Hubungan Antara Vitamin D Dan Fungsi Sistolik Ventrikel Kiri Jantung Pada Pasien Anak Dengan Penyakit Jantung Bawaan

Sari, Made Sustiana Purnama and dr. Dyahris Koentartiwi, Sp.A (K) and Dr.dr. Harjoedi Aji Cahyono, Sp.A (K) (2024) Hubungan Antara Vitamin D Dan Fungsi Sistolik Ventrikel Kiri Jantung Pada Pasien Anak Dengan Penyakit Jantung Bawaan. Sarjana thesis, Universitas Brawijaya.

Abstract

Penyakit jantung bawaan (PJB) adalah kelainan struktural pada jantung dengan prevalensi sekitar 8 per 1000 kelahiran hidup di Indonesia. Kondisi ini sering kali terkait dengan defisiensi vitamin D, yang dapat memengaruhi fungsi sistolik ventrikel kiri serta meningkatkan risiko gagal jantung dan remodeling miokard. Penelitian observasional analitik ini bertujuan untuk mengevaluasi hubungan antara kadar vitamin D dan fungsi sistolik ventrikel kiri yang dinilai dari fraksi ejeksi (EF) pada 40 anak dengan PJB di RS Saiful Anwar Malang selama periode Mei hingga Agustus 2024. Hasil penelitian menunjukkan bahwa median usia subjek adalah 16 hari (dalam rentang 1 hari hingga 8 tahun 8 bulan), dengan distribusi 21 laki-laki dan 19 perempuan. Median berat badan subjek tercatat 2,80 kg (rentang 0,86 - 20 kg), panjang badan median 47 cm (23 - 130 cm), dan lingkar kepala median 33 cm (23 - 49,5 cm). Status gizi subjek terdiri dari 6 anak dengan gizi buruk, 9 anak dengan gizi kurang, 25 anak dengan gizi baik, serta 6 anak lahir preterm dan 34 aterm. Kadar vitamin D median adalah 12,67 ng/ml (rentang 3,0 - 38,60 ng/ml), dengan rincian kadar berdasarkan klasifikasi: 1 subjek mengalami defisiensi berat (3,00 ng/ml), 28 subjek mengalami defisiensi (11,57±3,47 ng/ml), 9 subjek Insufisiensi (25,15±2,93 ng/ml) dan 2 subjek mengalami suffisiensi 35,80±3,95 ng/mL. Kelainan jantung ditemukan kombinasi PJB sebanyak 23 subjek diikuti Atrial Septal Defect (ASD) dengan frekuensi sebanyak 11 subjek, dan Patent Ductus Arteriosus (PDA) sebanyak 6 subjek. Pemeriksaan LVEF % didapatkan memiliki rerata±SB 69,94±8,22%. Analisis statistik didapatkan tidak ada hubungan antara hubungan kadar vitamin D dengan usia, jenis kelamin, status gizi, status kelahiran dan klasifikasi PJB dengan p>0,05. Kadar vitamin D dan EF menunjukkan nilai korelasi Spearman Rho r = 0,198 dengan p = 0,736, serta hasil ANOVA menunjukkan p = 0,661. Hal ini mengindikasikan bahwa tidak ada hubungan signifikan antara kadar vitamin D dan fungsi sistolik ventrikel kiri. Dengan demikian, dapat disimpulkan bahwa kadar vitamin D tidak berperan penting dalam mendukung fungsi sistolik pada anak-anak dengan PJB.

English Abstract

Congenital heart disease (CHD) refers to structural abnormalities of the heart with a prevalence of approximately 8 per 1,000 live births in Indonesia. This condition is often associated with vitamin D deficiency, which can affect left ventricular systolic function and increase the risk of heart failure and myocardial remodeling. This observational analytic study aimed to evaluate the relationship between vitamin D levels and left ventricular systolic function, assessed by ejection fraction (EF), in 40 children with CHD at Saiful Anwar Hospital in Malang during the period from May to August 2024. The results showed that the median age of the subjects was 16 days (ranging from 1 day to 8 years and 8 months), with a distribution of 21 males and 19 females. The median weight of the subjects was recorded at 2.80 kg (ranging from 0.86 to 20 kg), the median height was 47 cm (23 to 130 cm), and the median head circumference was 33 cm (23 to 49.5 cm). The nutritional status of the subjects consisted of 6 children with malnutrition, 9 children with moderate malnutrition, and 25 children with good nutrition, with 6 children being preterm and 34 term. The median vitamin D level was 12.67 ng/ml (range: 3.0 - 38.60 ng/ml), with details based on classification: 1 subject had severe deficiency (3.00 ng/ml), 28 subjects had deficiency (11.57±3.47 ng/ml), 9 subjects had insufficiency (25.15±2.93 ng/ml), and 2 subjects had sufficiency (35.80±3.95 ng/ml). Cardiac abnormalities consisted of a combination of CHD in 23 subjects, followed by Atrial Septal Defect (ASD) in 11 subjects, and Patent Ductus Arteriosus (PDA) in 6 subjects. The mean left ventricular ejection fraction (LVEF%) was found to be 69.94±8.22%. Statistical analysis indicated no relationship between vitamin D levels with age, sex, nutritional status, birth status, and classification of CHD, with p>0.05. The correlation between vitamin D levels and EF showed a Spearman correlation coefficient of r = 0.198 with p = 0.736, and the ANOVA results indicated p = 0.661. This indicates that there is no significant relationship between vitamin D levels and left ventricular systolic function. Thus, it can be concluded that vitamin D levels do not play a significant role in supporting systolic function in children with CHD

Item Type:	Thesis (Sarjana)
Identification Number:	0424060180
Uncontrolled Keywords:	Penyakit Jantung Bawaan, Vitamin D, Fungsi sistolik ventrikel kiri jantung , Fraksi Ejeksi (EF), Status Gizi.
Divisions:	Profesi Kedokteran > Spesialis Ilmu Kesehatan Anak, Fakultas Kedokteran
Depositing User:	Unnamed user with username nova
Date Deposited:	28 Feb 2025 02:45
Last Modified:	28 Feb 2025 02:45
URI:	http://repository.ub.ac.id/id/eprint/237791

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