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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Biomedika Indonesian Journal of Cardiology Narra J Zona Kedokteran: Program Studi Pendidikan Dokter Universitas Batam Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Basuni Radi
Departemen Kardiologi Dan Kedokteran Vaskuler, Fakultas Kedokteran, Universitas Indonesia- Pusat Jantung Nasional Harapan Kita
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Exercise-based cardiac rehabilitation adaptation protocol during Covid-19 pandemic achieved similar results as compared to non-pandemic usual practice: a single center experience Anggoro Budi Hartopo; Irsad Andi Arso; Ade Meidian Ambari; Bambang Dwiputra; Basuni Radi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 4 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005404202207

Abstract

During the Covid-19 pandemic, exercise-based cardiac rehabilitation (EBCR) faced challenges. Adaptation protocols were implemented to circumvent these challenges. The study aimed to investigate whether the adaptation protocols of EBCR during Covid-19 period influenced the result of cardiac rehabilitation. This was a retrospective cohort study. The subjects were patients who underwent an EBCR program in Dr. Sardjito General Hospital. Yogyakarta, Indonesia. The registry of cardiac rehabilitation was obtained and divided into two periods: non-Covid-19 period and Covid-19 period. During the non-Covid-19 period, 3 EBCR sessions per wk (10-12 total sessions) were performed. During the Covid-19 period, EBCR was reduced to 2 sessions per wk (10-12 total sessions). The functional capacities were evaluated as metabolic equivalents (METs) and exercise test time (min) by treadmill test. A total of 122 subjects completed the EBCR. There were no significant differences in METs and exercise minute achieved between two time periods. Among subjects with different sessions per wk, namely 2, 3, and 4-5 sessions per wk, there were no significant differences in METs (7.01±1.89; 7.23±1.74; and 7.33±2.13, p=0.813) and minutesachieved (6.72±1.94; 6.96±1.96; and 6.81±1.84, p=0.848) in the end sessions. In conclusion, the adaptation of EBCR protocols during the Covid-19 period by reducing the number of sessions per wk has similar results as compared to the usual regular EBCR practice.
Non-dominant handgrip strength is associated with higher cardiorespiratory endurance and elevated NT-proBNP concentrations in ambulatory male adult outpatients with stable HFrEF Triangto, Kevin; Radi, Basuni; Siswanto, Bambang B.; Tambunan, Tresia FU.; Heriansyah, Teuku; Harahap, Alida R.; Kekalih, Aria; Katsukawa, Hajime; Santoso, Anwar
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1278

Abstract

Understanding the significance of handgrip strength is essential for identifying frailty in heart failure patients. The aim of this study was to identify the association between handgrip strength and cardiorespiratory endurance while highlighting the importance of the musculoskeletal system in cardiac rehabilitation for patients with heart failure. An observational cross-sectional study was conducted at Harapan Kita Hospital, Jakarta, Indonesia, from April 2022 to April 2023, among patients with heart failure with reduced ejection fraction (HFrEF) attributed to cardiomyopathy or coronary artery disease. Patients were classified by a 6-minute walk test (6MWT) distance into <400 meters (low endurance) or ≥400 meters (high endurance). The short physical performance battery (SPPB), handgrip strength, ultrasonographic forearm muscle thickness, left ventricle ejection fraction, tricuspid annular plane systolic excursion, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured. Results indicated significant differences in non-dominant handgrip strength, gait speed, and sit-to-stand SPPB scores between patients achieving a 6MWT distance of ≥400 meters and those below this threshold, with values of 31.11±6.88 kg vs 27.66±6.66 kg (p=0.049), 0.52±0.08 m/s vs 0.61±0.13 m/s (p=0.001), and 10.71±2.47 seconds vs 12.85±4.11 seconds (p=0.014), respectively. Stronger non-dominant handgrip strength (>30 kg) was associated with higher endurance (odds ratio (OR): 3.80; 95%CI: 1.35–10.67; p=0.010) and thicker forearm muscles (>1.9 cm) as measured by ultrasonography (AUC: 0.713; 95%CI: 0.585–0.840, p=0.001). In conclusion, a cut-off of ≤30 kg for non-dominant handgrip strength could effectively stratify the male patients into a lower endurance group (6MWT ≤400 meters), which is associated with elevated NT-proBNP levels and reduced forearm muscle thickness.
Protokol Latihan BEST yang Disesuaikan dalam Rehabilitasi Gagal Jantung Triangto, Kevin; Radi, Basuni; Siswanto, Bambang Budi; Tambunan, Tresia Fransiska Ulianna; Heriansyah, Teuku; Harahap, Alida Rosita; Kekalih, Aria; Ambari, Ade Meidian; Dwiputra, Bambang; Desandri, Dwita Rian; Katsukawa, Hajime; Santoso, Anwar
Jurnal Kardiologi Indonesia Vol 45 No 3 (2024): July - September, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1738

Abstract

Introduction Heart failure with a reduced ejection fraction (HFrEF) significantly contributes to global morbidity and mortality, necessitating effective rehabilitation programs. Exercise-based rehabilitation improves functional capacity and quality of life in HFrEF patients, though responses vary. The tailored BEST (Breathing, Endurance, and Strengthening) exercise protocol addresses both cardiac and extracardiac rehabilitation, benefiting all patients regardless of response status. This study evaluated the protocol's effects on HFrEF patients and classified responses based on VO2max changes. Methods In this etiologic study with prospective cohort design, all participants underwent a three-month cardiac rehabilitation program using the BEST Exercise Protocol. Assessments included the 6-minute walk test (6MWT), short physical performance battery (SPPB), handgrip strength, chest expansion, ultrasonographic measurements, and NT-proBNP levels before and after the intervention, with statistical comparisons made within and between groups. Groupings of responder level will be reliant on 6MWT distance achievement at the end of the program, with ≥6% improvement classified as good responders. Results Out of 107 HFrEF patients (median age 55 years, ejection fraction 29.50±7.34%), 63.56% were good responders and 36.44% were poor responders (<6% improvement). Good responders showed significant improvements in most extracardiac parameters, including a 20% increase in 6MWT distance (470.96±69.21 meters post-rehabilitation), chest expansion, handgrip strength, and SPPB scores (p<0.001 for all). Poor responders also improved in chest expansion, sit-to-stand time, and postural balance, with minor 6MWT gains (407.33±72.50 meters). NT-proBNP levels decreased in both groups but were not statistically significant (p=0.288 and 0.368 for good and poor responders, respectively). Conclusion The tailored BEST Exercise Protocol offers substantial cardiac and extracardiac benefits for HFrEF patients by enhancing functional capacity and muscle strength. Both good and poor responders exhibited significant improvements, indicating the protocol's broad applicability. However, the lack of statistically significant NT-proBNP reduction suggests further studies on cardiac biomarkers are needed. The 6MWT provides accessible rehabilitation insights, though more precise evaluations like Cardiopulmonary Exercise Testing (CPET) can offer clearer insights into cardiopulmonary adaptations.
Exploring the Relationship Between Comprehensive Respiratory Assessment and Intra-Extracardiac Biomarkers in Heart Failure Rehabilitation Triangto, Kevin; Radi, Basuni; Siswanto, Bambang B.; Tambunan, Tresia FU.; Heriansyah, Teuku; Harahap, Alida R.; Kekalih, Aria; Katsukawa, Hajime; Santoso, Anwar
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 8 No. - (2024): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v8i-.248

Abstract

Introduction: Heart failure with reduced ejection fraction (HFrEF) is well-known as a systemic disease that involves cardiac and extracardiac issues, with respiratory function playing on of the key role in rehabilitation prognosis. Biomarkers such as soluble suppression of tumorigenicity 2 (sST2), myostatin, miRNA-133, and NT-proBNP indicate disease progression. Notably, sST2, which is also produced by the lungs, predicts heart failure outcomes. This study examines the relationship between comprehensive respiratory assessments (e.g., diaphragmatic ultrasonography, spirometry) and intra-extracardiac biomarkers to improve rehabilitation strategies. Methods: Sixty-nine HFrEF patients underwent respiratory evaluations, including diaphragmatic ultrasonography, spirometry, chest expansion measurements, and a six-minute walking test (6MWT). Biomarkers assessed were sST2, myostatin, miRNA-133, and NT-proBNP. Associations between respiratory parameters and biomarkers were analyzed using t-tests and correlation analyses. Results: The median age was 56 years, and 33 (47.82%) of the subjects had diaphragmatic dysfunction, resulting in poorer 6MWT performance (378.03±58.15 m vs 409.75±63.65 m, p=0.017) and other parameters. Superior chest expansion negatively correlated with sST2 (r=−0.387, p=0.001) and positively with miRNA-133 (r=0.442, p<0.001). Similar results were found for inferior chest expansion. No significant correlations were observed for other biomarkers. Conclusion: This study highlights strong associations between chest expansion and sST2/miRNA-133, suggesting that incorporating respiratory assessments and training into HFrEF rehabilitation could enhance outcomes by addressing cardiorespiratory insufficiencies. Given sST2's predictive value for heart failure prognosis, these findings support a multi-component rehabilitation strategy incorporating respiratory training, such as aerobic and inspiratory muscle exercises, to enhance cardiopulmonary outcomes. This integrated approach offers promise for future HFrEF rehabilitation protocols.
HUBUNGAN MITRAL VALVE GRADIENT TERHADAP KAPASITAS FUNGSIONAL PROTOKOL BRUCE TERMODIFIKASI PADA STENOSIS MITRAL RHEUMATIK PASCA KOMISUROTOMI MITRAL TRANSKATETER PERKUTAN (KMTP) Surya marthias; Amiliana Mardiani Soesanto; Ade Meidian Ambari; Basuni Radi; Amir Aziz AlKatiri
Zona Kedokteran: Program Studi Pendidikan Dokter Universitas Batam Vol 15 No 1 (2025): Zona Kedokteran: Program Studi Pendidikan Dokter Universitas Batam
Publisher : Universitas Batam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37776/zked.v15i1.1635

Abstract

Abstrak Latar belakang: Studi sebelumnya menyimpulkan bahwa MVG merupakan parameter yang berhubungan perbaikan gejala pasca KMTP. Tujuan: Evaluasi hubungan MVG terhadap perubahan kapasitas fungsional pasca KMTP. Metode: Studi quasi experimental dilakukan terhadap 78 subjek. Pemeriksaan ekokardiografi dan treadmill Bruce termodifikasi dilakukan 1-2 hari sebelum dan 1-2 minggu setelah KMTP. Data sebelum dan setelah KMTP dianalisis untuk mencari hubungan variabel terhadap perbaikan kapasitas fungsional pasca KMTP. Hasil: Rerata usia adalah 42 tahun, mayoritas perempuan, dan rerata IMT 22,27 kg/m2. Sebelum KMTP, 53% memiliki irama sinus dengan mayoritas memiliki fungsi ventrikel kiri yang baik dan ventrikal kanan yang baik. Sebesar 97% pasien datang dengan kelas NYHA II sebelum KMTP dan mengalami perbaikan signifikan kapasitas fungsional berupa perbaikan median lama latihan (241 ke 603 detik, p < 0,001) dan perbaikan median nilai VO2max estimasi (18,8 ke 32,8 mlO2/kg/menit, p<0,001). Dari uji korelasi, didapatkan variabel usia (r -0,23, adjusted R2=4,1%), pre-MVG (r 0,23, adjusted R2=4,2%), ∆ MVG (r 0,31, adjusted R2= 9,0%), dan pre-TR Vmax (r 0,3, adjusted R2=1,3%) berkorelasi terhadap perubahan kapasitas fungsional. Penurunan MVG > 50 % pasca KMTP (OR 2,89, p = 0,038) dan TR Vmax sebelum KMTP > 3,4 m/s (OR 3,42, p = 0,023) menjadi prediktor perbaikan kapasitas fungsional segera pasca KMTP. Kesimpulan: Penurunan MVG lebih dari 50% pasca KMTP berhubungan dengan perbaikan kapasitas fungsional segera pasca KMTP. Kata Kunci: fungsional, KMTP, lama latihan, MVG, stenosis mitral
Co-Authors Ade Meidian Ambari Ade Meidian Ambari Ade Meidian Ambari Ade Meidian Ambari Adhantoro Rahadyan Adnil Basha AH Raynaldo Ambari, Ade Meidian Amiliana M Soesanto Amiliana Mardiani Soesanto Amir Aziz AlKatiri Andang H Joesoef Andi Mahavira Andria Priyana Anggoro Budi Hartopo Anwar Santoso Anwar Santoso Anwar Santoso Aria Kekalih Ario Suryo Kuncoro Bambang Budi Siswanto Bambang Dwiputra Bambang Dwiputra Bima Suryaatmaja Budhi Setianto Budhi Setianto Budhi Setianto Dede Kusmana Desandri, Dwita Rian Diyan Ekawati Dwiputra, Bambang Dwita R Desandri R Desandri Dyana Sarvasti Eliana Susilowati Fadila Tulrahmi Harahap, Alida R. Harahap, Alida Rosita Harmani Kalim Henry A.P. Pakpahan Ignatius Faizal Yuwono Irsad Andi Arso Ismoyo Suni Katsukawa, Hajime Kiki Abdurachim Maarten Jan Cramer Pieter A Doevendans Risalina Myrtha Siti F Supari F Supari Solly Aryza Surya marthias Tambunan, Tresia Fransiska Ulianna Tambunan, Tresia FU. Taufik, Feni Fitriani Teuku Heriansyah, Teuku Triangto, Kevin Yasmin Tadjoedin Yasmin Tajoedin