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All Journal Jurnal Kedokteran Brawijaya Indonesian Journal on Computing (Indo-JC) Heart Science Journal Jurnal Klinik dan Riset Kesehatan
Rizal, Ardian
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Biochemistry, Genetics & Molecular Biology Computer Science & IT Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Journal : Heart Science Journal

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Acute Hemodynamic Index as a Predictor of In-Hospital Mortality in Mechanical Ventilated Acute Decompensated Heart Failure Patients Kurniawan, Dea Arie; Anjarwani, Setyasih; Rizal, Ardian; Satrijo, Budi; Yogibuana, Valerinna
Heart Science Journal Vol. 4 No. 1 (2023): Optimizing Outcome in Acute Cardiac Care
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.01.4

Abstract

Background: The likelihood of a poor clinical outcome is significantly increased in patients with acute decompensated heart failure. Mechanical ventilation was necessary for 23% of ADHF patients receiving treatment. The simple parameters of blood pressure and heart rate have good accuracy and repeatability. The development of the Acute Hemodynamic Index allowed for the calculation of pulse pressure and heart rate to be used as a basis for predicting intrahospital mortality.Methods: The medical records of patients who received care at CVCU RSSA were used in this retrospective, single-center study. ROC analysis and multivariate regression analysis were used to evaluate the prognostic performance of AHI. Statistical significance was determined by the P value of 0.05 or lower.Results: 252 patients with heart failure and low ejection fraction had their data analyzed. Hospital mortality is 82 percent. The cut-off was 4.19 mmHg/bpm, which was the AHI value. 68.8% of patients with fatal illnesses had low AHIs ( 4.19 mmHgbpm). AHI > 4.19 mmHgbpm patients have a 9-fold increased risk of dying in the hospital than patients with low AHI. AUC: 0.825 [0.743-0.907]; sensitivity: 0.814; specificity: 0.689; AUC: 0.825 [0.743-0.907; p = 0.000]; demonstrate the high predictive power of AHI.Conclusion: AHI has a strong degree of association with the likelihood of dying in the hospital from acute decompensated heart failure.
Atrial Fibrillation Development Risk Associated with Metabolic Syndrome Alfata, Fandy Hazzy; Rizal, Ardian; Rohman, Mohammad Saifur; Rahimah, Anna Fuji
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.2023.004.03.2

Abstract

Even in the absence of antecedent myocardial infarction or congestive heart failure, atrial fibrillation (AF) is the most frequent arrhythmia seen in daily practice. There are several important predisposing factors for the initiationof AF, including growing older, being a man, being female, having high blood pressure, and having cardiac and noncardiac illnesses. Metabolic syndrome (MS) contributes to the progression of AF through its impact on the atrial substrate. MS involves metabolic risk factors that increase the likelihood of atherosclerotic cardiovascular disease and type 2 diabetes. Insulin resistance plays a significant role in MS pathophysiology, leading to glucose and lipid metabolism dysregulation, increased inflammation, and neurohormonal activation. These processes contribute to the development of hypertension, a major risk factor for AF. Atrial remodeling, including electrical and structural changes, is a common substrate for AF, and MS components further contribute to this remodeling.Hypertension, a key feature of MS, is associated with structural, contractile, and electrical remodeling in the atria, increasing the risk of AF. The renin-angiotensin-aldosterone system, implicated in hypertension regulation, alsoinfluences the pathophysiology of AF through fibrosis, ion channel alterations, oxidative stress, and inflammation. Understanding the intricate interplay between MS and AF can provide insights into therapeutic strategies for managing these conditions and reducing cardiovascular risks.
Rapid degradation of left ventricular function after permanent right ventricular pacing in patients with high-grade atrioventricular block Setiawan, Dion; Prasetya, Indra; Anjarwani, Setyasih; Rizal, Ardian
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.2025.006.01.22

Abstract

Background: Permanent right ventricular (RV) pacing is a standard for high-grade atrioventricular (AV) block treatment. However, it may result in left ventricular (LV) dilatation, systolic dysfunction, and heart failure (HF) as a consequence of ventricular dyssynchrony and an abnormal myocardial contraction pattern. Pacing-induced cardiomyopathy (PICM) can develop months or years after implantation of a permanent pacemaker (PPM) in patients who have long-term and high-burden RVP. Case Illustration: We reported a case of a 56 years old Asian female having a record of PPM on VVIR mode implantation due to a high grade AV block presented with shortness of breath and bilateral leg swelling. Conclusion: Echocardiography showed a significant decrease in LV systolic function less than two years after PPM implantation. Coronary angiography showed widely patent vessels; subsequently, His-Bundle Pacing (HBP) was scheduled on the patient.
Fever-Induced Brugada-Pattern Electrocardiogram Nugraha, Yudha Tria; Prasetya, Indra; Martini, Heny; Rizal, Ardian
Heart Science Journal Vol. 5 No. 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.7

Abstract

Background: The Brugada syndrome is a type of cardiac arrhythmia frequently overlooked because of the dynamic character of the condition. Because it tends to progress into ventricular arrhythmias, it is a disorder that, if left untreated, carries the risk of being deadly. Not only is it essential for the practicing clinician to understand the situations that can disclose the concealed Brugada syndrome, but it is also essential for patients to understand these circumstances so that they can be educated to seek medical assistance quickly. This study aimed to describe the diagnosis and management of fever-induced Brugada pattern electrocardiogramCase presentation: Male in his 42-year-old with a history of intermittent fever for four days before hospital admission. High-degree fever was only relieved by taking antipyretics and was accompanied by nausea and muscle and joint pain. Upon arrival at the emergency department, he denied any complaints of chest pain or discomfort, shortness of breath, orthopnea, PND, leg swelling, palpitation, or syncope. A chest radiograph showed normal cardiac and pulmo (Figure 1); a first electrocardiogram showed Sinus Rhythm, HR 112 bpm, regular, FA normal, HA normal, P wave normal, PR interval 160 msec, QRS 80 msec, QTc 326 msec, Coved ST elevation at lead V1 (1 mm), V2 (3 mm), T inversion at lead V1-V2, suggesting sinus tachycardia with type II Brugada pattern.Conclusion: A Brugada pattern can be exposed to several stimuli, but fever is particularly potent. To assist urgent or emergency follow-up in cardiology, Emergency physicians must be informed of specific ECG findings based on the patient's clinical risk factors. The emergency doctor must be able to tell the difference between this pattern and a typical variation of RBBB, as a delayed diagnosis can have dire consequences.
Correlation Study of Cotinine and Monocyte Chemoattractant Protein-1 (MCP-1) with Carotid Intima-Media Thickness (cIMT) in Male Active Tobacco Smoke Satwikajati, Sawitri; Kurnianingsih, Novi; Tjahjono, Cholid Tri; Wihastuti, Titin Andri; Sargowo, Djanggan; Rizal, Ardian
Heart Science Journal Vol. 5 No. 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.6

Abstract

Background : Tobacco smoke exposure induces intima-media thickness by reducing nitric oxide and increasing adhesive molecule activity, with circulating cotinine serving as a marker; we hypothesize a correlation between monocyte chemoattractant protein-1 (MCP-1) and carotid intima-media thickness (cIMT) in active male smokers. Method : We conducted an observational cross-sectional analytic study involving 125 male participants, with 62 being active tobacco smokers and 63 non-smokers. Data were presented as mean ± SD, and the correlation between variables was analyzed using Pearson correlation. Result : Cotinine and MCP-1 levels were significantly higher in the smoker population (p 0.000) compared to non-smokers. The incidence of positive cIMT findings was higher in the smoker group (5%) than in the non-smoker group (2%). In the active smoker population, cotinine (r 0.21; p 0.11) showed a positive but non-significant correlation with positive cIMT findings, while MCP-1 showed a negative correlation (r -0.19, p 0.14) with positive cIMT findings. Smoking duration (r 0.162; p 0.223) and the amount of tobacco smoke (r 0.003; p 0.982) demonstrated a positive correlation with cotinine. MCP-1 exhibited a non-significant positive correlation with smoking duration (r 0.122; p 0.345) and a non-significant negative correlation with the amount of tobacco smoke (r -0.002; p 0.989). Conclusion : Among active tobacco smokers, cotinine showed a positive but non-significant correlation with positive cIMT findings, while MCP-1 exhibited a non-significant negative correlation with positive cIMT findings. 
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.
Personalized assessment and management of patients with coexisting supraventricular tachycardia and coronary artery disease: A case series Bahar, Mokhamad Aswin; Rizal, Ardian
Heart Science Journal Vol. 7 No. 1 (2026): Accelerating Clinical Breakthroughs: The Journey from Molecular Discovery to Pa
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.01.23

Abstract

Background: Supraventricular tachycardia (SVT) and coronary artery disease (CAD) are common cardiovascular diseases that can exist simultaneously, complicating diagnosis and treatment. This case series aims to present clinical scenarios and management strategies in patients with both conditions, emphasizing the decision-making process between ablation and revascularization. Case Presentations: Three male patients, between 51 and 63 years old, presented with recurrent palpitations which sometimes accompanied by chest discomfort or exertional dyspnea. All patients had cardiovascular risk factors. Angiography revealed either multivessel CAD or a history of percutaneous coronary intervention (PCI). Electrocardiogram (ECG) showed different tachyarrhythmias which included atrioventricular nodal reentrant tachycardia (AVNRT), atrial tachycardia (AT), and Wolff-Parkinson-White (WPW) syndrome. The management strategies depended on the main clinical issue present. The treatment of patients with significant ischemia involved PCI with drug-eluting stents (DES) to achieve both symptom relief and rhythm stabilization. On the contrary, when arrhythmia was the main driver of symptoms, catheter ablation successfully eliminated the tachyarrhythmia and enhanced the quality of life. Conclusions: Adequate diagnosis of arrhythmia, its underlying mechanisms, substrates, and triggers by use of electrophysiological study is crucial for well-adapted, multidisciplinary selection of intervention—catheter ablation, PCI, or both—as key to clinical best results.
Co-Authors Adi Nugroho, Dwi Adi, Andi Wahjono Alfata, Fandy Hazzy Anjarwani, Setyasih Arif Wicaksono Astiawati, Tri Aziz, Indra Jabbar Bahar, Mokhamad Aswin Baskoro, Shalahuddin Suryo Cholid Tri Tjahjono Cik, Kahadi Djanggan Sargowo Dwigustiningrum, Nur Kaputrin Fikry, Maurice Galuh, Lukitasari Ayu Haryati, Lina Indra Prasetya Inggita Kusumastuty Kahadi, Cik Kaputrin, Nur Karolina, Wella Kurnianingsih, Novi Kurniawan, Dea Arie Laitupa, Fitranti Suciati Lestari, Puspa Martini, Heny Mohammad Saifur Rohman Noverike, Nikhen Nugraha, Krishna Ari Nugraha, Yudha Tria Pramudyo, Miftah Putri, Valerinna Yogibuana Swastika Rahimah, Anna Fuji Rochmawati, Icmi Dian Saerang, Gebryel Dennis Saputri, Vemmy Lian Satria Mandala Satrijo, Budi Satwikajati, Sawitri Setiawan, Dion Suprapto, Ratih Paramita Suprayoga, Imam Mi'raj Titin Andri Wihastuti Widito, Sasmojo Wikananda, Adhika Prastya Yoga Waranugraha Yogibuana, Valerinna