Ringankan Beban Pesakit Jantung

Kisah joseph merupakan antara sekian banyak rakyuat negara ini yang menderita sakit jantung. Berdasarkan kadar semasa, tiga hingga 20 daripada setiap 1,000 penduduk negara ini mengalami masalah itu. Dianggarkan 660,000 orang akan menderita akibat masalah tersebut menjelang 2020.

Penyelidik perubatan menganggarkan jumlah itu akan meningkat dengan ketara apabila semakin ramai dihinggapi penyakit tekanan darah tinggi, diabetes dan penyakit jantung koronari.

Sebenarnya, peningkatan jumlah kes penyakit jantung sebahagiannya berpunca daripada kejayaan perubatan moden yang memungkinkan semakin banyak pesakit terselamat daripada serangan jantung untuk hidup lebih lama.

Bagaimanapun, pesakit terbabit kemudiannya terpaksa bergelut dengan masalah lemah jantung sebab pernah diserang penyakit berkenaan.

Masalah itu didapati meningkat dengan ketara dalam kalangan mereka yang berusia 65 tahun ke atas dan boleh mencapai kadar 100 kes bagi setiap 1,000 penduduk.

Di Malaysia, penyakit jantung menjadi pembunuh nombor satu sejak tiga dekad lepas. Manakala kegagalan jantung menjadi punca 10 peratus daripada mereka yang dimasukkan ke wad.

Peningkatan itu lebih ketara apabila Malaysia semakin menghampiri sasarannya untuk mencapai taraf negara maju dengan penduduk dianggarkan berjumlah 33.4 juta orang pada 2020.

Kebanyakan masalah jantung berpunca daripada ketidakmampuan organ itu mengepam jumlah darah yang diperlukan oleh tubuh dengan secukupnya.

Dalam sesetengah kes, ia berlaku apabila jantung tidak dapat membekalkan darah yang mencukupi atau tidak mampu mengepam darah ke bahagian tubuh lain kerana kurang bertenaga.

Gejala dan tanda lazim yang menunjukkan seseorang itu mengalami kegagalan jantung ialah kesukaran untuk bernafas, kelesuan dan mengalami kesesakan bendalir.

Tanda lain termasuk kembung pada bahagian abdomen, kerap batuk dengan mengeluarkan kahak berbuih serta lemah ingatan.

Presiden Persatuan Jantung Kebangsaan Malaysia (NHAM), Prof. Dr. Sim Kui Hian berkata, tahap keseriusan kegagalan jantung mengikut klasifikasi Persatuan Jantung New York (NYHA)terbahagi kepada empat kategori – Kelas 1 (tiada had dikenakan bagi kegiatan), Kelas II (had dikenakan bagi kegiatan tertentu, khususnya kegiatan berat), Kelas III (had dikenakan bagi kegiatan harian kurang daripada biasa) dan Kelas IV (sukar bernafas ketika berehat atau menjalankan kegiatan minimum).

“Kegagalan jantung mempunyai kaitan dengan kelemahan prognosis (ramalan). Bagi pesakit yang tergolong dalam Kelas III dan IV NYHA, prognosis menganggarkan akan berlaku 50 peratus kematian pada tahun pertama.

“Bagaimanapun, pada keseluruhannya, prognosis bertambah baik dalam tempoh dua dekad lepas hasil kemajuan dalam bidang farmaseutikal dan pembedahan, manakala bagi pesakit yang mengalami kegagalan jantung lebih teruk, prognosisnya tetap kekal demikian,” katanya pada taklimat kepada media.

Namun, kata Dr. Kui Hian, kajian global baru-baru ini tentang rawatan yang diberi kepada pesakit yang mengalami kegagalan jantung kronik di 37 negara, termasuk Malaysia, menunjukkan penggunaan sejenis agen penurunan kadar denyutan jantung kepada tahap terapi standard, mampu mengurangkan risiko kematian.

Ia juga mengurangkan keperluan mereka untuk dimasukkan ke wad

Kajian SHIFT ( Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial ), yang di jalankan selama empat tahun dengan dibiayai pengeluar ubat-ubatan, Servier, yang hasilnya dibentangkan pada Kongres Kardiologi Persatuan Eropah di Stockholm dan disiarkan dalam The Lancet menunjukkan kaedah itu amat bermanfaat dalam merawat kegagalan jantung.

Antara penemuan paling penting dalam kajian itu ialah agen penurunan kadar denyutan jantung dikenali sebagai Ivabradine , mampu menambah baik keadaan kardiovaskular, gejala dan kualiti kehidupan apabila ia digabungkan dengan terapi berpandukan garis panduan sedia ada terhadap pesakit yang mengalami kegagalan jantung dan kelemahan sistolik.

Kajian ini memberi fokus terhadap kesan ubat-ubatan yang digunakan bersama saluran F, yang mampu mengurangkan kadar denyutan jantung.

Saluran F berfungsi menjana nadi elektrik yang menyebabkan jantung berdenyut.

Prof. Dr. Wan Azman Wan Ahmad, seorang daripada penyelidik utama dalam kajian SHIFT di Malaysia berkata, penemuan itu merupakan kemajuan penting dalam merawat kegagalan jantung kerana ia mengurangkan risiko kematian dan keperluan pesakit yang mengalami kegagalan jantung mendapat rawatan di wad.

“Kini, pesakit jantung mempunyai harapan baru bukan saja dalam memberi kualiti kehidupan lebih baik kepada mereka dan mengurangkan risiko kematian, tetapi juga memberi lebih banyak peluang kepada pesakit yang tidak sesuai menerima rawatan jantung yang menggunakan kaedah lain, untuk selamat,” katanya.

Kajian itu merupakan penyelidikan morbiditi-mortaliti terbesar yang pernah dijalankan tentang kegagalan jantung yang dialami lebih 6,500 pesakit dari 37 negara, yang didiagnos mengalami kegagalan jantung peringkat sederhana dan teruk serta kadar jantung sekurang-kurangnya 70 denyutan seminit, untuk tempoh 23 bulan.

SHIFT juga adalah kajian yang julung kali diadakan untuk mengesahkan bahawa pengurangan kadar denyutan jantung boleh mengurangkan risiko kematian atau keperluan pesakit yang mengalami kegagalan jantung dimasukkan ke wad.

Ini seterusnya menunjukkan bahawa kadar denyutan jantung mempunyai pengaruh besar terhadap penyakit.

Pakar kardiologi, Dr. Choo Gim Hooi pula berkata, penemuan itu merupakan suatu kejayaan penting dalam usaha merawat kegagalan jantung.

“Kajian SHIFT memberi gambaran penting kepada pesakit dan doktor tentang masa depan dalam bidang rawatan dan pengurusan kegagalan jantung.

“Walaupun banyak kes kegagalan jantung mungkin tidak dapat dipulihkan kepada keadaan asalnya, tetapi hasil daripada kajian SHIFT, kini pesakit mempunyai harapan untuk menikmati kualiti kehidupan lebih baik dan mampu hidup dengan lebih lama,” katanya.

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