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All Journal Amerta Nutrition Jurnal Ilmu Kedokteran dan Kesehatan PREPOTIF : Jurnal Kesehatan Masyarakat Heart Science Journal
Saskia Dyah Handari
Departmen Of Cardiology And Vascular Medicine, Faculty Of Medicine, Universitas Ciputra, Surabaya.
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Journal : Heart Science Journal

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Cardiac computed tomography beyond anatomical coronary artery disease assessment: A contemporary review Vori, Ira; Handari, Saskia Dyah
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.2025.006.03.9

Abstract

Cardiac computed tomography (CT) has undergone a remarkable transformation over the past two decades, evolving from a purely anatomical imaging modality to a comprehensive cardiac assessment tool. This review examines recent technological advancements and expanded clinical applications of cardiac CT. Contemporary systems, equipped with dual-energy imaging, wide-detector arrays, and sophisticated reconstruction algorithms, now enable functional assessment through myocardial perfusion imaging and CT-derived fractional flow reserve (CT-FFR), alongside advanced plaque characterization. Technical developments have improved temporal and spatial resolution while optimizing radiation exposure through refined dose management protocols. The integration of anatomical and functional data has proven particularly valuable in triple rule out at emergency department and also a guide for revascularization decisions, as physiological significance often supersedes anatomical severity in clinical decision-making. Additionally, cardiac CT has emerged as an essential tool in pre-procedural planning for structural heart interventions, including transcatheter aortic valve replacement, left atrial appendage (LAA) closure, and mitral valve (MV) interventions. The modality also demonstrates significant utility in electrophysiology applications, particularly in planning pulmonary vein isolation procedures. Recent guidelines from major cardiovascular societies have incorporated these advances, positioning cardiac CT as a first-line diagnostic tool for stable chest pain and a cost-effective gatekeeper for invasive procedures. Future directions include expanded applications in quantitative plaque assessment, artificial intelligence integration, and personalized risk stratification, promising to further enhance the role of cardiac CT in clinical practice.
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.
WHO risk chart associated with the presence of coronary plaque on coronary computed tomographic angiography in asymptomatic indonesian population Indrihapsari, Pratiwi; Saskia Dyah Handari; Cholid Tri Tjahjono
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.2025.006.03.11

Abstract

Background: Cardiovascular risk assessment tools, like the WHO Risk Chart, often categorize asymptomatic individuals as low risk, even when they have unmanaged cardiovascular risk factors. Among these patients, estimation of CAD is associated with significant differences in CACS; however, the relationship between WHO Risk Chart and CACS has not been studied. Objective: We studied WHO Risk Chart’s ability to detect for coronary plaque throughout CACS via CCTA. Methods: A total of 440 subjects aged 40 to 74 years old, who underwent CCTA for health checkup between January 2023 and December 2024 were enrolled. Clinical information was gathered from medical records, including risk factors, CACS, and CCTA results. Statistical analysis was performed using SPSS 24, applying univariate, bivariate, and multivariate regression analyses to identify correlations. Results: The WHO Risk Chart showed a significant correlation with CACS and the presence of coronary plaque (p <0.05). In total, 148 individuals were identified with normal coronary arteries, while 292 individuals presented with coronary plaque. Notable differences were found among genders, WHO Risk Chart, smoking status, hypertension, dyslipidemia, diabetes mellitus, and CACS levels between the two groups (p<0.05). The correlation coefficient suggests that an increase in the WHO Risk Chart is associated with a rise in CACS, indicating a bidirectional relationship between these two parameters. Conclusion: In an asymptomatic population from Indonesia, the WHO Risk Chart shows a strong positive correlation with CACS.
The Effect of Exercise Training as Adjuvant Treatment on Functional Capacity in Congenital Heart Disease with Negative Vaso Reactivity Test Pulmonary Hypertension Patient at Saiful Anwar Hospital Malang Pratiwi, Irma Kamelia; Martini, Heny; Tjahjono, Cholid Tri; Anjarwani, Setyasih; Handari, Saskia Dyah
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.2023.004.03.3

Abstract

BackgroundPulmonary hypertension associated with congenital heart disease (CHD) is an important subgroup that accounts for approximately 11% of all patients with PAH. Physical limitations are one of the main symptoms of hemodynamic changes in patients with PH. Objective This study aimed to evaluate the effect of physical exercise therapy for 12 weeks as an additional therapy with PDE-5 inhibitors on the functional capacity of patients with Congenital Heart Disease accompanied by Pulmonary Artery Hypertension (CHD – PH). MethodThis research was an analytic experimental study with a prospective cohort research method. This study used data sources obtained from medical records to adjust subjects based on inclusion and exclusion criteria, initial cardiac training test examination data was carried out at IPJT in patients selected as subjects. The patient's clinical outcomes were followed in the next 12 weeks. ResultThis research was conducted on 16 samples divided into two groups, namely the control and study groups. The evaluation after 12 weeks found that there was an increase in mileage as measured through the 6MWT submaximal test and a better duration of physical activity in the study group tested through the Endurance Shuttle Walk Test (ESWT). This is consistent with the effect of physical exercise, which suppresses systemic inflammation and causes vasodilation, thereby increasing oxygen delivery to the tissues. This causes more optimal aerobic metabolism and reduces lactate production. So that the patient did not quickly feel tired during activities. However, there was no significant increase in the Incremental Shuttle Walk Test. This could be due to the relatively short training duration of 12 weeks. Conclusion A positive correlation exists between physical exercise and increased functional capacity of patients with CHD who were evaluated using 6MWT and ESWT.
The hidden grip: A case of secondary hypertension entwined with renal artery stenosis Rahmawati, Novi; Handari, Saskia Dyah; Hargiyanto, Erlangga Diasmara
Heart Science Journal Vol. 7 No. 1 (2026): Accelerating Clinical Breakthroughs: The Journey from Molecular Discovery to Pa
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.01.20

Abstract

Background: Renal artery stenosis (RAS) is a vascular disorder characterized by narrowing of the renal artery. It often leads to renovascular hypertension (RVH) and, if untreated, progression to end-stage renal disease. Atherosclerosis and fibromuscular dysplasia (FMD) are the most common etiologies, with clinical manifestations ranging from asymptomatic to resistant hypertension. Diagnosis involves imaging modalities such as Doppler ultrasound (DUS), CT angiography (CTA), and confirmation by digital subtraction angiography (DSA). We report a case to emphasize the diagnostic and therapeutic challenges of RAS in young patients. Case Illustration: A 17-year-old male presented with persistent grade 2 hypertension unresponsive to dual antihypertensive therapy and a history of repeated hospitalizations. Imaging revealed significant stenosis with post-stenotic dilatation in the right renal artery. CTA and DSA confirmed the diagnosis of RVH secondary to RAS, with Fibromuscular Dysplasia (FMD) as the suspected etiology. The patient underwent successful angioplasty and stenting, resulting in improved blood pressure control and reduced medication requirements. Upon follow-up, the patient’s symptoms have resolved, and their blood pressure is under control. RAS remains a challenging and underdiagnosed cause of secondary hypertension, particularly in younger patients. While optimal medical therapy is the first-line approach, it may be insufficient in high-risk individuals. Non-invasive modalities provide valuable initial assessment, but DSA remains the gold standard for diagnosis and intervention. Revascularization, especially via stenting, is recommended in selected cases with significant stenosis, viable renal tissue, and resistant hypertension. Guidelines emphasize tailored therapy and careful post-procedure monitoring to detect restenosis or symptom recurrence. This case underscores the importance of early recognition and individualized intervention to improve outcomes.. Conclusions: RAS should be considered in young patients with grade 2 hypertension. Early diagnosis and appropriate intervention are critical to preventing long-term renal and cardiovascular complications.
Co-Authors Adhitya Ginting Agung, Purwakaning Purnomo Anjarwani, Setyasih Antonius Yansen Suryadarma Caesario, Fahreza Cholid Tri Tjahjono Cholid Tri Tjahjono Christine, Catarina Lilian Damayanti, Ni Nyoman Rere Dion, Aldy Djanggan Sargowo Firdaus, Achmad Jauhar Fransiska Anggreni Sihotang Galuh, Lukitasari Ayu Hargiyanto, Erlangga Diasmara Hebert Adrianto Imam Mi&#039;raj Suprayoga Indra Prasetya Indrihapsari, Pratiwi Jefri, Wilhelmus Kahadi, Cik Kusuma, Irwin Prijatna Martini, Heny Mirna Rahmasari Muhammad Firdaus Nidom, Astria Novitasari Novi Rahmawati Panggabean, Ronald Torang Marsahala Pratiwi, Irma Kamelia Putri, Firda Aulia Rahimah, Anna Fuji Satrijo, Budi Sembiring, Yan Efrata Suprapta, Aloysius Yuwono Victor Kurniawan Yuwono Vori, Ira Yasa, Oka Suputra Yurike Dhika Adhela