Articles
<![CDATA[Coronavirus Infection Induced Coagulopathy As A Trigger Factor Of Arterial Thrombosis In Patient With Atherosclerotic Risk Factor: A Case Report ]]>
<![CDATA[Irma Kamelia]]>;
<![CDATA[Heny Martini]]>;
<![CDATA[Novi Kurnianingsih]]>;
<![CDATA[Indra Prasetya]]>
<![CDATA[ Heart Science Journal Vol 2, No 4 (2021): Management of Thrombosis in Covid-19 Patient with Cardiovascular Disease ]]>
Publisher : <![CDATA[Universitas Brawijaya ]]>
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DOI: 10.21776/ub.hsj.2021.002.04.8
<![CDATA[Background : A newly emerging pandemic of Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory coronavirus 2 is responsible for significant morbidity and mortality worldwide. As one of the effects is hematological changes related to the COVID-19 infection causing patient tend to thrombosis than hemorrhagic. Current review of evidence and statements on management of coagulopathy and thrombotic complications related to this novel disease is needs to be exploredCase : Male 53 years old referred from Private Hospital, due to Severe pneumonia due to COVID-19 and Acute Limb Ischemia. This patient was assessed as Pneumonia COVID-19 severe with acute limb ischemia bilateral grade IIB and performed bilateral surgical thrombectomy with antegrade approach using fogarty catheter with the result was thrombus 10cm along the left femoral artery and thrombus 2cm in the right femoral artery. Discussion : With consideration of atherosclerotic diseases in this patient, we decided to give rivaroxaban as an anticoagulant combined with aspilet and statin high dose. But due to lack of source in our hospital, and patient also denied for further management, treatment for the patient cannot be optimal, so the patient discharge with unresolved limb ischemia.Conclusion : This case showed that the increase risk of heparin resistance in SARS-CoV-2 patient, it is recommend- ed to monitor heparin activity of UFH treatment based on anti-Xa levels instead of aPTT alone]]>
<![CDATA[Arteriovenous Fistula Stenosis: A Case Report ]]>
<![CDATA[Seprian Widasmara]]>;
<![CDATA[Novi Kurnianingsih]]>;
<![CDATA[Ardian Rizal]]>;
<![CDATA[Sasmojo Widito]]>
<![CDATA[ Heart Science Journal Vol 2, No 2 (2021): Dealing with Vascular Disease ]]>
Publisher : <![CDATA[Universitas Brawijaya ]]>
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DOI: 10.21776/ub.hsj.2021.002.02.8
<![CDATA[BackgroundThe arteriovenous fistula (AVF) is the preferred hemodialysis access type because it has better patency rates and fewer complications than other access types. Dialysis vascular access failure is common, is rated as a critical priority by both patients and health professionals, and is associated with excess morbidity, mortality, and healthcare costs.Case IllustrationA 64 years old man with stage V CKD on routine HD was admitted to hospital with difficulty in cannulation during his last hemodialysis. He already had arteriovenous fistula for hemodialysis access in his left arm since 2 years ago. In the last month before admission, he went to surgery to make hemodialysis access via arteriovenous fistula in his right arm, but failed to mature. Vascular ultrasound on dialysis vascular access was ordered. The examination revealed there was stenosis in the juxta-anastomosis site and cephalic venous stenosis in his left arm. He underwent percutaneous angioplasty with POBA in the anastomose arteriovenous fistula and implantation stent in the left cephalic vein.DiscussionDysfunction of hemodialysis access is a major problem for patients undergoing hemodialysis. It is generally due to venous stenosis, which diminishes flow in the hemodialysis access arteriovenous, thereby leading to poor dialysis. Fistulas tend to develop stenosis most commonly either at the juxta-anastomosis site and the outflow vein. Peripheral venous stenosis is the most common cause of arteriovenous fistula dysfunction and may lead to access thrombosis. The first-line treatment of stenosis should be balloon angioplasty. Stent placement in the peripheral vein is generally not recommended except in special circumstances.ConclusionHemodialysis vascular access is the “lifeline” for patients on hemodialysis. Vascular access-related complications can lead to patient morbidity and reduced quality of life. Surgery often cannot be provided as rapidly as a percutaneous approach. Catheter-based interventions are successful in restoring flow in more than 80% of hemodialysis accesses that undergo stenosis and have replaced surgical revision as the treatment of choice for failing or stenosed accesses]]>
<![CDATA[Management of Acute Uncomplicated Stanford B Aortic Dissection in The Era of Endovascular Repair: A Case Report ]]>
<![CDATA[Putri Annisa Kamila]]>;
<![CDATA[Novi Kurnianingsih]]>;
<![CDATA[Sasmojo Widito]]>;
<![CDATA[Djanggan Sargowo]]>;
<![CDATA[Budi Satrijo]]>
<![CDATA[ Heart Science Journal Vol 1, No 3 (2020): Management of Coronary Artery Disease: From Risk Factors to The Better Long-Term ]]>
Publisher : <![CDATA[Universitas Brawijaya ]]>
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DOI: 10.21776/ub.hsj.2020.001.03.8
<![CDATA[Introduction:Uncomplicated type B aortic dissections have been traditionally treated with medication therapy. While it may provide good short-term results, longterm prognosis may be less favorable. With improvements in endovascular repair and the potential risk of disease progression, thoracic endovascular aortic repair (TEVAR) has been considered inpatients with uncomplicated type B aortic dissection. We present the case of 78-year-old gentleman who presented with acute uncomplicated type B aortic dissection managed by endovascular repair Case illustration:A 78 year-old hypertensive patient admitted to the hospital with persistent chest discomfort and cough for 2 weeks. The CT aortic angiogram showed type B dissection. Based on the recent guidelines, TEVAR should be considered in patients with uncomplicated type B aortic dissection, thus we prepared the patient for TEVAR procedure. First we established multidisciplinary vascular team for the pre-procedural preparation of the patient. We perform careful measurement through detailed CT angiography reconstruction from carotid to femoral arteries. We found proximal diameter was 30-35mm, distal diameter was 23mm and landing zone right after left brachial ostium, suitable for stent graft Valiant Captivia 36-32x150mm. The CT also showed that both femoral artery were normal, we decided to use right femoral artery as the access. We proceed to the procedure 2 days later, under general anaesthesia, digital subtraction angiography revealed dissection of descending aorta, and selected device was inserted. Subsequent contrast injection revealed total occlusion of the false lumen. Patient was transferred to ICU for postprocedural care, and extubated the day after. The hospital stay was uneventful, and one-month follow up CT shows no endoleak. Conclusion :Management of uncomplicated Stanford B dissections is very challenging. TEVAR has emerged as an alternative to surgery with lower morbidity and mortality rates that might offer good long-term results. ]]>
<![CDATA[Peripartum Cardiomyopathy (PPCM): How to Diagnose and Deal with? ]]>
<![CDATA[Monika Sitio]]>;
<![CDATA[Cholid Tri Tjahjono]]>;
<![CDATA[Heny Martini]]>;
<![CDATA[Novi Kurnianingsih]]>
<![CDATA[ Heart Science Journal Vol 2, No 1 (2021): How to Diagnose Heart Failure and Deal with The Treatment Complexity ]]>
Publisher : <![CDATA[Universitas Brawijaya ]]>
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DOI: 10.21776/ub.hsj.2021.002.01.08
<![CDATA[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.]]>
<![CDATA[Multimodality Cardiovascular Imaging of Hyperthrophic Cardiomyopathy : A Review Article ]]>
<![CDATA[Veny Kurniawati]]>;
<![CDATA[Ardian Rizal]]>;
<![CDATA[Mohammad Saifur Rohman]]>;
<![CDATA[Novi Kurnianingsih]]>;
<![CDATA[Anna Fuji Rahimah]]>
<![CDATA[ Heart Science Journal Vol 1, No 3 (2020): Management of Coronary Artery Disease: From Risk Factors to The Better Long-Term ]]>
Publisher : <![CDATA[Universitas Brawijaya ]]>
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DOI: 10.21776/ub.hsj.2020.001.03.2
<![CDATA[AbstractThe most common genetic cardiomyopathy, HCM has a prevalence about 0.2%. It is transmitted autosomal dominant inheritance pattern. The natural history is benign but adverse outcomes can be happened in some patients including sudden cardiac death, symptoms secondary to dynamic left ventricular outflow tract (LVOT) obstruction, diastolic filling abnormalities, atrial fibrillation, and LV systolic dysfunction.Imaging modalities can be used to evaluate cardiac structure and function, the presence and severity of dynamic obstruction, mitral valve abnormalities, mitral regurgitation, as well as myocardial ischemia and fibrosis. Echocardiography is the initial imaging modality for evaluation of cardiac structure. CMR is recommended when echocardiographic images is not adequate in selected patients with high index of suspicion for HCM. In case of contraindication to CMR, patients with ICDs or pacemakers, Cardiac CT is recommended. Imaging can be used to guide treatment, screening and preclinical diagnosis in patient HCM.]]>
<![CDATA[Type 1 Diabetes Mellitus and Premature Coronary Artery Disease ]]>
<![CDATA[Dyah Ayu Ikeningrum]]>;
<![CDATA[Djanggan Sargowo]]>;
<![CDATA[Novi Kurnianingsih]]>;
<![CDATA[Anna Fuji Rahimah]]>
<![CDATA[ Heart Science Journal Vol 3, No 3 (2022): Cardiovascular Disease in Young Adulthood: Who, When, and How to Screen? ]]>
Publisher : <![CDATA[Universitas Brawijaya ]]>
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DOI: 10.21776/ub.hsj.2022.003.03.2
<![CDATA[Cardiovascular disease, which affects more than half of all diabetics, is the leading cause of morbidity and mortality in patients with type 1 and type 2 Diabetes Mellitus (DM). Around 55% of diabetes patients are thought to have it, in comparison to 2-4% of the general population. A significant risk factor for the development of Coronary Artery Disease (CAD) exists in people with Type 1 Diabetes Mellitus (T1DM). However, it is worth noting that the present Models of risk prediction for T1DM have a variety of flaws. CAD risk is expected to double or quadruple over the next two to four decades, and diabetes mellitus is the third most significant risk factor for the etiology of illness. As a result, diabetes increases the chance of developing Acute Coronary Syndromes (ACS), whose incidence surpasses 20% after seven years, compared to a rate of 3.5 percent in non-diabetics – a rate comparable to individuals who have already experienced an Acute Myocardial Infarction (AMI). Additionally, it is crucial to identify any well-defined specific risk factors for T1DM as well as any extra subclinical atherosclerosis that may influence these patients at an advanced stage of disease progression. T1DM patients have more severe lesions, a lower left ventricle (LV) ejection fraction, a higher risk of cardiac events, and a higher rate of silent ischemia when compared to non-diabetics. They continue to have impaired microcirculation and endothelial function, both of which contribute to tissue perfusion problems.]]>
<![CDATA[Atherosclerosis Early Detection In Type 1 Diabetes Mellitus ]]>
<![CDATA[Seprian Widasmara]]>;
<![CDATA[Novi Kurnianingsih]]>;
<![CDATA[Mohammad Saifur Rohman]]>;
<![CDATA[Anna Fuji Rahimah]]>
<![CDATA[ Heart Science Journal Vol 3, No 3 (2022): Cardiovascular Disease in Young Adulthood: Who, When, and How to Screen? ]]>
Publisher : <![CDATA[Universitas Brawijaya ]]>
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DOI: 10.21776/ub.hsj.2022.003.03.3
<![CDATA[Atherosclerosis continues to be a significant consequence in type I diabetes mellitus (T1DM). Cardiovascular disease, caused by accelerated atherosclerosis, is the leading cause of illness and often premature death in patients with T1DM. Risk management is critical. Patients with T1DM who are at an increased risk include those who are less than 10 years old at the time of diagnosis, have a longer history of diabetes, have microvascular problems, or have several risk factors. It is frequently difficult to evaluate vascular hazard and the degree of atherosclerosis on an individualized level, especially early on.]]>
<![CDATA[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 ]]>
<![CDATA[Seprian Widasmara]]>;
<![CDATA[Novi Kurnianingsih]]>;
<![CDATA[Indra Prasetya]]>;
<![CDATA[Cholid Tri Tjahjono]]>;
<![CDATA[Budi Satrijo]]>
<![CDATA[ Heart Science Journal Vol 3, No 4 (2022): Prevention, Screening dan Rehabilitation : The Back Bone of Quality Care Improve ]]>
Publisher : <![CDATA[Universitas Brawijaya ]]>
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DOI: 10.21776/ub.hsj.2022.003.04.3
<![CDATA[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.]]>
<![CDATA[Secondary Hypertension due to Abdominal Coarctation; How do we identify and manage it?: A Case Report ]]>
<![CDATA[Oktafin Srywati Pamuna]]>;
<![CDATA[Novi Kurnianingsih]]>;
<![CDATA[Anna Fuji Rahimah]]>;
<![CDATA[Heny Martini]]>
<![CDATA[ Heart Science Journal Vol 3, No 3 (2022): Cardiovascular Disease in Young Adulthood: Who, When, and How to Screen? ]]>
Publisher : <![CDATA[Universitas Brawijaya ]]>
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DOI: 10.21776/ub.hsj.2022.003.03.6
<![CDATA[BackgroundCoarctation of the abdominal aorta (AoA) is a very uncommon condition, accounting for 0.5-2 percent of all aortic stenosis cases. We present an 11-year-old child who has been diagnosed with abdominal aorta coarctation. Case IllustrationAn 11-years old boy complained about dizziness since 1.5 years ago with hypertension. He underwent hypertension treatment for 1.5 years with a pediatrician but there is no improvement in his blood pressure. His current blood pressure was 150/95 mmHg in upper extremities and 120/80 mmHg in lower extremities with three antihypertensives drugs. We found bruit in the abdomen and decreases pulse in lower extremities. An echocardiogram shows no congenital defect. The first was on suspicion of renal stenosis and underwent ultrasonography of the abdomen but was not conclusive. Computed Tomography Angiographic (CTA) showed severe stenosis in the abdominal aorta on level thoracal 11-12. Aortogram shows significant stenosis in the abdominal aorta with a pressure gradient was 47 mmHg. He underwent percutaneous transluminal angioplasty with BMS self-stent implantation. At two months of follow up his blood pressure target was achieved with a minimal dose of oral antihypertensive drugs DiscussionHow to diagnose coarctation of the abdominal aorta is still challenging and often underdiagnosed. Patients with young age and persistent hypertension should be more careful in diagnosis. A bruit in the abdomen with a weak pulse in the lower extremity raises suspicion of Coarctation of the Abdominal Aorta. An angioplasty procedure, either with or without a stent or a surgery might be used as the primary therapy. ]]>
<![CDATA[Restraint Stress Impacts on Behavioral Changes and Adrenal and Kidney Tissue Histopathology of Adult Mice ]]>
<![CDATA[Davy Reyhanditya]]>;
<![CDATA[Viona Faiqoh Hikmawati]]>;
<![CDATA[Nia Kurnianingsih]]>;
<![CDATA[Fatchiyah Fatchiyah]]>
<![CDATA[ Jurnal Kedokteran Brawijaya Vol. 32 No. 1 (2022) ]]>
Publisher : <![CDATA[Fakultas Kedokteran Universitas Brawijaya ]]>
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DOI: 10.21776/ub.jkb.2022.032.01.1
<![CDATA[Restraint stress causes changes in the brain parameters. Little research has been done on the impact of restraint stress on other tissues, including adrenal glands and kidneys. This study aimed to determine the effect of restraint stress on eating behaviors, depressive-like, anxiety-like behaviors, weight gain as well as histopathological changes in the kidneys and adrenal glands. Twenty adult BALB/c mice were assigned into control male, stressed male, control female, and stressed female. Restraint stress was applied two hours/day for 14 days. Tail suspension and open field tests were carried out to perform behavior analyses. Adrenal and kidney histological slides were observed under an Olympus CX-31 microscope and visualized using an Olympus E330 camera. The two-way ANOVA test was used for statistical analysis using GraphPad Prism 9.0.0 software. We found that restraint stress defeat appetite and reduces weight gain particularly in stressed female. However, depressive- and anxiety-like behavior were demonstrated in both sexes. Adrenal and kidney tissues of stressed mice demonstrated a higher number of necrotic cells than control. The pyknosis phase was more common than the karyorrhexis and karyolitic phases. Interestingly, male mice were more receptive to stress than female mice. These findings indicate that restraint stress leads to behavioral changes and cellular defects in the adrenal glands and kidneys, particularly in male mice. The sympathetic activation and hypothalamus-pituitary-axis stimulation are assumed as the underlying stress effect of the restraint procedure. The restraint stress method has the potential to be used in future research on stress-responsive target organs.]]>
