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All Journal International Journal of Integrated Health Sciences Indonesian Journal of Cardiology
Akbar, Mohammad Rizki
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Health Professions Medicine & Pharmacology

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Comparison of Left Ventricular Function after His Bundle Pacing vs Left Bundle Branch Area Pacing Implantation Prakoso, Kurniawan; Wibawa, Kevin; Karwiky, Giky; Akbar, Mohammad Rizki; Martha, Januar Wibawa; Iqbal, Mohammad
Jurnal Kardiologi Indonesia Vol 45 No 2 (2024): April - June, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1708

Abstract

Background: Right ventricular pacing may lead to deterioration of left ventricular (LV) function. Recent guideline suggests the use of conduction system pacing (CSP) with either his bundle pacing (HBP) or left bundle branch area pacing (LBBAP). This study aimed to investigate the difference of LV function between HBP and LBBAP. Methods: This is a prospective cohort study enrolling patients age >18 years requiring CSP implantation from June 2020 to January 2024 in Hasan Sadikin General Hospital, Bandung. Data regarding QRS duration and several echocardiography parameters were obtained at baseline and during follow up within 1 year after CSP implantation. Results: From 66 patients, 35 were included in the HBP group. There was no difference in QRS duration at baseline between both groups with higher left ventricular ejection fraction (LVEF) in HBP group (51.2 ± 13.9% vs 45.6 ± 11.1%, p=0.078). During follow up, HBP group showed narrower QRS duration (113.40 ± 17.06ms vs 120.81 ± 12.12ms, p=0.029). LV function was preserved in HBP group while there was a trend of LV function improvement in LBBAP group (53.1 ± 11.7% in LBBAP vs 53.9 ± 11.5% in HBP group, p=0.536). Further analysis in 33 patients with LV dysfunction showed a trend of LVEF improvement in both groups (35.3 ± 7.9% to 44.6 ± 11.28% in HBP and 38.7 ± 6.9% to 51.4 ± 13.1% in LBBAP group). Conclusion: HBP resulted in narrower QRS complex. However, both HBP and LBBAP showed a trend of LV function improvement in patients with LV dysfunction.
Mexiletine in the treatment of LQT2, LQT3, and acquired LQTS: a meta-analysis Ihsan, Dhiya; Iqbal, Mohammad; Cool, Charlotte Johanna; Achmad, Chaerul; Pramudyo, Miftah; Prameswari, Hawani Sasmaya; Akbar, Mohammad Rizki
Jurnal Kardiologi Indonesia Vol 46 No 2 (2025): April - June, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1835

Abstract

Background: High mortality in patients with Long QT Syndrome (LQTS) can be reduced with proper treatment. Gene-specific therapy is crucial, as many treatments are not equally effective across different LQTS types. While mexiletine has been established in the treatment of LQT3, its use in other types of LQT need further evaluation. Methods: A meta-analysis was conducted using systematic electronic searches of PubMed, Embase, and Cochrane Library. We assessed QTc reduction and cardiac events after Mexiletine treatment. Inclusion criteria: any study with no language restriction that diagnoses any type of LQTS, uses mexiletine treatment, and provides QTc comparison before and after treatment. Animal studies were excluded. The NIH Study Quality Assessment Tools and Newcastle-Ottawa Scale were used to evaluate bias. Data were analyzed using Review Manager 5.4 and MedCalc software Results: Nine studies (n=281) were included. Mexiletine reduced QTc by -64ms (mean difference [MD], -64.22; 95% confidence interval [CI] -76.13 to -52.30; p<.001; I2 60%). Sensitivity and subanalyses showed consistent efficacy. In five studies (n=76), the number of patient with high-risk QTc (>500ms) significantly decreased (Risk Ratio [RR], 0.38; 95% CI 0.26-0.55; p<.001). Five studies (n=141) showed a significant reduction in cardiac events (RR, 0.25; 95% CI 0.14-0.44; p<.001). Two studies reported gastrointestinal (GI) problems and vertigo as side effects of mexiletine treatment. Conclusion: Mexiletine significantly reduces QTc and cardiac events in LQT2, LQT3, and aLQT patients. Mexiletine also significantly reduces the number of Long QT patients with high-risk QTc Funding: No external funding was received for this study Registration: CRD420250652574
Subclinical Left Ventricular Dysfunction Prevention in Breast Cancer Patients after FAC Chemotherapy: A Carvedilol Trial Astuti, Astri; Sumantra, I Gede; Aafiyah, Adila; Abdurahman, R. Maman; Sihite, Teddy Arnold; Akbar, Mohammad Rizki; Hasan, Melawati; Martanto, Erwan
International Journal of Integrated Health Sciences Vol 12, No 1 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v12.n1.3570

Abstract

Objective:  To assess the cardioprotective effects of Carvedilol in preventing subclinical left ventricular dysfunction (SLVD) in breast cancer patients after completing FAC chemotherapy.Methods: This prospective study employed a quasi-experimental clinical trial conducted from September 2018 to May 2019. Breast cancer patients receiving FAC chemotherapy were divided into two groups: intervention (IG) and control (CG). The IG received Carvedilol 6.25 mg b.i.d., which was increased every three weeks until reaching a tolerated dose. The study evaluated changes in left ventricular global longitudinal strain (GLS) and the incidence of SLVD (GLS reduction ≥15% and GLS >-18%) 24 weeks after initiating the FAC regimen.Result: Of the 81 women enrolled in the study, 31 were in the IG. No significant changes in GLS were observed during or after completing FAC chemotherapy in the IG, whereas the CG showed contradictory results. At the end of the follow-up period, the delta GLS reduction was lower in the IG (0.7; 95% CI -0.60, 3.60) compared to the CG (3.00; 95% CI -2.16, 4.19), with a p-value of 0.035. Similarly, the percentage reduction in GLS was 3.6% in the IG and 14.29% in the CG, resulting in a p-value of 0.05. The incidence rate of SLVD (GLS reduction ≥15% and GLS > -18%) was lower in the IG (41.9% and 25.8%) than in the CG (58% and 48%).Conclusion: Carvedilol may have a cardioprotective effect in preventing the incidence of SLVD, as evaluated by GLS reduction and changes, in women with breast cancer after completing a full cycle of the FAC regimen.
In-Hospital Outcomes Comparison Between Off-Pump and On-Pump CABG: Indonesian Tertiary Center Experience Dewi, Triwedya Indra; Jungjunan, Ridho; Raharjo, Pradana Pratomo; Rezkita, Aliya Rahmadewi; Hidayat, Syarief; Martha, Januar Wibawa; Nusjirwan, Rama; Akbar, Mohammad Rizki
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4119

Abstract

Background: Coronary artery disease (CAD) often requires revascularization. Coronary artery bypass grafting (CABG) is a cornerstone intervention that improves patients’ survival. Both on-pump and off-pump CABG have their own advantages and limitations, with reported outcomes vary across studies.Objective: to investigate the differences in the outcomes of patients undergoing off-pump and on-pump CABG.Methods: A retrospective cohort study was performed on 186 patients aged ≥18 years undergoing on-pump or off-pump CABG between June 2020 and December 2023. Outcomes included were all-cause mortality, postoperative acute renal failure, length of postoperative stay, and complete revascularization rate. Comparative analysis was conducted using Chi-Square test and independent T-test. Multivariate analysis, including logistic regression tests, was carried out to identify independent predictors associated with each outcome.Results: The on-pump group presented more diabetes (42.9% vs. 28.4%; P=0.040) and lower left ventricular ejection fraction (LVEF) values (43 [IQR 16–79] vs. 53 [23–75]; P=0.001). Patients in this group also had higher rates of postoperative renal failure (61.5% vs. 24.2%; P<0.001), longer stays (64.8% vs. 41.1%; P=0.001), and better complete revascularization (98.9% vs. 92.6%; P=0.035), but no significant difference in mortality (16.5% vs. 13.7%; P =0.594). Multivariate analysis identified diabetes, LVEF ≤40%, and postoperative renal failure as predictors of mortality.Conclusions: On-pump CABG is associated with higher rates of complete revascularization. However, the adoption of this technique is linked to a higher risk of postoperative acute kidney failure and prolonged hospital stays. No difference in mortality is observed between those with off-pump and on-pump.
Association Between Cardiovascular Risk Factors and CAD Severity by CAD-RADS Categories and Comprehensive CTA Score Raharjo, Pradana Pratomo; Purnomowati, Augustine; Kusumawardhani, Nuraini Yasmin; Astuti, Astri; Achmad, Chaerul; Pramudyo, Miftah; Karwiky, Giky; Akbar, Mohammad Rizki
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4173

Abstract

Background: Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide, including in Indonesia. Risk factors (RFs) play an important role in both pathogenesis and management of cardiovascular (CV) diseases. Coronary computed tomography angiography (CTA) is a reliable non-invasive diagnostic method. Coronary Artery Disease Reporting and Data System (CAD-RADS) categories and comprehensive CTA score describes CAD severity on coronary CTA and provides additional prognostic value.Objective: To explore the link between traditional cardiovascular risk factors and CAD severity based on CAD-RADS and comprehensive CTA scores.Methods: This retrospective, single-center study was conducted at a tertiary hospital using data from the Cardiovascular Imaging Database of the hospital from January 2020 to June 2022. Data meeting the inclusion and exclusion criteria were analyzed using ordinal and binary regressions.Results: A total of 423 patients' data were analyzed. Ordinal regression revealed significant links between age ≥ 65 years, male gender, hypertension, diabetes, and higher CAD severity based on both CAD-RADS and comprehensive CTA scores. Binary regression showed that older age and male gender were independently associated with CAD-RADS ≥ 3 and comprehensive CTA score ≥ 6. Diabetes was linked to CAD-RADS ≥ 3, and hypertension was tied to a comprehensive CTA score ≥ 6. The number of risk factors showed a trend toward CAD severity (p=0.069) and a significant link with comprehensive CTA score (p=0.012).Conclusion: There is a significant association between traditional cardiovascular risk factors and CAD severity as quantified by both CAD-RADS and comprehensive CTA score.
Co-Authors Aafiyah, Adila Abdurahman, R. Maman ASTRI ASTUTI Augustine Purnomowati Chaerul Achmad Cool, Charlotte Johanna Daniel Happy Putra Dewi, Triwedya Indra Erwan Martanto Hasan, Melawati I Gede Sumantra, I Gede Ihsan, Dhiya Januar Wibawa Martha Jungjunan, Ridho Karwiky, Giky Kusumawardhani, Nuraini Yasmin Prakoso, Kurniawan Prameswari, Hawani Sasmaya Pramudyo, Miftah Raharjo, Pradana Pratomo Rama Nusjirwan Rezkita, Aliya Rahmadewi Sihite, Teddy Arnold Syarief Hidayat Wibawa, Kevin