Kristine D. Tumabiene

University of the Philippines Manila, Manila, Metro Manila, Philippines

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Publications (4)1.25 Total impact

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    ABSTRACT: Background. Cardiac tamponade is a life-threatening hemodynamic condition from pericardial effusions that increase intrapericardial pressure sufficiently to externally compress and restrict cardiac chamber filling, constrain cardiac output, and induce backward failure. The number of pericardial effusions arising from cardiothoracic post-surgical and catheter-based procedures accounts for 70% of all the cases in one series. In the Philippines, tuberculous infection remains as one of the most common etiologies of pericarditis, and accounts for 25.1% of the 438 cases of pericardial effusion in a local review.
    No preview · Article · Dec 2014 · Acta medica Philippina
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    ABSTRACT: Background: Development of new forms of intervention to improve overall cardiac performance for heart failure remains to be a continuing challenge. Majority of patients with left ventricular dysfunction are dependent on pulmonary vascular resistance and right ventricular performance, parameters that are also important determinants of exercise and functional capacity. Sildenafil, a selective 5-phosphodiesterase inhibitor, is a proven effective therapy for primary and secondary pulmonary arterial hypertension. We conducted this meta-analysis to investigate the role of Sildenafil in lowering pulmonary arterial pressure and improving exercise capacity among patients with systolic heart failure complicated by pulmonary hypertension. Methods: The search for studies was conducted using the keywords Sildenafil, phosphodiesterase inhibitor, PDE5 inhibition, chronic heart failure, and exercise capacity. We included randomized controlled trials on patients with stable chronic heart failure and systolic ejection fraction of <40%, randomized to 25 to 75 mg Sildenafil three times a day versus placebo, on top of standard heart failure therapy. Clinical efficacy outcomes included peak exercise oxygen uptake (VO2), ventilation to CO2 production slope (VE/VCO2) indicative of ventilatory efficiency, ejection fraction, and pulmonary artery systolic pressure. Safety outcomes included the occurrence of headache and flushing. Results: We identified 4 trials on Sildenafil that satisfied our eligibility and validity criteria. They enrolled 144 heart failure patients who were followed up from 1 to 12 months. There was a significant increase in the peak exercise oxygen uptake (VO2) (mean difference 3.74, 95% CI 3.25-4.23), decrease in ventilation to CO2 production slope (mean difference -5.63, 95% CI -7.02 - -4.25), and decrease in the mean pulmonary arterial pressure (mean difference -9.76, 95% CI -10.9- -8.62). There was no significant incidence of headache in the Sildenafil group (odds ratio [OR] 3.83, 95% CI 1.02-14.34; P=0.05) and no significant difference in flushing (odds ratio [OR] 1.70, 95% CI 0.54-5.37; P=0.36). Conclusions: This meta-analysis shows that Sildenafil improves exercise capacity, evidenced by the improvement in ventilatory efficiency, oxygen uptake, and pulmonary arterial pressure reduction. This could be translated clinically into improvement in functional capacity, clinical status and quality of life. Sildenafil therefore can be an adjunct to standard medical therapy for congestive heart failure, although larger clinical trials would be warranted given the small population of the current trials included in this meta-analysis.
    Full-text · Article · Jan 2014

  • No preview · Conference Paper · Dec 2013
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    ABSTRACT: Isolated left ventricular apical hypoplasia is a newly recognized type of cardiomyopathy, with only a few cases reported since it was first described in 2004. We report this case of a 21-year-old Filipino female presenting with unstable supraventricular arrhythmia and heart failure, with characteristic features of isolated left ventricular apical hypoplasia on echocardiography and cardiac magnetic resonance imaging. To our knowledge, this is the first reported adult case in Asia.
    No preview · Article · Jun 2012 · Echocardiography