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All Journal Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya The Indonesian Biomedical Journal Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Jurnal Ilmiah Kesehatan Cardiovascular and Cardiometabolic Journal (CCJ)
Dian Paramita Kartikasari
Airlangga University
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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 1 
Successful Triple Valve Surgery in an Undernourished Patient: What to Prepare? Dian Paramita Kartikasari; Esti Hindariati
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 5, No 2 (2021)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v5i2.6189

Abstract

ABSTRACT  Valvular heart disease accountsfor 10% to 20% of all cardiac surgical procedures in the United States. The decision to intervene, as well as the type of intervention for a patient with severe valvular heart disease, should be based on an individual risk-benefit analysis. Once a patient is considered a candidate for cardiac surgery, a comprehensive patient evaluation of medical conditions and comorbidities helps improve operative outcomes and minimize the mortality rate. Patients with severe valvular heart disease with chronic heart failure at times, progressing to malnutrition. Patients undergoing cardiac surgery experience a systemic inflammatory response, which contributes to acute organ injury leading to a higher incidence of comorbidities and worse malnutrition. Therefore, preoperative risk and nutritional assessment are critical in performing safe cardiac surgical procedures. We report a case of a malnourished 17-year-old man with multiple valvular heart disease with optimal preparation, including good nutritional status leading to good outcome of complex cardiac surgery even in the high risk patients. Keywords             : valvular heart disease, malnutrition, perioperative assessmentCorrespondence   : dr.dianparamita@yahoo.com
Cardiac Pacemaker in Pregnancy: How to Manage? Dian Paramita Kartikasari; Rerdin Julario
Cardiovascular and Cardiometabolic Journal Vol. 2 No. 1 (2021): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v2i1.2021.30-35

Abstract

Despite the increasing use of permanent cardiac pacemakers in a younger patient population, there are little data related to pregnancy. Normal physiologic alterations of pregnancy need to be taken into account in the management of the pregnant woman with a pacemaker in place. Similarly, gestational events including the potential for  surgical intervention require a basic knowledge of pacemaker technology and monitoring. We present a case of a patient with junctional escape rhythm and was implanted pacemaker during pregnancy. A 24 years old women referred from obstetric outpatient clinic with asymptomatic bradycardia and cryptogenic stroke 2 years earlier. ECG shows sinus arrest with junctional escape rhythm. After multi-disciplinary discussion, team decided to implant double chamber pacemaker implantation. The pacemaker setting is adjusted to prepare caesarean section at 39 weeks gestation with delivery of an aterm infant. The postoperative course was uneventful. Pre-pregnancy pacemaker settings were re-established after the postpartum period. The current literature on managing pregnant patients with pacemakers is quite limited. Such patients require a multidisciplinary approach to care. Electromagnetic Interference (EMI) should be noticed. 
microRNA-1 Induces Transdifferentiation of Peripheral Blood CD34+ Cells into Cardiomyocytes-like Cells Budi Susetio Pikir; Andrianto Andrianto; I Gde Rurus Suryawan; Hanestya Oky Hermawan; Dian Paramita Kartikasari; Primasitha Maharany Harsoyo
The Indonesian Biomedical Journal Vol 14, No 3 (2022)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v14i3.1888

Abstract

BACKGROUND: Transdifferentiation is a method to provide cells sources for cellular cardiomyoplasty. CD34+ cells are potential cells sources because these cells can differentiate into cardiomyocytes through several mechanisms. MicroRNA (miR-1) is known to have the ability to inhibit the expression of histone deacetylase 4 (HDAC4). HDAC4 is a gene that essentially contributes in cardiomyocytes differentiation. However, the study reporting an evidence that miR-1 can induce transdifferentiation of CD34+ peripheral blood cells into mature cardiomyocytes is limited.METHODS: CD34+ cells were taken from peripheral blood and isolated using a magnetic-activated cell sorting (MACS) method in vitro. Mature mimics of miR-1 were transfected into isolated CD34+ cells and then incubated for 48 hours for quantification of HDAC4 mRNA using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). On the fifth day after miR-1 transfection, cardiomyocyte-like cells were identified based on their morphology and cardiac troponin expression using immunocytochemistry.RESULTS: Transfection of miR-1 in CD34+ isolated cells decreased HDAC4 gene expression by -0.54 fold at second day and caused a significant increase in percentage of cardiac troponin positive cells (median: 31.34; p<0.05) at fifth-day post-transfection. The efficiency of transdifferentiation was 32%. The miR-1 transfection had a significant negative relationship with HDAC4 gene expression (B=-1.000; p=0.001). HDAC4 gene expression had a negative and significant relationship with the percentage of cardiac troponin-positive cells (B=-0.701; p=0.001).CONCLUSION: This study suggests that miR-1 can induce transdifferentiation of peripheral blood CD34+ cells into cardiomyocytes-like cells by decreasing HDAC4 gene expression.KEYWORDS: transdifferentiation, microRNA-1, CD34, cardiomyocyte, HDAC4
Evaluation of Right and Left Ventricular Function in Ebstein Anomaly Using RVGLS and LVGLS: A Narrative Literature Review Sembiring, Matthew Risdian Pratama; Lefi, Achmad; Kartikasari, Dian Paramita
Jurnal Ilmiah Kesehatan Vol 17 No 2 (2025): Jurnal Ilmiah Kesehatan
Publisher : Universitas Mohammad Husni Thamrin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37012/jik.v17i2.3133

Abstract

Ebstein anomaly is a rare congenital heart defect characterized by tricuspid valve malformation, atrialization of the RV, and hemodynamic disturbances that may affect both ventricles. Assessing ventricular function in this condition is essential because it is closely related to disease progression, clinical symptoms, and long term prognosis. Conventional parameters such as TAPSE, RVFAC, and LVEF are commonly used but have limitations. Speckle Tracking Echocardiography (STE), through Right Ventricular Global Longitudinal Strain (RVGLS) and Left Ventricular Global Longitudinal Strain (LVGLS), provides higher sensitivity for detecting ventricular dysfunction. This narrative literature review evaluates the role of RVGLS and LVGLS in patients with Ebstein anomaly. Evidence shows that RVGLS is more accurate in identifying RV dysfunction compared with TAPSE and RVFAC, and possesses strong prognostic value for mortality. LVGLS can detect LV dysfunction at a subclinical stage even when LVEF remains preserved, reflecting involvement of longitudinal myocardial fibers due to ventricular interdependence and secondary remodeling. After tricuspid valve surgery, both RVGLS and LVGLS remain sensitive indicators of changes in ventricular performance. Overall, RVGLS and LVGLS demonstrate superiority over conventional systolic parameters and are recommended as primary tools for evaluating biventricular function in patients with Ebstein anomaly
THE RELATIONSHIP BETWEEN SOCIOECONOMIC AND DEMOGRAPHIC FACTORS AND RHEUMATIC HEART DISEASE AT DR. SOETOMO GENERAL HOSPITAL: - Silaen, Kevin Ebenhaezer; Lefi, Achmad; Umiastuti, Pirlina; Kartikasari, Dian Paramita
Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Vol. 13 No. 1 (2026): Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Univers
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/vj53q325

Abstract

Rheumatic heart disease (RHD) is a public health problem, especially among low-income populations in developing countries. This study aims to examine the relationship between demographic and socioeconomic factors and the incidence of RHD at Dr. Soetomo General Hospital, Surabaya. This is an analytic study using a cross-sectional approach, with 284 respondents in 2024. Primary data were collected through questionnaires and analyzed using SPSS. The Chi-Square test revealed a significant relationship between age and RHD (p = 0.000 < 0.005), particularly among individuals aged 40-59 years. Other variables, such as gender, residential area, population density, and economic status, did not show a significant association. These findings underscore the need for targeted public health interventions specifically designed for specific age groups. Further research is recommended, utilizing larger sample sizes and a more detailed classification of RHD severity levels, to enhance prevention and disease management strategies.
Task-Shifting Echocardiography Training for Rheumatic Heart Disease Screening in Indonesia: A Feasibility Study Kartikasari, Dian Paramita; Lefi, Achmad; Kikuko, Irawati Hajar; Laksitarini, Asri; Saputra, Pandit Bagus Tri; Saputra, Mahendra Eko; Pasahari, Diar; Agustina, Emildha Dwi
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 17 No. 1 (2026): JANUARY 2026 (IN-PROGRESS ISSUE)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V17I12026.96-102

Abstract

Highlights: Rheumatic heart disease remains a significant health concern in low-and middle-income countries, as it is often challenging to detect in its early stages due to subtle or absent symptoms, particularly during the subclinical phase. Task-shifting echocardiographic screening of RHD to general practitioners offers a scalable solution in low-resource settings.   Abstract Introduction: Rheumatic heart disease (RHD) remains a significant health burden in low- and middle-income countries. Early detection of RHD by trained general practitioners (GPs) allows for faster intervention to prevent disease progression. This study aimed to evaluate the feasibility and effectiveness of training non-expert health workers in Indonesia to perform echocardiographic screening for RHD, addressing the country’s unique challenges and bridging the gap in healthcare resources. Methods: A quasi-experimental pre-post intervention study was conducted involving 18 GPs with no prior echocardiography experience. The training consisted of one day of lecture-based instruction and six days of supervised hands-on practice. Knowledge was assessed using a newly developed RHD-echocardiography test that underwent face and content validation by two cardiologists and demonstrated good internal consistency (Cronbach’s alpha = 0.82). Pre- and post-training knowledge was compared using paired t-tests. Diagnostic sensitivity and specificity were calculated using cardiologist-confirmed findings from a subsequent one-month school-based screening of 440 students. Results: The mean pre-test score was 64 ± 11, significantly increasing to 95 ± 7.5 after training (p<0.001). Image quality was diagnostically adequate in 97.7% of examinations. Sensitivity and specificity of GP-acquired screening echocardiograms were 41.4% (95% Confidence Interval/CI: 29.9%-53.0%) and 73.7% (95% CI: 69.1%-78.3%), respectively. No significant differences in scores were observed by gender or age group. Conclusion: Although participants initially had limited exposure to echocardiography, the structured short-term curriculum substantially improved knowledge, image acquisition skills, and screening capability. Task-shifting echocardiographic screening to mid-level providers appears feasible in Indonesia and warrants further refinement and scale-up.
Co-Authors Agustina, Emildha Dwi Andrianto Budi Susetio Pikir Esti Hindariati Hanestya Oky Hermawan Kikuko, Irawati Hajar Laksitarini, Asri Lefi, Achmad Pasahari, Diar Primasitha Maharany Harsoyo Rerdin Julario Saputra, Mahendra Eko Saputra, Pandit Bagus Tri Sembiring, Matthew Risdian Pratama Silaen, Kevin Ebenhaezer Suryawan, I Gde Rurus Umiastuti, Pirlina