL, sedangkan rerata CD4 aktual dan CD4% adalah 516,08±252,03 sel/uL dan 19,66±7,97 %. Semua subyek penelitian memiliki fungsi sistolik normal. Rerata GLS ventrikel kiri adalah 17,02±0,71. GLS ventrikel kiri berkorelasi positif dengan CD4 aktual (r=0,43; p=0,008) dan CD4% (r=0,349; p=0,034). Penderita HIV dengan jumlah CD4 aktual ?400 sel/uL memiliki GLS ventrikel kiri yang lebih baik dibandingkan dengan yang <400 sel/uL (p=0,022).

Kesimpulan: Jumlah CD4, terutama CD4 aktual dan CD4 percentage berkorelasi dengan disfungsi sistolik subklinis yang diukur dengan global longitudinal strain pada penderita HIV asimtomatik. Hal ini mungkin dapat menjelaskan peran CD4 terhadap patogenesis gagal jantung pada penderita HIV.

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Published
2021-03-23
Section
Original Article