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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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The Effect of Lipopolysaccharide Challenge in RAW 264.7 Cells on Nitric Oxide Release and Cell Viability Suprapto, Ratih Paramita; Kusumastuty, Inggita; Rizal, Ardian; Adi Nugroho, Dwi
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.2

Abstract

Lipopolysaccharide (LPS) is a major component of a gram-negative bacterial wall that is widely used and well-established to induce inflammation in vitro. In addition, the in vitro model using RAW 264.7 cells is the most commonly applied in screening the anti-inflammatory and elucidating the pathophysiology of inflammation-based disease, as well.  However, there is still limited data on the efficacy of different doses of LPS in inducing inflammation in RAW 264.7 cells. This study aimed to evaluate the effect and safety of LPS at various doses in RAW 264.7 cells. RAW 264.7 cells were exposed to LPS at different dose ranges (10ng/mL-10µg/mL) for 24 hours. The nitric oxide (NO) release as inflammatory responses and viability test were evaluated using Griess assay and CCK-8 assays, respectively. The result showed that NO production was increased at different doses of LPS compared to the control although not significant. Whereas, All LPS-treated RAW 264.7 cells tended to increase but not significantly compared to the control groups. This study showed that the LPS treatment effectively induced inflammation in RAW 264.7 cells as shown by NO production and was considerably safe as the viability was comparable between LPS and control group for RAW cells 264.7 at least up to 10µg/mL for 24 hours.
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.
When bones meet blood vessels: BMP-2 expression and vascular calcification in a rat model of metabolic syndrome Sihotang, Fransiska Anggreni; Rohman, Muhammad Saifur; Satrijo, Budi; Sargowo, Djanggan; Rizal, Ardian
Heart Science Journal Vol. 7 No. 2 (2026): The Evolving Landscape of Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.02.14

Abstract

Background: Vascular calcification (VC) is a significant contributor to cardiovascular morbidity, particularly in conditions like metabolic syndrome (MetS). Bone Morphogenetic Protein-2 (BMP-2) is implicated in the osteogenic differentiation of vascular cells, potentially linking MetS to VC. Objective: This study aimed to investigate aortic BMP-2 expression and the presence of VC in a rat model of MetS and assess the effects of Metformin, Empagliflozin, and a green tea/green coffee extract combination. Methods: Male Sprague-Dawley rats were induced with MetS using a high-fat, high-sucrose diet combined with a low-dose streptozotocin injection (30 mg/kgBW). Rats were divided into five groups (n=5): Normal control (NORM), MetS (METS), MetS + Metformin (MFN, 500 mg/kgBW), MetS + Empagliflozin (EMP, 30 mg/kgBW), and MetS + GTCE (300 mg/kgBW green tea + 200 mg/kgBW green coffee). Treatments were administered daily via oral gavage for 9 weeks. Result: Aortic tissue was collected for histological analysis and qRT-PCR to measure relative BMP-2 mRNA expression. Histological analysis revealed calcification in the aortic wall of the METS group rats. Compared to the NORM group, BMP-2 mRNA expression was significantly upregulated in the METS group (p<0.001). Treatment with MFN, EMP, and GTCE significantly downregulated BMP-2 mRNA expression compared to the METS group (p<0.001 for all). Conclusion: This study demonstrates that MetS induction in this rat model might promotes aortic calcification and significantly increases BMP-2 mRNA expression. Pharmacological interventions with Metformin, Empagliflozin, and green tea/coffee extract attenuated the MetS-induced upregulation of BMP-2 expression. These findings suggest a potential role for BMP-2 in MetS-associated vascular changes.
Diagnosis and management of vasovagal syncope: A comprehensive review Veliawan, Zhafran; Rizal, Ardian
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.2

Abstract

Syncope is a distinct type of  transient loss of consciousness characterized by rapid onset and complete spontaneous recovery. Syncope is categorized into three different kinds according to the 2018 European Society of Cardiology guidelines. Different types of syncope ultimately converge on a common pathophysiological occurrence: global cerebral hypoperfusion, resulting from the circulatory system's inability to maintain blood pressure at a level sufficient to provide adequate cerebral perfusion. Vasovagal syncope, often referred to as the "common faint," is the predominant etiology of syncope. Although classified as a benign condition, recurrent syncope incurs significant costs and adversely effects the quality of life for patients, particularly in the elderly. Typical vasovagal syncope predominantly manifests in young adults and is frequently identified based on medical history, provided there is no structural heart disease. Atypical vasovagal syncope frequently presents with a short or nonexistent prodrome, and inattention regarding the loss of consciousness is prevalent, leading to potential misdiagnosis, such as falls. This article provides an overview of the evaluation and management of vasovagal syncope.
Antiarrhythmic properties and mechanisms of SGLT2 inhibitors in managing atrial fibrillation patients with metabolic syndrome Rahmawati, Novi; Rizal, Ardian; Putri, Diana Yuswanti
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.3

Abstract

Atrial fibrillation (AF) frequently occurs in patients with metabolic syndrome (MetS), a cluster of cardiometabolic abnormalities including obesity, hypertension, dyslipidemia, and type 2 diabetes mellitus (T2DM), which collectively promote adverse atrial electrical and structural remodeling. These intertwined conditions significantly complicate AF management and contribute to disease progression. Sodium–glucose cotransporter 2 (SGLT2) inhibitors, initially developed as glucose-lowering agents, have demonstrated robust cardiovascular and renal benefits beyond glycemic control. Accumulating clinical evidence from post-hoc analyses, real-world studies, and large meta-analyses indicates that SGLT2 inhibitors significantly reduce the incidence of new-onset and recurrent AF, particularly in patients with MetS and T2DM. Mechanistic studies revealed that the antiarrhythmic effects of SGLT2 inhibitors arise from pleiotropic actions targeting key arrhythmogenic pathways. These include restoration of intracellular Na⁺ and Ca²⁺ homeostasis via inhibition of the Na⁺/H⁺ exchanger and CaMKII signaling, suppression of oxidative stress and inflammation through modulation of NADPH oxidase and NLRP3 inflammasome activity, attenuation of atrial fibrosis by inhibiting the TGF-β/Smad pathway, and improvement of mitochondrial function and bioenergetics through activation of the PGC-1α/NRF-1/Tfam axis. Additional systemic benefits, such as weight reduction, improved hemodynamics, decreased epicardial adipose tissue, and autonomic nervous system modulation, further contribute to atrial electrical stability. This review summarizes current clinical and mechanistic evidence supporting the role of SGLT2 inhibitors as a promising upstream therapeutic strategy for AF prevention and management in patients with MetS.
Acute pulmonary embolism following radiofrequency catheter ablation in a young asian female on hormonal contraceptive injection Triatmojo, Nicodemus; Rizal, Ardian; Wikananda, Adhika Prastya; Kurnianingsih, Novi; Anjarwani, Setyasih
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.17

Abstract

Background: Acute pulmonary embolism (APE) is an uncommon yet severe complication following radiofrequency catheter ablation (RFCA) for arrhythmic disorders, with reported incidences ranging from 0% to 1.7%. Hormonal contraceptive injections, specifically Depot Medroxyprogesterone Acetate, significantly increase the risk of venous thrombosis. Early identification of APE is challenging due to non-specific symptoms, but critical indicators include sudden shortness of breath, chest pain, and loss of consciousness. Timely and tailored treatment, including weight-based dose adjustments for fibrinolytic therapy in Asian patients, is crucial for optimal outcomes. Case Presentation: We present the case of a 23-year-old Asian female with no prior history of thromboembolic diseases, who was on Depot Medroxyprogesterone Acetate for contraception. She underwent an uncomplicated RFCA procedure for frequent premature ventricular contractions. Patient was immobilized for nine hours post-procedure, upon her first attempt to mobilize and walk to the bathroom, she suddenly experienced shortness of breath, chest pain, and a brief loss of consciousness. Her vital signs were unstable, with a blood pressure of 85/55 mmHg, heart rate of 133 bpm, respiratory rate of 32 breaths/minute, and oxygen saturation of 88%. Echocardiography revealed right ventricular dilatation and a positive McConnell sign. A CT pulmonary angiography confirmed a filling defect in the left pulmonary artery, leading to an APE diagnosis. Considering her Asian ethnicity and low BMI, the patient was successfully treated with a reduced dose of alteplase (50 mg) administered over two hours to minimize bleeding risk. Her vital signs stabilized during fibrinolytic therapy, with no hemorrhagic complications. Following three months of oral rivaroxaban treatment, a follow-up CT pulmonary angiography revealed complete resolution of the embolism. Conclusions: This case underscores that APE, though rare, is a serious complication of RFCA, especially when combined with prolonged immobilization and hormonal contraceptive use. The abrupt onset of symptoms, including shortness of breath and loss of consciousness upon initial mobilization, is a critical indicator of Acute PE. Early mobilization within 2-4 hours post-RFCA is indicated to minimize embolic risk. Individualized treatment strategies, such as weight-based fibrinolytic dosing, are essential for managing APE in specific patient populations to optimize efficacy and safety. Clinicians should exercise caution with patients using hormonal contraception undergoing procedures involving vascular puncture.
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 Fransiska Anggreni Sihotang 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 Miftah Pramudyo Mohammad Saifur Rohman Muhammad Saifur Rohman Noverike, Nikhen Novi Rahmawati Nugraha, Krishna Ari Nugraha, Yudha Tria Putri, Diana Yuswanti 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 Triatmojo, Nicodemus Veliawan, Zhafran Widito, Sasmojo Wikananda, Adhika Prastya Yoga Waranugraha Yogibuana, Valerinna