Cholid Tri Tjahjono
Brawijaya Cardiovascular Research Center Department Of Cardiology And Vascular Medicine Faculty Of Medicine, Universitas Brawijaya Malang

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Diastolic Dysfunction Following Acute Myocardial Infarction with ST Segment Elevation Imelda Krisnasari; Anna Fuji Rahimah; Sasmojo Widito; Cholid Tri Tjahjono
Heart Science Journal Vol 3, No 2 (2022): Improving ST-Elevation Myocardial Infraction Patients Prognosis
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.02.2

Abstract

ST segment elevation myocardial infarction (STEMI) caused by atherosclerotic vulnerable plaque rupture or plaque erosion, resulting in activation of the coagulation cascade. It causes a temporal sequence known as the “ischemic cascade,” which first involves the metabolic process, the diastolic dysfunction, and then systolic dysfunction. Diastolic dysfunction in STEMI patient is an independent predictor for long-term outcome. Rapid and early restoration of blood flow is critical to ensure cell recovery and prevent additional damage. 
The Effect of Add-on Garcinia mangostana L. Extract on Endothelial Dysfunction in Type 2 Diabetes Mellitus Subjects with High Risk Framingham Score: A Cohort Study Olivia Handayani; Djanggan Sargowo; Mohammad Saifur Rohman; Budi Satrijo; Cholid Tri Tjahjono; Dadang Hendrawan
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (30.406 KB) | DOI: 10.21776/ub.hsj.2020.001.01.5

Abstract

Background : Garcinia mangostana L. has been extensively used for years as antioxidant and anti-inflammation. However, its role in the context of endothelial disease was lacking.Objectives : To assess the effect of add-on G. mangostana L. extracts on endothelial dysfunction in type 2 diabetes subjects with high-risk Framingham score, compared to placebo.Methods : This was a prospective cohort study conducted in type 2 diabetes subjects with high-risk Framingham score. Subjects were randomized into two groups. The first group received 2,520 mg/day of G. mangostana L. extract. The second group was given a placebo for 90 days. The outcome measure of our study was the levels of endothelial progenitor cell (EPC), circulating endothelial cell (CEC), nitric oxide (NO), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), IL-6, hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), Superoxide dismutase (SOD) and fasting blood glucose. Multiple linear regression was used to determine the correlation and effect estimate.Results: A total of 49 patients were included in our study. Of those, elevated levels of EPC and SOD were observed in treatment group compared to placebo. On the other hand, the level of CEC, IL-1, Il-6, NO, MDA, TNF-α, fasting blood glucose and HbA1c was found significantly lower than placebo.Conclusion: Garcinia mangostana L. extract is associated with an increased levels of EPC and SOD, and it is also correlated with a decreased levels of CEC, IL-1, Il-6, NO, MDA, TNF-α, fasting blood glucose and HbA1c.
Peripartum Cardiomyopathy (PPCM): How to Diagnose and Deal with? Monika Sitio; Cholid Tri Tjahjono; Heny Martini; Novi Kurnianingsih
Heart Science Journal Vol 2, No 1 (2021): How to Diagnose Heart Failure and Deal with The Treatment Complexity
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.01.08

Abstract

Peripartum cardiomyopathy (PPCM) is a diagnosis of exclusion, where patients present with heart failure (HF) secondary to left ventricular (LV) systolic dysfunction without any other cause of HF identified in the last month of pregnancy or within first five months after delivery, abortion, or miscarriage. PPCM is a life-threatening condition which frequently under diagnosed and inadequately treated, whereas the morbidity and mortality rate ranges between 7% and 50%. Early diagnosis is important to decrease morbidity and mortality. Therefore, it is necessary to report the case related to this condition.A 34-year-old woman was referred to RSSA with worsening shortness of breath (SOB). She has given birth about 2.5 months prior to admission. History taking and supporting findings form this case were supported to diagnosis of PPCM. She was treated with diuretic, aldosterone antagonist, ACE-I, beta blocker, anticoagulant, and bromocriptine. The symptoms were improved in the following days. She was discharged with better condition and educated to comply with medication.
Management of Antithrombotic Therapy in Post PCI Patient Undergoing Pericardiotomy due to Large Pericardial Effusion : A case report Dedy Irawan; Sasmojo Widito; Mohammad Saifur Rohman; Cholid Tri Tjahjono
Heart Science Journal Vol 2, No 4 (2021): Management of Thrombosis in Covid-19 Patient with Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.04.9

Abstract

Background : Stent thrombosis is a serious complication following percutaneous coronary intervention (PCI), and dual antiplatelet therapy (DAPT) is necessary to avoid it. Surgery, on the other hand, is a common cause for stopping DAPT. Because patients were exposed to the possibility of a major adverse cardiovascular event (MACE) when DAPT was stopped, this circumstance poses a clinical dilemma.Objective : This case report aimed to describe the management of antithrombotic therapy in post PCI patient requiring DAPT who underwent pericardiostomy.Case : A 69-year-old woman with large pericardial effusion without cardiac tamponade, breast cancer on chemo- therapy, heart failure stage C NYHA functional class II, chronic coronary syndrome post-DES implantation at proximal-mid LAD, and hypertension. The patient underwent pericardiotomy procedures five days after DAPT discontinuation. For the bridging therapy, continuous UFH administration was initiated at a dose of 18 IU/kg/hour after the cessation of DAPT. The UFH dose was adjusted to achieve activated partial thromboplastin time (APTT) 1.5 to 2.0 times the control value. The UFH was discontinued 6 hours before surgery. After surgery, UFH infusion was restarted 6 hours after the confirmation of hemostasis. The administration of UFH then continued until three days after DAPT was restarted. No complications were found during and after the pericar- diostomy.Conclusion : We reported an antithrombotic treatment strategy in a post PCI patient undergoing pericardiostomy with discontinuation of DAPT, which was successfully treated with UFH without any complication. The UFH has been widely used in perioperative settings as a bridging therapy during the interruption of DAPT and may be considered in this condition. 
Role of LAVi/A’ and E/’ as A Predictor of Major Adverse Cardiac Event on Patient with Acute Myocardial Infraction with ST Segment Elevation Undergo Through Percutaneous Coronary Intervention Aditya Reza Pratama; Budi Satrijo; Anna Fuji Rahimah; Djanggan Sargowo; Cholid Tri Tjahjono; Muhammad Rizki Rizki Fadlan
Heart Science Journal Vol 2, No 1 (2021): How to Diagnose Heart Failure and Deal with The Treatment Complexity
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.01.05

Abstract

Introduction:STEMI is still a major health problem in industrialized and developing countries. The risk of adverse cardiovascular events remains substansial and may vary significantly across of STEMI patients. Echocardiography is recommended tool for diagnosis and predict outcomes. Increased LA volume index (LAVI) has been shown to be a powerfull predictor of mortality after AMI. The ratio of the  left atrial volume index (LAVI) and late diastolic mitral annular velocity (A’) is additional benefits in the assessment od advance diastolic dysfunction in ACS for predicting outcome.Methods:This study retrospective cohort was conducted in patient admitted to Saiful Anawar General Hospital with STEMI who undergo PCI from 2019-2020. All patient underwent echocardiography measurement within 24-48 hours and we follow-up patient for 6 months until 12 months. Echocardiography measurement that we conducted were LVEF, E/A, E/e’, LAVI/A’ and LV diastolic function were measured according to ASE guidelines. All of the patients were given standard medical therapy. Patients who did not adhere to medication were excluded. The study endpoints were hospitalisation and mortality because of cardiac problem. Result:We collected the data from 169 STEMI patients. However, about 39 STEMI patients were excluded because of incomplete data, lost follow-up, become atrial fibrillation, refused participation and death. Finally, a total of 130 patients were involved in the analysis process. The patients mean age was 61.48 ± 7 years, and 78% of them were male. The receiver operating characteristics curve indicated that LAVI/A’ ≥ 4.0 predicted these events (AUC 0.892, 95% CI 0.819-0.965) and E/e’  ≥ was 13.4 (AUC 0.874, 95% CI; 0.806-0.942). The MACE incident in 6 months with LAVI/A’ ≥ 4.0 was 40%, E/e’ ≥ 13.4 was 20% and LAVI/A’ ≥ 4.0 + E/e’ ≥ 13.4 was higher 60%. The incidence MACE incident was LAVI/A’ > 4.0 sensitivity 92% and specifity 88% (CI 95%), E/e’ > 13.4 sensitivity 80% and specifity 74% (CI 95%), LAVI/A’ > 4.0 + E/e’ > 13.4 sensitivity 92% and specifity 88% (CI 95%). Conlussion:The LAVI/A’ ratio is available as echo index which reflects LV chronic diastolic function in patient with STEMI. It can predict MACE, particularly in those with STEMI undergo PCI. Combined LAVI/A’ > 4.0 and E/e’ >13,4 ratio suggests MACE better than LAVI/A’ > 4.0 and E/e’ >13,4 alone.Keywords: ST-elevation Myocardial Infarction, Echocardiography, LAVI/A’, E/e’, Percutaneous Coronary Intervention
Evaluasi Penggunaan Aspirin Jangka Panjang terhadap Fungsi Ginjal Pasien Penyakit Jantung Koroner Ema Pristi Yunita; Puji Astuti Nur Hidayanti; Cholid Tri Tjahjono
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 10, No 3
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.53312

Abstract

Low-dose aspirin (75-100 mg/day) is a long-term platelet antiaggregation therapy for certain coronary heart disease (CHD) patients. This study aims to evaluate the long-term use of aspirin on kidney function by examining the changes in the levels of serum creatinine, blood urea nitrogen (BUN), and creatinine clearance of CHD patients. The research method used was a prospective observational cohort analysis. The number of study subjects was 37 CHD patients who took 80 mg/day of aspirin and never experienced kidney disease. Serum creatinine and BUN levels were examined in the 1st and 3rd month of the study. Patient creatinine clearance values were calculated using the Cockcroft-Gault equation. The results of the study showed that the mean levels of serum creatinine, BUN, and creatinine clearance on the 1st and 3rd month were 1.03 ± 0.27 mg/dL and 1.03 ± 0.29 mg/dL; 13.05 ± 4.10 mg/dL and 14.65 ± 4.44 mg/dL; 73.16 ± 18.14 mL/min and 72.92 ± 19.76 mL/min, respectively. The paired t-test results showed that the differences in the mean of creatinine serum, BUN, and creatinine clearance on the 1st and 3rd month were not statistically significant (p > 0.05). The One Way ANOVA test results on the effect of the duration of aspirin use on kidney function were also not statistically significant (p > 0.05) however there is a tendency to decrease creatinine clearance and increase in serum creatinine and BUN. Long-term use of low-dose aspirin has the potential to cause a decrease in kidney function that is seen from a decrease in creatinine clearance as well as an increase in serum creatinine and BUN.
KNOWLEDGE AND ACTIVITY OF COMMUNITY HEALTH WORKERS REGARDING HYPERTENSION AND ITS MANAGEMENT IN MALANG Mifetika Lukitasari; Dwi Adi Nugroho; Budi Satrijo; Mohammad Saifur Rohman; Cholid Tri Tjahjono
Journal of Nursing Science Update (JNSU) Vol. 7 No. 1 (2019)
Publisher : Department of Nursing, Faculty of Health Sciencce, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (6565.835 KB) | DOI: 10.21776/ub.jik.2019.007.01.7

Abstract

Community health workers have had an increasing role in CVD prevention and control. Their knowledge and activity contributed to hypertension management in community. Hence, this study aimed to assess the knowledge of community health workers in community. This cross sectional study was conducted in 94 community health workers. All of the participants worked in primary geriatric community health service (posyandu lansia). Hypertension knowledge and management activity in the community was assessed by questionnaire. Most of the community health workers (57%) had high knowledge level. Participants with high knowledge had significant awareness of hypertension and higher knowledge on hypertension therapy, medication adherence, life style, diet, and hypertension complication compared to those of low knowledge level. Moreover, both groups had similar activities in community regarding hypertension management, such as blood pressure measurement, health education, and body mass index measurement. This study suggested that all health care workers shared similar activity in community hypertension management regardless their knowledge level.
Correlation of Urine Albumin Creatinine Ratio And C-Reactive Protein Levels on Carotid Artery Intima-Media Thickness And Flow-Mediated Dilatation Response In Children and Adolescent with Type 1 Diabetes Mellitus At Dr Saiful Anwar Hospital Malang Seprian Widasmara; Novi Kurnianingsih; Indra Prasetya; Cholid Tri Tjahjono; Budi Satrijo
Heart Science Journal Vol 3, No 4 (2022): Prevention, Screening dan Rehabilitation : The Back Bone of Quality Care Improve
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.04.3

Abstract

Background:Early and accelerated atherosclerosis is a major cause of cardiovascular disease and often causes premature death in T1DM patients. In DMT1, atherosclerosis can be detected since adolescence. The initial association between urinary albumin to creatinine ratio (ACR) and c-reactive protein (hs-CRP) with subclinical cardiovascular disease in children and adolescents with T1DM supported findings from previous studies. Imaging tests using ultrasound can detect subclinical atherosclerosis in this patient population. Carotid artery intima-media thickness (cIMT) and flow-mediated dilatation response (FMD) have been frequently used to detect subclinical atherosclerosis.Objective: To find correlation between ACR and hsCRP on the thickness values of cIMT and FMD in children and adolescent DMT1 patients at Dr Saiful Anwar Hospital MalangMethods: This is a cross-sectional study with 82 subjects of DMT1 patients who routinely control the pediatric outpatient clinic of RSUD Dr. Saiful Anwar Malang, with the research period January – July 2019 and December 2021 – March 2022.Results: There was correlation between ACR with FMD and cIMT (r=-0.593; p=0.000 and r=0.339; p=0.002, respectively). There was also correlation between hsCRP with FMD and cIMT (p=-0.375; p=0.001 and r= 0.414; p=0.023, respectively).Conclusion: ACR and hsCRP have a correlation with increasing CIMT values and decreasing FMD values in children and adolescents with DMT1 patients.
Phase I Cardiac Rehabilitation Intervention In Patients Undergoing Coronary Artery Bypass Grafting Ardhani Galih; Cholid Tri Tjahjono; Ardian Rizal; Heny Martini
Heart Science Journal Vol 3, No 4 (2022): Prevention, Screening dan Rehabilitation : The Back Bone of Quality Care Improve
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.04.2

Abstract

Patients undergoing coronary artery bypass grafting (CABG) have a risk of postoperative complications that result in prolonged hospitalization and even death. Interventions in the form of phase I cardiac rehabilitation are needed to help speed up the postoperative recovery process and prevent complications after CABG. Although a lot of research has been carried out, it is necessary to conduct further studies of research articles regarding interventions that can be carried out in cardiac rehabilitation programs that are safe and easy to perform in postoperative CABG patients. The purpose of this literature review was to examine safe and effective interventions in phase I cardiac rehabilitation in patients undergoing CABG. The implementation of phase I cardiac rehabilitation in patients undergoing CABG started from the preoperative phase and continued postoperatively until the patient was discharged. Phase I cardiac rehabilitation interventions, both pre and postoperative, consist of education and counselling, physical exercise, breathing exercises, effective coughing exercises, inspiratory muscle training, and chest physiotherapy. The results of this literature review can be used as a basis for determining standard operating procedures for the implementation of phase I cardiac rehabilitation for hospitals that provide CABG services.
A Case Report Improving Quality of Life in Pulmonary Hypertension with Exercise Training Therapy Ni Putu Frida Baskarani; Cholid Tri Tjahjono
Clinical and Research Journal in Internal Medicine Vol. 3 No. 2 (2022): November 2022
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2022.003.02.8

Abstract

Pulmonary hypertension is an increase in pulmonary artery pressure >25 mmHg. This causes some disturbing clinical complaints. The most common causes of pulmonary hypertension are idiopathic and congenital heart disease. ASD (Arterial Septal Defect) is a congenital heart disease that occurs in 1.6 per 1000 live births, with a fairly high life expectancy. However, most people with ASD are not aware of a heart problem before the appearance of a clinically significant disorder. Most patients with ASD with complications of pulmonary hypertension will complain of being easily tired, fainting easily and having difficulty carrying out daily activities, even light activities. Most ASD cases apply shunt closure therapy as the main therapy, but not a few ASD cases cannot be shunted closure because it is a contraindication that can lead to more severe complications, especially with complications of chronic pulmonary hypertension. One of the non-medical therapies used to improve the quality of life of patients with pulmonary hypertension is exercise therapy. This therapy provides a variety of physical exercises that aim to increase the strength of respiratory muscles and extremities. From this case, exercise therapy is able to provide a significant improvement in the quality of life of the patient with an increase in the patient's ability to perform physical activities, as evidenced by the increase in distance traveled when doing the six-minute walk test (SMWT).
Co-Authors Adhika Prastya Wikananda Aditya Reza Pratama Adriyawan Widya Nugraha Afifah, Yuri Afifuddin, Mokhammad Alfata, Fandy Hazzy Amanda, Febrina Ambari, Ade Meidian Anandini, Hesti Anggoro Budi Hartopo Anggraeni, Vita Yanti Anjarwani, Setyasih Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Ardani Galih Ardhani Galih Ardhani Galih Ardhia, Jessica Fio Ardian Rizal Ardian Rizal Arif Wicaksono Arif Wicaksono Arifah, Medisa Roro Putri Nur Aris Munandar ZI Arityanti, Dean Aryanugraha, Teguh Ashari, Yordan Wicaksono Astiawati, Tri Ayu Asri Devi Adityawati Ayu Asri Devi Adityawati Badai Bhatara Tiksnadi Bambang Rahardjo Budi Satrijo Budi Satrijo Dadang Hendrawan David Rubiyaktho Dedy Irawan Desandri, Dwita Rian Diah Ivana Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Dwi Adi Nugroho Dwiputra, Bambang Elvira Sari Dewi Ema Pristi Yunita Ema Pristi Yunita, Ema Pristi Erwan, Nabila Erina Evit Ruspiono Evit Ruspiono Fahmy Rusnanta Fandy Hazzi Alfata Fathurohim, Zainal Febrianora, Mega Firdaus, Achmad Jauhar Fitra, Maha Galih Prakosa, Ardani Hasan, Harris Hayati, Yati Sri Hendrawati Hendrawati Heny Martini Heny Martini Hergaf, Indah Widyasari Hidayanti, Puji Astuti Nur Idris Idham Ikeningrum, Dyah Ayu Imelda Krisnasari Indhiarti, Tantri Refa Indra Prasetya Indra Prasetya Indra Prasetya Indriani, Anin Indriyani, Damayanti Irsad Andi Arso, Irsad Andi Iskandar Iskandar Jannah, Riska Raudhatul Kartika, Annisa Wuri Krevani, Citra Kiki Kurnianingsih, Novi Lestari, Defyna Dwi Liemena Harold Adrian Machfud, Savinka Salsabiela Iriana Maimun Zulhaidah Arthamin, Maimun Zulhaidah Makes, Indira Kalyana Martini, Heny Mayangsari, Veny Mifetika Lukitasari Mohammad Ryan Ramadhan Mohammad Saifur Rohman Mohammad Saifur Rohman Monika Sitio Muchammad Dzikrul Haq Karimullah Muhammad Abusari Muhammad Firdaus Muhammad Munawar Muhammad Ridwan Muhammad Rizki Fadlan Muhammad Rizki Fadlan Muhammad Rizki Rizki Fadlan Ni Putu Frida Baskarani Novi Kurnianingsih Novi Kurniningsih Oktafin Srywati Pamuna Olivia Handayani Pawik Supriadi Pratiwi, Irma Kamelia Puji Astuti Nur Hidayanti Putri, Valerina Yogibuana Swastika Qhabibi, Faqrizal Ria Rahimah, Anna Fuji Ratna Pancasari Raynaldo, Abdul Halim Rita Hamdani Rizal, Ardian RWM Kaligis Saskia Dyah Handari Sasmojo Widito Sasmojo Widito Satrijo, Budi Satwikajati, Sawitri sawitri satwikajati Seprian Widasmara Setyasih Anjarwani Setyowati, Danti Utami Susilowati, Eliana Swastika Putri, Valerinna Yogibuana Swastikaputri, Valerina Yogibuana Syaoqi, Muhammad Tarsidin, Najmi Fauzan Titin Andri Wihastuti Tonny Adriyanto Vori, Ira Widiani, Luh Widito, Sasmojo Wira Kimahesa Anggoro Wulandari, Ayu Pramitha Yasmine Fitrina Siregar Yoga Waranugraha Yogibuana, Valerinna Yudha, Tria Yusuf Arifin Zulhaidah A, Maimun