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All Journal J-Dinamika: Jurnal Pengabdian Kepada Masyarakat Heart Science Journal Jurnal Klinik dan Riset Kesehatan
Widito, Sasmojo
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Myocardial Bridging: Tinjauan Mendalam Mengenai Anomali Koroner Nurudinulloh, Akhmad Isna; Widito, Sasmojo
Jurnal Klinik dan Riset Kesehatan Vol 3 No 3 (2024): Edisi Juni
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.03.03.5

Abstract

Myocardial bridging (MB) is a congenital coronary anomaly where segment of the epicardial coronary artery traverses through the myocardium for a portion of its length. While traditionally regarded as a benign condition, there is a growing focus on specific subsets of MB associated with ischemic symptoms and requires treatment. Increasing attention is being given to specific subsets of MB associated with ischemic symptomatology. The emergence of modern functional and anatomical imaging techniques; coronary angiography, coronary computed tomography angiography (CCTA), instantaneous wave-free ratio (iFR), dan diastolic fractional flow reserve (dFFR), has improved our capacity to characterize symptoms associated with MB. In cases involving symptomatic patients, medical therapy often represents an effective treatment option. For individuals who do not respond satisfactorily to medical interventions, comprehensive multimodal assessment; percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and myotomy should be considered.
SGLT2 inhibitor, a new bullet in heart failure management Saidi, Zaki; Widito, Sasmojo
Heart Science Journal Vol. 5 No. 4 (2024): The Current Perspective About Cardiometabolic Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2024.005.04.5

Abstract

The global health landscape is confronted with substantial challenges stemming from diabetes mellitus and heart failure (HF). The escalating incidence of diabetes mellitus (DM), in correlation with HF, underscores the imperative necessity for efficacious strategies in the realm of prevention and management. The most recent advancements in therapeutic approaches, specifically Sodium-glucose transporter 2 inhibitors (SGLT2i), present a promising prospect for enhancing outcomes and addressing the existing gaps in HF management. This paper aims to elucidate the significance of SGLT2i in the therapeutic management of both reduced and preserved heart failure, with or without the presence of DM. SGLT2i are new heart failure drugs. In trials, SGLT2i improved diastolic dysfunction, reduced oxidative stress, inflammation, fibrosis, and myofilament rigidity. The first SGLT2 inhibitor studies, EMPA-REG OUTCOME, DECLARE-TIMI 58, and CANVAS, showed that Empagliflozin and Canagliflozin reduced HF mortality and rehospitalization in type 2 diabetes mellitus (T2DM) patients. Dapagliflozin reduces HF hospitalizations without impacting T2DM mortality. Canagliflozin avoided creatinine rises, kidney disease deaths, and cardiovascular deaths in the CREDENCE Study. SGLT2i improve health in heart failure with preserved ejection fraction (HFpEF). SGLT2i improved health status statistically in the PRESERVED-HF and EMPEROR-Preserved investigations. SGLT2i became known as a promising therapeutic choice in the treatment of HF. The substantial evidence from prominent large-scale clinical trials has substantiated the cardiovascular and renal protective effects of SGLT2i. Furthermore, the benefits of these medications are relevant for individuals who have been diagnosed with heart failure with reduced ejection fraction (HFrEF), as well as those who are experiencing heart failure with preserved ejection fraction (HFpEF).
Unveiling The Diagnosis Pitfall: Complete Heart Block Presenting In Acute Coronary Syndromes Without Chest Pain And Non-Ischemic Electrocardiography In A Young Adult Suprayoga, Imam Mi'raj; Rizal, Ardian; Widito, Sasmojo; Rahimah, Anna Fuji
Heart Science Journal Vol. 4 No. 4 (2023): The Science and Art of Caring for Critically III Patients in Intensive Cardiac
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.04.8

Abstract

Background: The majority of studies indicate that the asymptomatic or atypical presentation of acute coronary syndrome (ACS) as a significant manifestation of coronary artery disease (CAD) is associated with a poor prognosis.Objective: The purpose of this study was to characterize the clinical characteristics and management of ACS patients who presented without chest pain and non-ischemic electrocardiogram (ECG).Case presentation: A 31 years old man with syncope was brought to our hospital. ECG revealed total AV block (TAVB) without ST segment changes. First, he was diagnosed with cardiac syncope because his ECG showed no ischemic sign. He had a strong familial history of CAD, so we examined his cardiac enzymes and found an increase in serial cardiac enzymes. Then, he was diagnosed with non-ST elevation myocardial infarction (NSTEMI). Early invasive strategy with chronic total occlusion (CTO) at osteal right coronary artery (RCA) and acute total occlusion at mid RCA with implantation of 1 DES at osteal-proximal RCA was selected for this patient. After five days of hospitalization, he discharged home with medicines. Conclusion: In order to significantly lower their morbidity and mortality, this group of high-risk patients needs to receive improved early diagnostic and treatment choices.
The Relationship Between Cha2ds2-Vasc Scores And The Degree of TIMI Flow in Patients With Acute St-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention at Dr. Saiful Anwar Malang Aji, Bayu; Widito, Sasmojo; Anjarwani, Setyasih; Kurnianingsih, Novi; Ruspiono, Evit
Heart Science Journal Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.10

Abstract

Background: Suboptimal reperfusion of the compromised myocardium in the area of the culprit coronary arteries is one of the main problems associated with primary PCI that need reliable risk stratification methods to accurately predict the occurrence of decreased TIMI flow given its complex pathophysiology. Some parameters are included CHA2DS2-VASc score.Objective: To understand the relationship between CHA2DS2-VASc and the decreased TIMI flow in STE-ACS patients who had underwent primary PCI at RSUD dr. Saiful Anwar Malang.Material and Methods: The study was cohort retrospective with the inclusion criteria being all STE-ACS patients who underwent primary PCI in RSUD Dr. Saiful Anwar Malang from January 2018 – August 2023. Patients were assigned to TIMI flow grade <3 group (N =169) and TIMI flow grade 3 (N = 677) according to TIMI Flow degree after primary PCI. All the patient’s angiogram were evaluated for TIMI score and CHA2DS2-VASc score is based on a guideline. We concluded data in SPSS program and used the Spearman test and p value of .05 was considered as significant.Result: From a total sample of 846 patients, the correlation between STE-ACS onset and TIMI flow indicates that a higher number of patients with STE-ACS onset <12 hours was found in the TIMI flow <3 and 3 groups (p=0.000). The cutoff CHA2DS2 VASC score's sensitivity and specificity values were ascertained using ROC analysis with cut off value 2.5. The incidence of decreased TIMI flow rate was more significant in the CHA2DS2-VASc ≥3 group with DM (+) and age ≥64 (OR value 0.156, p=0.000) than in the CHA2DS2-VASc ≥3 group without DM and age < 64. With an OR value of 2.94 (p=0.000), Killip class > 2 is another powerful predictor of lower TIMI flow.Conclusion: The only variables in the CHA2DS2-VASc score component that are most strongly associated with the risk of reducing the degree of TIMI flow are DM, age, and Killip class.
The Association between CHA2DS2-VASc Score with Increased Serum Creatinine Level in ACS Patients Undergoing PCI at RSUD dr. Saiful Anwar Malang Fathoni, Emil; Widito, Sasmojo; Anjarwani, Setyasih; Satrijo, Budi; Putri, Valerinna Yogibuana Swastika
Heart Science Journal Vol. 4 No. 4 (2023): The Science and Art of Caring for Critically III Patients in Intensive Cardiac
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.04.4

Abstract

Background: The current literature on the relationship between the congestive heart failure, hypertension, age, diabetes mellitus, prior stroke or TIA or thromboembolism, vascular disease, age, sex category (CHA2DS2-VASc) score and increased Serum Creatinine (SCr) among Acute coronary syndrome (ACS) patients is noticeably limited in scope. Therefore, the primary objective of this study was to assess the correlation between CHA2DS2-VASc score with increased of Serum Creatinine in patients with ACS undergoing Percutaneous coronary intervention (PCI) procedures.Material and Methods: In this study, a total of 527 participants were recruited, comprising two groups: Increased SCr level (n=159) and normal SCr level (n=368). Data pertaining to clinical information and demographic characteristics, such as gender, age, diabetes mellitus (DM), hypertension (HT), congestive heart failure (CHF), history of stroke or transient ischemic attack (TIA), and vascular disease, were gathered from various sources, including registry data and medical records, diagnostic physical examination, electrocardiography and laboratory records. Logistic regression analysis was employed to assess the association between the CHA2DS2-VASc score and the incidence of increased SCr level.Result: In our study, we observed that the CHA2DS2-VASc scores were significantly higher in the group of patients who increase SCr level compared to those who did not increase SCr level. Furthermore, our Receiver Operating Characteristic (ROC) analysis revealed that a CHA2DS2-VASc score cutoff of 3 was determined to be the optimal threshold for estimating the increased SCr level (AUC= 0.805, 95% CI 0.762-0.848; p<0.01).Conclusion: The CHA2DS2-VASc score serves as a valuable tool for estimating the likelihood of SCr in patients undergoing PCI, offering a foundational assessment. Additionally, in PCI patients, an increase in the CHA2DS2-VASc score exceeding 3 is indicative of a heightened incidence of increased SCr level.
Troubleshooting for Kinked Coronary Catheter: How to Manage? ; A Case Series Noverike, Nikhen; Satrijo, Budi; Widito, Sasmojo; Kurnianingsih, Novi; Abusari, Muchamad
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.7

Abstract

Background: Catheter entrapment and knotting are two problems that might arise during coronary angiography, regardless of the method used. It is not uncommon for the catheter shaft to become kinked during diagnostic or interventional procedures. Still, if the manipulation fails, an invasive retrieval method is usually necessary for cases with extensive catheter kinking.Case Illustration: We present two cases illustrating how different angiography approaches could lead to severe catheter kinking. Because of the significant tortuosity of the vasculature, even a gentle opposite rotation maneuver and the antegrade advancement of multiple guidewires failed to untwist the guide catheter. Once a twisted catheter has been identified via fluoroscopy, the twist can be eased by gently twisting the catheter in the opposite direction. It is not always easy. It could lead to using other interventional techniques such as snare, balloon, or surgical procedures. In our cases, we used a snare to snag the catheter's tip and untied the loop's knot. This prevented the need for unscheduled surgical intervention. We evaluated from angiography. There were no further complications. The patients were released from the hospital the following day.Conclusion: Although a kinked catheter could become entrapped, various approaches can be taken to deal with this difficulty and prevent the need for surgical intervention.
A 56 Year Old Male with Acute Stent Thrombosis During Percutaneous Coronary Intervention, How to Resolve This Problem? Millisani, Hayla Iqda; Rohman, Mohammad Saifur; Prasetya, Indra; Widito, Sasmojo
Heart Science Journal Vol. 4 No. 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascul
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.8

Abstract

Background: Acute stent thrombosis is the complete occlusion of a coronary artery of the previously implanted stent. This unusual complication occurs in percutaneous coronary intervention (PCI), development of myocardial ischemia, and poor prognosis for the patient. After PCI, acute stent thrombosiscan occur within 0-24 hours and cause the symptoms like acute coronary syndrome. Incidents of stent thrombosis are about 0.6% to 3.4% for Drug Eluting Stent (DES) implantation, depending on the lesion and patient factors. The etiology of acute stent thrombosis is multifactorial, and early detectioncan reduce the mortality rate.Case Illustration: A 56 yo male visited Rumah Sakit Saiful Anwar Malang with stable angina pectoris (Class III symptoms with medical therapy) planned for elective cardiac catheterization with routine medical treatment. During PCI, he complained the chest pain, and from cine angiography evaluation showed no flow at the diagonal branch because of the acute thrombosis. Then got thrombosuction and got a white thrombus. After the PCI procedure, he got fibrinolytic with streptokinase 1.5 million units for 60 minutes. He was transferred to CVCU for observation and discharged after five days.Conclusion: Acute stent thrombosis is a severe complication during and after PCI because it is related to high mortality. The mechanisms by which ST arises are complex and multifactorial and must be early detection.
Challenge case of ventricular arrhythmia in young women Kaputrin, Nur; Rizal, Ardian; Karolina, Wella; Widito, Sasmojo
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.16

Abstract

Background: Torsade de pointes (TdP) and ventricular fibrillation can cause rapid mortality. The etiological cause the ventricular arrhythmia must be detected and treated early, especially in the ER. Objective: We report a patient with severe hypokalemia and TdP following the administration of Amiodarone in QT-interval prolongation Case Report: A 32-year-old girl with diarrhea and vomiting for two days arrived to the ED with a seizure with her hand flexed and leg straight down. Her family reported she didn't take prescriptions regularly. She was GCS 224, hemodynamically stable, typical ECG showed extended QTc and her head CT was normal. During observation at the ED, she had seizure and the monitor revealed a Torsade de Pointes (TdP) ) with a pulse rate of 160-180 bpm. She was given Amiodarone and peroral Bisoprolol 5 mg. She returned to sinus rhythm with PVC bigeminy and was admitted to the ICU Laboratory data showed hypokalemia (1.9) improved (2.9) after treatment. Eight hours later, she experienced a TdP without pulse palpability for less than 1 minute, then Ventricular Fibrillation, began CPR, and the doctor in charge gave her a defibrillation operation once. She returned with sinus tachycardia 110-130 bpm. The next day, she was having recurring TdP episodes without a pulse. The doctor conducted CPR and defibrillation and returned with 120-130 bpm sinus tachycardia. The patient consulted a cardiologist and was prescribed lidocaine 1 mg/hour and continued Bisoprolol 5 mg for long QT problem. Observation The seizure ended 12 hours later, the patient was alert, GCS 456, and the ECG showed sinus rhythm with extended QTc. Over the days before discharge, electrocardiography demonstrated reduced QT-interval prolongation. Conclusion: Life-threatening ventricular arrhythmia in a young female can be caused by QT-interval prolongation. It must be diagnosed and treated immediately to avoid mortality.
An alternative retrograde access puncture for EVLA: a case report Kurniawan, Catur Rizky; Kurnianingsih, Novi; Widito, Sasmojo
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.18

Abstract

Background: CVI manifests with a variety of clinical symptoms, spanning from varicose veins to venous ulcers, significantly impacting patients' daily lives. While traditional treatments such as compression therapy and surgery remain options, on endovenous laser treatment (EVLT) has emerged as a viable alternative.  This article delves into the management of CVI, with a particular focus EVLT as a minimally invasive intervention. Through two case illustrations, it sheds light on the difficulties encountered when accessing the great saphenous vein (GSV) using the conventional antegrade approach, particularly in cases involving obesity and vasospasm. Consequently, a retrograde EVLT technique utilizing proximal GSV access, resulting in successful vein ablation with minimal complications. Overall, this approach presents a promising addition to the management of CVI, offering enhanced patient care and improved outcomes. Case Presentation: Two patients with CVI and challenging antegrade GSV access underwent retrograde EVLT using proximal GSV access. Despite initial difficulties, including obesity and vasospasm, successful vein ablation was achieved with minimal complications. Post-procedural evaluations demonstrated significant symptomatic improvement, highlighting the efficacy of the retrograde technique. Conclusion: Retrograde EVLT utilizing proximal GSV access proves to be a safe and effective alternative in cases where antegrade access is challenging. The technique offers simplicity, minimal complications, and high patient satisfaction, with outcomes comparable to traditional approaches. Extended follow-up studies are needed to confirm the long-term effectiveness of retrograde EVLT compared to antegrade methods. Overall, retrograde EVLT presents a valuable option for managing CVI, particularly in patients with anatomical complexities or vasospasm, contributing to improved patient care and outcomes.
Integrasi Sistem Informasi Geografis dan Sistem Informasi Manajemen Keanggotaan untuk Meningkatkan Aksesibilitas Layanan Kesehatan pada Ikatan Dokter Indonesia (IDI) Cabang Malang Raya Rozi, Imam Fahrur; Ariyanto, Rudy; Arianto, Rakhmat; Hapsari, Ratih Indri; Ananta, Ahmadi Yuli; Rohadi, Erfan; Widito, Sasmojo; Zakaria, Arief Syukron; Budiarti, Arry; Saputra, Zainal Ulu Prima; Irawan, Ferry Buyung Bakhtiar; Sholiha, Afifah
J-Dinamika : Jurnal Pengabdian Masyarakat Vol 10 No 1 (2025): April
Publisher : Politeknik Negeri Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The Indonesian Medical Association (IDI) Chapter Malang Raya, which covers area of Malang City, Batu City, and Malang Regency, faces challenges in managing doctor membership data and presenting information related to customer services and public services. To overcome these obstacles, a website-based information system was developed that integrates the Membership Management Information System with the Geographic Information System (GIS). The Membership Management Information System facilitates efficient management data of physician member of IDI chapter Malang Raya, including status of membership, competence of medical doctors, speciality, and subspeciality. Whereas GIS system serves to map the location of doctor practices. Integration these two systems making it easier for people to find the nearest health services. The system was developed using the waterfall methodology, which involves the stages of requirements analysis, design, implementation, testing and maintenance. The result is a platform that can improve IDI's internal efficiency and make it easier for people to access health services. This system has the potential to be further developed with the addition of security features and functionality such as real-time monitoring and mobile application integration, thus supporting more responsive and integrated health services
Co-Authors Abusari, Muchamad AJI, BAYU Ananta, Ahmadi Yuli Anjarwani, Setyasih Arif Wicaksono Atma Gunawan Budiarti, Arry Cholid Tri Tjahjono Emil Fathoni, Emil Erfan Rohadi Hapsari, Ratih Indri Ikeningrum, Dyah Ayu Imam Fahrur Rozi Indra Prasetya Indrihapsari, Pratiwi Irawan, Ferry Buyung Bakhtiar Kaputrin, Nur Karolina, Wella Kurnianingsih, Novi Kurniawan, Catur Kurniawan, Catur Rizky Millisani, Hayla Iqda Mohammad Saifur Rohman Noverike, Nikhen Nurudinulloh, Akhmad Isna Putri, V.Y.S Putri, Valerina Yogibuana Swastika Putri, Valerinna Yogibuana Swastika Rahimah, Anna Fuji Rakhmat Arianto Rizal, Ardian Rudy Ariyanto Ruspiono, Evit Saidi, Zaki Saputra, Zainal Ulu Prima Satrijo, Budi Sholiha, Afifah Suprapta, Aloysius Suprayoga, Imam Mi'raj Swastikaputri, Valerina Yogibuana Titin Andri Wihastuti Zakaria, Arief Syukron