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The role of colchicine on ventricular remodelling following myocardial infarction and ischemia-reperfusion injury: article review Caesario, Fahreza; Prasetya, Indra
Heart Science Journal Vol. 5 No. 4 (2024): The Current Perspective About Cardiometabolic Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2024.005.04.3

Abstract

Acute myocardial infarction (AMI) is a major cause of cardiac dysfunction, arrhythmias, and a poor prognosis. Even though new technologies have been developed to aid in opening the culprit coronary artery and correcting ischemia-related stenosis by percutaneous coronary intervention (PCI), the ventricular remodelling that induces cardiac failure as a consequence of AMI remains unchanged. Colchicine, a versatile anti-inflammatory medication, has been documented in mitigating cardiac remodelling and enhancing cardiac function following AMI. This article provides an in-depth review of the processes by which colchicine affects ventricular remodeling after AMI, highlighting the potential role of inflammation in the pathogenesis and progression of ventricular dysfunction.
Recognizing Total Anomalous Pulmonary Venous Drainage (TAPVD) from Natural History to the Supportive Imaging Modalities Caesario, Fahreza; Swastika Putri, Valerinna Yogibuana
Heart Science Journal Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.3

Abstract

Congenital Heart Disease (CHD) prevalence was 8 until 9 for each thousand live births, and among all of the CHD, there is only one condition that involved the malformation of the venous system that called Total Anomalous Pulmonary Venous Drainage (TAPVD). TAPVD can be found and yet to be diagnosed in all ages, not only in the childhood era. Adult individuals with TAPVD are susceptible to being misdiagnosed as having a significant secundum atrial septal defect if the condition is not known or suspected. A systematic history taking, physical examination, and another supportive imaging modalities is needed to ensure this structural anomaly.
How to decide appropriate percutaneous coronary intervention (PCI) technique for managing heavy calcified coronary lesions: serial case-report Caesario, Fahreza; Rohman, Mohammad Saifur
Heart Science Journal Vol. 5 No. 4 (2024): The Current Perspective About Cardiometabolic Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2024.005.04.15

Abstract

Background: Coronary artery calcification (CAC) is still challenging for interventional cardiologists. Their contribution to major adverse cardiac events occurs from the high risk of stent thrombosis or in-stent restenosis and target lesion revascularization. Optimal preparation, such as coronary plaque modification before stenting, is required to reduce the risk of periprocedural adverse events. This case presentation aimed to describe the appropriate management of heavy calcified coronary lesions.Case Presentation: Two cases of heavy calcified coronary lesions with different baselines as Acute Coronary Syndromes (ACS) and elective PCI were presented. In our ACS patients, the Primary PCI was done by coronary angioplasty without stenting because of the complexity of the heavily calcified lesion. A referral to tertiary health care was made for further PCI procedures using a combination of calcium-ablation and balloon-based techniques. A treatable complication occurred after the orbital atherectomy was performed with good results. The second case was an elective PCI patient with heavy calcified lesions findings from coronary angiography. The balloon-based technique was performed using non-compliant and scoring balloons without complication and showed good results.Conclusion: The challenging points in managing heavy calcified coronary lesions are procedure complexity and the higher stent failure rate. Many modifying coronary calcification algorithms using advanced modalities have been proposed, which could be used to select the appropriate technique as experienced and increase the success rate.
Effects of the Low-Dose Colchicine Regimen on Left Ventricular Adverse Remodeling and Systolic Function in Acute Myocardial Infarction Patients With Anterior ST Segment Elevation Undergoing Primary Percutaneous Coronary Intervention: A Randomized Controlled Trial Caesario, Fahreza; Prasetya, Indra; Rohman, Mohammad Saifur; satrijo, Budi; Anjarwani, Setyasih
Heart Science Journal Vol. 5 No. 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.9

Abstract

Background: Inflammation in reperfusion injury results in adverse ventricular remodeling and reduced systolic function. The anti-inflammatory effects of colchicine have shown beneficial effects in cardiovascular disease.Objective: To determine the effects of low-dose colchicine on left ventricular (LV) adverse remodeling and systolic function in acute myocardial infarction with anterior ST-segment elevation (anterior STEMI) patients undergoing primary percutaneous coronary intervention (PPCI).Material and Methods: This prospective, randomized, double-blinded study randomly assigned anterior STEMI patients who underwent PPCI to receive either low-dose colchicine (1mg loading dose followed by 0.5mg daily) or a matching placebo for 30 days in addition to standard therapy. Outcomes included adverse LV remodeling and systolic function, determined by transthoracic echocardiography (TTE) in the first and third month.Result: Enrollment comprised 196 patients, with 92 patients in the colchicine group and 104 patients in the placebo group. Adverse LV remodeling and a decrease in systolic function were observed in both groups. No significant differences in LV remodeling were observed between the colchicine and placebo groups, as indicated by the change in LV end-systolic volume index (LVESVI) at the first month (16.5% vs. 18.25% [p=0.091]) and third month (19.5% vs. 21.5% [p=0.124]). Similar results were found in LV systolic function between the colchicine and placebo groups, with a reduction in LV ejection fraction (LVEF) observed in the first month (6.3% vs. 8.95% [p=0.083]) and third month (9.5% vs. 11.5% [p=0.163]). Diarrhea was the only reported side effect, occurring in 6.5% of patients in the colchicine group.Conclusion: Low-dose colchicine administration in anterior STEMI patients undergoing PPCI did not reduce LV adverse remodeling or systolic function.
Giant left coronary artery with coronary cameral fistula in significant coronary artery disease : A case report Caesario, Fahreza; Handari, Saskia Dyah
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.2025.006.02.18

Abstract

Background : Coronary Artery Fistula are coronary anomalies that affected populations with rare incidences. Concomitant disease such as coronary artery disease (CAD) may be occurred in CAF and causing complexity to its management. Objective : This case presentation aimed to describe the characteristic, diagnosis and management of CAF with concomitant disease such as CAD. Case Presentation : We will discuss A 56 year old male admitted as an outpatient with left sided chest pain as the chief complain. The chest pain was described as ischemic chest pain with supporting examination lead to the suspicion of coronary artery disease.  Contrast enhanced CT Angiography examination was planned for diagnosing Coronary Artery Disease in this patient. 3D reconstruction of the coronary tree revealed giant LAD (Diameter 6.5 – 7mm) with normal size of LCx and Dominant RCA. The distal LAD was communicating with the LV cavity through big coronary fistulae. Impression of significant stenosis showed in the proximal RCA described as mixed plaque causing >70% Stenosis. PCI of the RCA and CAF Closure management was proposed but there was a disagreement of further coronary intervention from the patient. Conclusion : CAF in concomitant CAD is a complex structural disease with challenging management. Combination of surgical procedure was the recommendation for the management of this case.