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All Journal Interaksi Online Journal of Politic and Government Studies Jurnal Mudarrisuna: Media Kajian Pendidikan Agama Islam Berkala Kedokteran Indonesian Journal of Cardiology Heart Science Journal Narra J Jurnal Abdimas Kartika Wijayakusuma JUSTIN (Jurnal Sistem dan Teknologi Informasi) Jurnal Klinik dan Riset Kesehatan Jurnal Penelitian Dan Pengkajian Ilmiah Sosial Budaya Eduvest - Journal of Universal Studies JRIIN :Jurnal Riset Informatika dan Inovasi Karimah Tauhid Adil Indonesia Journal
Indra Prasetya
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Journal : Heart Science Journal

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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.
The influence of renal insufficiency on in-hospital major adverse cardiovascular events in STEMI patients receiving primary percutaneous coronary intervention Anjarwani, Setyasih; Nurudinulloh, Akhmad Isna; Widito, Sasmojo; Gunawan, Atma; Prasetya, Indra
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.2025.006.02.12

Abstract

Introduction: Renal insufficiency (RI) is related to poor clinical results in STEMI patients receiving primary percutaneous coronary interventions (PCI). Objectives: This study evaluates the effect of RI on in-hospital major adverse cardiovascular events (MACE) in STEMI patients receiving primary PCI. Methods: The study was predicated on the registry of 1447 STEMI patients from January 2020–December 2023. Study samples were categorized into two groups: RI (eGFR<60mL/min/1.73m²) and no RI (eGFR≥60mL/min/1.73m²). Patients’ characteristics and in-hospital MACE in the two groups underwent analysis. Results: Among 848 consecutive subjects, 238 (28%) had RI, and 610 (72%) had no RI. Age (p = 0.000), diabetes mellitus (p = 0.007), and onset STEMI>12 hours (0.043) were correlated with RI. Dyslipidemia (p = 0.025), Onset STEMI>12 hours (p = 0.006), and RI (p = 0.000) were correlated with MACE. RI was correlated with MACE (OR 2.04, 95% CI: 1.46–2.85, p = 0.000). RI was correlated with sub-group analysis of MACE; cardiogenic shock (OR 2.00, 95% CI: 1.34-2.99, p = 0.001), acute heart failure (OR 1.80, 95% CI: 1.22-2.65, p = 0.003), malignant arrhythmia (OR 2.40, 95% CI: 1.61-3.58, p = 0.000), and mortality (OR 2.74, 95% CI: 1.78-4.24, p = 0.000). Conclusions: RI was correlated with in-hospital MACE in STEMI patients receiving primary PCI. In a sub-group analysis of in-hospital MACE, RI constituted a strong independent predictor of cardiogenic shock, acute heart failure, malignant arrhythmia, and mortality, respectively.
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.
Successful unroofing of anomalous aortic origin of the left coronary artery with intramural course in patient with near syncope Firdaus, Achmad Jauhar; Handari, Saskia Dyah; Prasetya, Indra; Tjahjono, Cholid Tri
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.2025.006.03.17

Abstract

BACKGROUND: Left Anomalous Coronary Artery from the Opposite Sinus of Valsalva (L-ACAOS) refers to a congenital heart defect in which the left coronary artery originates from the right coronary sinus of Valsalva. This condition may increase the risk of sudden cardiac death (SCD), especially for those participating in intense physical exertion. This paper presents a case of a malignant type L-ACAOS in a young male who underwent successful surgical correction. CASE: A 35-year-old male without any known coronary artery disease risk factors presents with angina and near syncope while competing in a marathon run. He regularly participates in endurance sporting events without any complaints. However, in the last two years, he has begun to complain of angina during exertion. The ECG examination showed early repolarization in the inferior and lateral leads with no significant lab abnormalities. This led to coronary computed tomography angiography (CCTA), which revealed that the left coronary artery originates from the right coronary sinus and runs between the pulmonary trunk and ascending aorta, indicating a malignant-type anomalous coronary artery. He then undergoes a surgical correction with unroofing of the left main coronary artery and relocate the LMCA orifice to the left sinus. The procedure proceeded uneventfully with satisfactory results. CONCLUSION: Anomalous coronary arteries are concerning because they are associated with increased risks of SCD. The intramural course is associated with a higher risk of SCD due to stenosis caused by lateral compression that leads to ischemia and potentially fatal arrhythmias, making early detection and intervention critical.
Predictive value of GRACE and APACHE-II scores on mortality in acute coronary syndrome patients admitted to CVCU Prasetya, Indra; Hakim, Dennis Ievan; Anjarwani, Setyasih
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.2025.006.03.16

Abstract

BACKGROUND: Acute coronary syndrome (ACS) is correlated with elevated death and fatality rates. The Global Registry of Acute Coronary Events (GRACE) score is frequently employed for risk stratification in ACS. Nevertheless, intensive care physicians frequently utilize more comprehensive and general prognostic judgments derived from critically ill individuals, one of which is the Acute Physiology and Chronic Health Evaluation II (APACHE-II) score. OBJECTIVES: To compare the effectiveness of the score compared to APACHE-II score in predicting cardiovascular care unit () mortality. METHODS: A Retrospective cohort study was carried out at a single center, utilizing data from ACS patients admitted to the CVCU of RSUD Dr. Saiful Anwar Malang from 2021 to 2023. Both GRACE and APACHE-II scores were computed at the initial admission to hospital. The discriminative capability was computed using the area under the curve (AUC), and calibration was verified by the Hosmer-Lemeshow (HL) test. Multivariate logistic regression was performed to ascertain independent determinants of death. RESULTS: CONCLUSION: APACHE-II exhibited enhanced efficacy in predicting CVCU mortality in ACS patients, and both scoring systems continue to serve as valuable instruments.                
The effectiveness of supervised exercise training regarding NT-pro BNP level as a prognostic value among patients with congenital heart disease-related to pulmonary hypertension Setyowati, Danti Utami; Martini, Heny; Prasetya, Indra
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/ub.hsj.2025.006.04.5

Abstract

Congenital heart disease-related to pulmonary hypertension (CHD-PH) constitutes a significant subset of related Pulmonary Hypertension (PH), representing around 11% of all PH patients. Considering the emergence of novel medicines and enhanced patient outcomes in PH, it continues to be a life-shortening condition, and the time frame before diagnosis has not altered. Current strategies to enhance outcomes emphasize on early diagnosis and a treatment methodology designed to put individuals with PH into a low-risk category for one-year mortality. The N-terminal prohormone of BNP (NT-pro BNP) is secreted by cardiomyocytes in reaction to mechanical strain and wall stress. An increased concentration of NT-pro BNP is included in some PH risk stratification methods and screening protocols. The initial recommendation to restrict physical exertion in individuals with PH was based on its adverse impact on their clinical status. But clinicians have recently concentrated on the significance of physical exercise in those with PH. Consistent physical activity can enhance functional capacity, elevate quality of life (QoL), and increase prognosis and life expectancy as well. This literature review seeks to consolidate research about the impact of physical activity on NT-ProBNP levels in individuals with CHD-PH.  
Impact of supervised physical activity as adjunctive therapy on functional capacity and NT-pro BNP in patients with negative-reactivity test pulmonary hypertension related to congenital heart disease patient in Saiful Anwar Hospital Malang : A preliminary study Setyowati, Danti Utami; Martini, Heny; Prasetya, Indra; Tjahjono, Cholid Tri; Yogibuana, Valerinna
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/ub.hsj.2025.006.04.10

Abstract

Background: Appropriate levels of physical activity (PhA) provide health benefits to patients with chronic diseases, including patients with pulmonary hypertension-related to congenital heart disease (CHD-PH), representing around 4-10% of all PH patients. Objective: The purpose of this analysis was to determine the benefits and effectiveness of PhA as an additional therapy to optimal medication vs. control group on the functional capacity and N-terminal prohormone of B-type natriuretic peptide (NT-pro BNP) in patients with inoperable CHD-PH. Methods: A clinical preliminary study was conducted with 26 consecutive patients in stable condition before the study. Each patient was educated about the benefits of PhA and efficacy parameters of the six-minute walking distance (6MWD) and NT-Pro BNP levels have been evaluated at baseline and after 12 weeks. Results: The study included participants aged 33 ± 11 years, 84% of whom were female. All patients tolerated PhA without severe adverse events. Patients significantly improved the mean 6MWD compared to baseline by 382.9 ± 64.7 (p=0,000) and 318.3 ± 74 (p=0,041) meters after 12 weeks (training vs. control group). Ln NT-pro BNP improved significantly in the training group (p=0,002). There were no differences at week 12 in the delta 6MWD and NT-pro BNP levels, with all P values >0,05. Likewise, there is no correlation between the two variables Conclusions: PhA as an add-on to medical therapy may enhance work capacity and other prognostic relevant parameters in patients with inoperable CHD-PH. However, further larger, multi-center randomized controlled trials, is warranted to validate these preliminary findings
Rapid degradation of left ventricular function after permanent right ventricular pacing in patients with high-grade atrioventricular block Setiawan, Dion; Prasetya, Indra; Anjarwani, Setyasih; Rizal, Ardian
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.22

Abstract

Background: Permanent right ventricular (RV) pacing is a standard for high-grade atrioventricular (AV) block treatment. However, it may result in left ventricular (LV) dilatation, systolic dysfunction, and heart failure (HF) as a consequence of ventricular dyssynchrony and an abnormal myocardial contraction pattern. Pacing-induced cardiomyopathy (PICM) can develop months or years after implantation of a permanent pacemaker (PPM) in patients who have long-term and high-burden RVP. Case Illustration: We reported a case of a 56 years old Asian female having a record of PPM on VVIR mode implantation due to a high grade AV block presented with shortness of breath and bilateral leg swelling. Conclusion: Echocardiography showed a significant decrease in LV systolic function less than two years after PPM implantation. Coronary angiography showed widely patent vessels; subsequently, His-Bundle Pacing (HBP) was scheduled on the patient.
A 56 Year Old Male with Acute Stent Thrombosis During Percutaneous Coronary Intervention, How to Resolve This Problem? Millisani, Hayla Iqda; Rohman, Mohammad Saifur; Prasetya, Indra; Widito, Sasmojo
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.2023.004.03.8

Abstract

Background: Acute stent thrombosis is the complete occlusion of a coronary artery of the previously implanted stent. This unusual complication occurs in percutaneous coronary intervention (PCI), development of myocardial ischemia, and poor prognosis for the patient. After PCI, acute stent thrombosiscan occur within 0-24 hours and cause the symptoms like acute coronary syndrome. Incidents of stent thrombosis are about 0.6% to 3.4% for Drug Eluting Stent (DES) implantation, depending on the lesion and patient factors. The etiology of acute stent thrombosis is multifactorial, and early detectioncan reduce the mortality rate.Case Illustration: A 56 yo male visited Rumah Sakit Saiful Anwar Malang with stable angina pectoris (Class III symptoms with medical therapy) planned for elective cardiac catheterization with routine medical treatment. During PCI, he complained the chest pain, and from cine angiography evaluation showed no flow at the diagonal branch because of the acute thrombosis. Then got thrombosuction and got a white thrombus. After the PCI procedure, he got fibrinolytic with streptokinase 1.5 million units for 60 minutes. He was transferred to CVCU for observation and discharged after five days.Conclusion: Acute stent thrombosis is a severe complication during and after PCI because it is related to high mortality. The mechanisms by which ST arises are complex and multifactorial and must be early detection.
Fever-Induced Brugada-Pattern Electrocardiogram Nugraha, Yudha Tria; Prasetya, Indra; Martini, Heny; Rizal, Ardian
Heart Science Journal Vol. 5 No. 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.7

Abstract

Background: The Brugada syndrome is a type of cardiac arrhythmia frequently overlooked because of the dynamic character of the condition. Because it tends to progress into ventricular arrhythmias, it is a disorder that, if left untreated, carries the risk of being deadly. Not only is it essential for the practicing clinician to understand the situations that can disclose the concealed Brugada syndrome, but it is also essential for patients to understand these circumstances so that they can be educated to seek medical assistance quickly. This study aimed to describe the diagnosis and management of fever-induced Brugada pattern electrocardiogramCase presentation: Male in his 42-year-old with a history of intermittent fever for four days before hospital admission. High-degree fever was only relieved by taking antipyretics and was accompanied by nausea and muscle and joint pain. Upon arrival at the emergency department, he denied any complaints of chest pain or discomfort, shortness of breath, orthopnea, PND, leg swelling, palpitation, or syncope. A chest radiograph showed normal cardiac and pulmo (Figure 1); a first electrocardiogram showed Sinus Rhythm, HR 112 bpm, regular, FA normal, HA normal, P wave normal, PR interval 160 msec, QRS 80 msec, QTc 326 msec, Coved ST elevation at lead V1 (1 mm), V2 (3 mm), T inversion at lead V1-V2, suggesting sinus tachycardia with type II Brugada pattern.Conclusion: A Brugada pattern can be exposed to several stimuli, but fever is particularly potent. To assist urgent or emergency follow-up in cardiology, Emergency physicians must be informed of specific ECG findings based on the patient's clinical risk factors. The emergency doctor must be able to tell the difference between this pattern and a typical variation of RBBB, as a delayed diagnosis can have dire consequences.
Co-Authors Abadi, Sahlan Adlan El Fatih, Muhammad Afifah, Yuri Agung Sasongko Ahmad Aviv Mahmudi Aji, Nugroho Priyo Anjarwani, Setyasih Anna Fuji Rahimah Arista Candra Irawati Aryanugraha, Teguh Astiawati, Tri Atma Gunawan Bagaswoto, Hendry P. Bahar, Mokhamad Aswin Baskoro, Shalahuddin Suryo Burhan Burhan, Burhan Caesario, Fahreza Cholid Tri Tjahjono Cholid Tri Tjahjono Dadang Suprijatna Danny, Siska S. Dewi U. Djafar, Dewi U. Dewi Utari Djafar, Dewi Utari Dilla Maulida Dyah Puspita Saraswati Dzaki Ilhami, Muhammad Efendi, Rizki Arief Filano, Marco Firdaus, Achmad Jauhar firmansyah, Yoki Habib, Faisal Hakim, Dennis I. Hakim, Dennis Ievan Hedi Pudjo Santosa Hendry Purnasidha Bagaswoto Ilhami, Yose R. Ilhami, Yose Ramda Juzar, Dafsah A. Juzar, Dafsah Arifa Karolina, Wella Kuhn, Corinna Maria Kurnianingsih, Novi Kushandajani . Laukkanen, Noora Julia Lestari, Puspa Martini, Heny Millisani, Hayla Iqda Mohammad S. Rohman Mohammad Saifur Rohman Muhammad Sony Maulana Muzakkir, Akhtar F. Muzakkir, Akhtar Fajar Nita Sari, Nita Noverike, Nikhen Novi Rahmawati Nugraha, Tria Yudha Nugraha, Yudha Tria Nurudinulloh, Akhmad Isna Pamuna, Oktafin Srywati Pashira, Andranissa Amalia Perani Rosyani Prastya, Andhika Primada Qurrota Ayun Priyatno Harsasto Putri, Valerinna Yogibuana Swastika Raden Djuniarsono Rahimah, Anna Fuji Ratna Pancasari Rhiza Amdi, Muh Ririn Handayani Rizal, Ardian Rochmawati, Icmi Dian Rudi, Hasrian Sakti, Pradhika Perdana Saputri, Vemmy Lian Saskia Dyah Handari Satrijo, Budi Setiawan, Dion Setyowati, Danti Utami Siska Suridanda Danny Sungkar, Safir Wanty Eka Jayanti Widito, Sasmojo Windya Harieska Pramujati Wirawan, Hendy Yogibuana, Valerinna Yudha, Tria Zhao, Zihan zunardi, Lutfi hafiz