Respon Otonomik Jantung yang Buruk pada Pasien Diabetes Melitus Paska Infark Miokard Akut
Abstract
Diabetes mellitus (DM) dengan penyakit kardiovaskular sangat erat kaitannya. Pada beberapa penelitian telah dihubungkan antara diabetes mellitus dengan respon otonomik denyut jantung yang buruk, sedangkan hubungan diabetes mellitus dengan respon otonomik denyut jantung yang buruk pada pasien paska IMA masih belum ada. Pemulihan denyut jantung (HRR) dan denyut jantung istirahat (resting HR) merupakan alat investigasi yang baik, terpercaya, dan mudah diukur dalam mengevaluasi pengaturan otonomik jantung dan sebagai faktor prediktor kuat untuk semua kasus mortalitas pada orang dewasa yang sehat maupun pada seseorang dengan penyakit kardiovaskular. Penelitian ini bertujuan untuk mengetahui bahwa diabetes mellitus tipe 2 sebagai faktor yang memperburuk denyut jantung saat istirahat, terhadap pemulihan denyut jantung setelah uji latih treadmill pada pasien pasca infark miokard, serta merupakan variabel penting sebagai faktor prediktor kejadian morbiditas dan mortalitas pada pasien dengan paska infark miokard akut. Pada analisis bivariat ditemukan pasien dengan diabetes mellitus tipe 2 dan tanpa diabetes mellitus tipe 2 berbeda secara bermakna dalam memperburuk respon otonomik denyut jantung (denyut jantung saat istirahat dan denyut jantung pemulihan) pada pasien paska IMA (p<0,01). Pada analisis multivariat tidak ditemukan adanya pengaruh faktor umur, jenis kelamin, riwayat keluarga, dislipidemia, hipertensi, merokok, aktifitas fisik, dan penyekat beta terhadap respon otonomik denyut jantung yang buruk pada pasien DM paska IMA (p>0,05).
Kata kunci: Diabetes mellitus tipe 2, Infark miokard akut, denyut jantung saat istirahat, denyut jantung pemulihan, treadmill.
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[Relationship Between Type 2 Diabetes Mellitus and Poor Heart Rate Autonomic Response In Post IMI Patients].
Diabetes mellitus (DM) and cardiovascular disease are very closely related. Several studies have shown the link of diabetes with poor heart rate autonomic response, whereas data on the relationship of diabetes mellitus with poor heart rate autonomic response in post AMI patients are still not available. Heart rate recovery (HRR) and resting heart rate (resting HR) is an investigative tool that is both reliable and easy to measure in evaluating the cardiac autonomic regulation and as a strong predictor factor for allcauses of mortality in healthy adults as well as in ones with cardiovascular disease. This study aimed to determine that type 2 diabetes mellitus is a factor that worsens heart rate at rest worsens recovery heart rate after treadmill exercise test in patients with post myocardial infarction, and that it is an important variable factor as predictor for incidence of morbidity and mortality. The bivariate analysis showed that patients with type 2 diabetes mellitus and those without type 2 diabetes mellitus differed significantly in worsening the autonomic response of the heart rate (heart rate at rest and recovery heart rate) in post-AMI patients (p<0.01). Multivariate analysis didn’t find any relationship of the other variables i.e. age, gender, family history, dyslipidemia, hypertension, smoking, physical activity, and beta blockers with poor heart rate autonomic response in post-AMI diabetic patients (p>0.05).
Keywords: Type 2 diabetes mellitus, acute myocardial infarction, heart rate at rest, heart rate recovery, treadmill.
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