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All Journal Heart Science Journal
Rahimah, Anna Fuji
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Health Professions Immunology & microbiology Medicine & Pharmacology

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Echocardiography Features in Patient Rheumatic Mitral Stenosis Dwigustiningrum, Nur Kaputrin; Rahimah, Anna Fuji; Karolina, Wella; Martini, Henny
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.2024.005.02.5

Abstract

Rheumatic mitral stenosis (RMS) is a progressive valvular heart disease that can lead to significant morbidity and mortality, especially in developing countries. Echocardiography plays a crucial role in the diagnosis, assessment, and management of patients with RMS. This study aims to review the utility echocardiography feature in patient RMS. We discuss the key echocardiographic parameters used for assessment and severity of RMS, and associated valvular abnormalities. Additionally, we explore the role of multimodality imaging, such as transesophageal echocardiography in enhancing the diagnostic accuracy and therapeutic decision-making in RMS. A thorough understanding of echocardiographic findings in RMS is essential for clinicians involved in the care of these patients, as it aids in risk stratification, treatment planning, and monitoring of disease progression. Integrating echocardiography is a widely used non-invasive method for comprehensive assessment, monitoring disease progression and evaluating treatment efficacy, ensuring optimal management for patient with RMS.
Cardiac imaging in cardiovascular complications due to COVID-19 Galuh, Lukitasari Ayu; Sargowo, Djanggan; Satrijo, Budi; Handari, Saskia Dyah; Rahimah, Anna Fuji
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.2024.005.04.6

Abstract

Cardiovascular complications are a common manifestation of acute phase and chronic phase of coronavirus disease 2019 (COVID-19) infection. Complications include cardiomyopathy, myocardial infarction, arrhythmias, heart failure, and deep venous thrombosis. Imaging is widely used in patients with suspected myocardial injury or myocarditis. Because of its availability and portability, transthoracic echocardiography (TTE) is used as the initial imaging modality in patients with suspected COVID-19 myocarditis. Echocardiographic studies performed on patients with suspected or confirmed COVID-19 should be as focused as necessary to obtain diagnostic views but should also be comprehensive enough to avoid the need to return for additional images. Following COVID-19 infection, a variety of persistent respiratory, neurological, cardiovascular, and other symptoms can persist for weeks, months, or even years. A cardiac examination and any resulting abnormalities in the structure and function of the heart may occasionally last for several months following a COVID-19 diagnosis. This is referred to as long  COVID syndrome. Cardiac magnetic resonance (CMR) imaging has often been used clinically to complement echocardiography, particularly tissue characterization imaging which demonstrated subclinical myocardial edema with or without fibrosis in patients recovered from illness.
Neutrophil-Lymphocyte Ratio (NLR) as A Predictor for Non-ST Elevation Myocardial Infarction (NSTEMI) in the Emergency Room Zunardi, Lutfi Hafiz; Anjarwani, Setyasih; Prasetya, Indra; Satrijo, Budi; Rahimah, Anna Fuji
Heart Science Journal Vol 5, No 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.7

Abstract

AbstractBackground: The usefulness of the NLR as an approach to identifying cases of acute coronary syndrome (ACS) needs to be improved.Objective: This research was designed to determine the effectiveness of the NLR in identifying individuals who presented to the emergency room complaining of anginal due to ACS.Methods: The single-center cross-sectional study was performed at Saiful Anwar General Hospital in Malang, East Java, Indonesia, from July 2020 to December 2023. Patients were involved in this study with complaints of angina suspected of ACS. During further observation in the emergency room, based on the findings of the troponin I analysis, individuals were divided into unstable angina pectoris (UAP) and NSTEMI.Results: Study results were collected from 282 individuals diagnosed with Non-ST Elevation Acute Coronary Syndrome (NSTEACS), with 75.9% male and a mean age of 58.39 ± 10.27 years. The NLR threshold was 4.5 (AUC: 0.78, 95% CI: 0.765–0.867, P <.001) assessed during admission, which showed a sensitivity of 79% and a specificity of 78% in accurately predicting the probability of subsequent troponin positivity. Multivariate analysis revealed that the NLR at hospitalization remained an essential marker of troponin positivity during follow-up.Conclusions: In the end, NLR could be considered an initial test in emergency services to predict the diagnosis of NSTEMI in people experiencing angina. 
Scoring system for early detection in pulmonary hypertension type I based on clinical presentation, electrocardiography, and chest X-ray at RSUD dr. Saiful Anwar Galuh, Lukitasari Ayu; Martini, Heny; Rahimah, Anna Fuji
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.2024.005.04.12

Abstract

Background: In Indonesia, pulmonary hypertension prevalence is 1:10.000 population. Due to its atypical symptoms, often PH patients come as a late presenters thus they have a worse prognosis. The golden standard to diagnose is Right Heart Catheterization (RHC) which is not widely available.Objectives: To generate a scoring system based on clinical presentation, electrocardiogram, and chest x-ray for early detection.Methods: A hospital-based cross-sectional survey was conducted in RSUD dr. Saiful Anwar, East Java from July 2020 – November 2023 with data from the medical record in which all variables are obtained at one period. Data were analyzed using bivariate analysis, multiple logistic regression, and Area Under Curve (AUC) from Receiver Operating Characteristic (ROC).Results: A total of 244 patients who were above 18 years old were conducted RHC at RSUD dr. Saiful Anwar East Java. We found a total score of 12 consisting of Dyspnea on Effort (DOE) score 2, Palpitation score 1, Increasaed P2 score 2, Increased JVP (Jugular vein pressure) score 2, RV (Right Ventricular) Heaves score 2, Right bundle branch block (RBBB) score 1, and Cardiomegaly (CTR >50%) score 2. With a 2 x 2 table, we found that a score of ⩾5 is likely for pulmonary hypertension diagnosis.Conclusion: Our study is a predictive model with a scoring system that has good sensitivity and specificity in selected populations where one of its limitations is sampling bias thus cannot yet be applied to the general population and needs further research for validation.
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.
Unveiling strategies in acute cardiac care for ventricular septal rupture following acute myocardial infarction: Lessons from cases Nurudinulloh, Akhmad Isna; Anjarwani, Setyasih; Prasetya, Indra; Yogibuana, Valerinna; Rahimah, Anna Fuji; Karolina, Wella
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.17

Abstract

Background: Ventricular septal rupture (VSR) following acute myocardial infarction (AMI) is drastically decreasing in the reperfusion era but mortality remains high. VSR correction is the definitive treatment and using mechanical support to delay closure is an attractive option despite data on success being limited. Case Illustration: A 60-year-old man presented with late presentation of anterior STEMI complicating hemodynamic deterioration. Echocardiography showed apical VSR 11-14 mm L-R shunt. Patient was given adequate fluids, multiple inotropic agents, and IABP insertion, then a successful PPCI procedure was performed immediately. IABP was maintained for hemodynamic stabilization and patient was scheduled for interventional closure. Unfortunately, the patient worsened due to cardiogenic shock and passed away on the 5th day of admission. In another case, a 61-year-old man came to our hospital also with a late presentation of anterior STEMI but stable in hemodynamics. Echocardiography showed apical VSR 9-11 mm L-R shunt. Coronary angiography showed CAD three vessel disease with critical stenosis at LAD. In hospital’s heart team discussion, patient was planned to be performed VSR closure percutaneously and continue with PCI procedure. Both procedures were performed successfully. Patient was improved and discharged on 20th day of admission. Conclusion: Rapid diagnosis and prompt treatment are the keys to optimal management of VSR complicating late presentation STEMI. Mechanical circulatory support and correction of VSR are required to optimize patient outcomes despite VSR is still a challenging case.
Hype or hope: The role of alcohol septal ablation in improving outcomes for young patients with obstructive hypertrophic cardiomyopathy: A case series Saputri, Vemmy Lian; Rizal, Ardian; Rahimah, Anna Fuji; Karolina, Wella; Yogibuana, Valerinna; Prasetya, Indra
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.19

Abstract

Background: Hypertrophic cardiomyopathy (HCM) is a disease that has a poor prognosis and a higher likelihood of death in young people. Alcohol septal ablation (ASA) is a minimally invasive procedure that involves the injection of ethanol through a septal perforator to lead to infarction of the hypertrophied septum. This case series aims to present data on the beneficial effects of ASA in promoting hope for enhanced outcomes in young patients with HCM. Case: Patient 1: A 32-year-old male with HCM has been suffering from chest discomfort and atrial fibrillation since 2020. Echocardiography detected an increased obstruction in the left ventricular outflow tract (LVOT), resulting in a gradient of 104 mmHg. The patient underwent ASA to decrease the gradient to 37 mmHg, reducing hospitalizations throughout a 12-month follow-up period. Patient 2: A 27-year-old female diagnosed with HCM has been frequently suffering episodes of near syncope and shortness of breath with light activity over the past 6 months. The echocardiography findings showed a significant increase in the resting gradient in the LVOT. Following ASA, the resting gradient decreased to 54 mmHg during a 3-month follow-up. The patient did not suffer further near syncope events, and her NYHA functional class improved throughout a 9-month follow-up period. Conclusion: The effectiveness of ASA as a treatment option is hope for young patients with obstructive HCM, which is demonstrated in this case series, leading to relieving symptoms, reduced repeated hospitalization, and improved functional capacity.
Challenging diagnostic for open artery ischemia Akbar, Akita Rukmana; Rahimah, Anna Fuji
Heart Science Journal Vol. 6 No. 4 (2025): The Pursuit of Precision: Navigating Risks, Refining Diagnosis, and Securing Lo
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Ischemic heart disease has traditionally been linked to obstructive coronary artery disease. However, a significant subset of patients presents with ischemic symptoms despite having non-obstructive coronary arteries—a condition termed Open Artery Ischemia (OAI). This encompasses entities like ANOCA(angina with no obstructive coronary arteries), INOCA(ischemia with nonobstructive coronary arteries), and MINOCA(myocardial infarction with nonobstructive coronary arteries), which challenge conventional diagnostic paradigms.​ Patients with OAI often experience persistent chest discomfort and demonstrable ischemia, yet their angiograms reveal no significant epicardial blockage. These individuals, frequently women in midlife, endure considerable morbidity, including diminished quality of life and recurrent hospitalizations. Underlying mechanisms such as microvascular dysfunction, vasospasm, and systemic inflammation contribute to their symptoms.​ This review aims to elucidate the clinical features, pathophysiological mechanisms, and diagnostic challenges of OAI. By highlighting the importance of advanced diagnostic tools and a patient-centered approach, we advocate for increased awareness and better management strategies for this often-overlooked condition.
Co-Authors Adi, Andi Wahjono Akbar, Akita Rukmana Alfata, Fandy Hazzy Anjarwani, Setyasih Arif Wicaksono Aryanugraha, Teguh Astiawati, Tri Djanggan Sargowo Dwigustiningrum, Nur Kaputrin Emil Fathoni, Emil Galuh, Lukitasari Ayu Haryati, Lina Indra Prasetya Karolina, Wella Kurnianingsih, Novi Laitupa, Fitranti Suciati Martini, Henny Martini, Heny Mohammad Saifur Rohman Noverike, Nikhen Nugraha, Krishna Ari Nurudinulloh, Akhmad Isna Putri, Valerinna Yogibuana Swastika Rizal, Ardian Saputri, Vemmy Lian Saskia Dyah Handari Satrijo, Budi Suprayoga, Imam Mi'raj Widito, Sasmojo Wikananda, Adhika Prastya Yoga Waranugraha Yogibuana, Valerinna zunardi, Lutfi hafiz