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All Journal Heart Science Journal
Valerinna Yogibuana
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Health Professions Immunology & microbiology Medicine & Pharmacology

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The effect of exercise training as adjuvant treatment on mean pulmonary arterial pressure by echocardiography and functional capacity in congenital heart disease with negative vaso reactivity test pulmonary hypertension patient at Saiful Anwar Hospital Malang Firdaus, Muhammad; Heny Martini; Wella Karolina; Valerinna Yogibuana; Cholid Tri Tjahjono
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.2025.006.02.13

Abstract

  Background : PH is defined by mPAP >20 mmHg at rest. Exercise training enhances hemodynamics and exercise capacity in PH patients. Echocardiography is essential for assessing and evaluating PAP in PH cases. Objective : This study aims to determine the effect of 12-weel exercise training on mPAP by echocardiography and functional capacity Methods : A prospective cohort study at Saiful Anwar General Hospital (Sept 2024-Jan 2025) investigated exercise effects on mPAP and functional capacity in pulmonary hypertension patients. Participants were randomized to control (medication only) or treatment (medication plus exercise training) groups. Both underwent SMWT and echocardiography at baseline and after 12 weeks. Standardized exercise was monitored by healthcare experts. Result : This study compared 12 non-vasoreactive PH patients receiving standard therapy to 12 undergoing exercise training. The treatment group showed a significant mPAP decrease (66.8 to 63.4 mmHg, p=0.006), while the control group's reduction was non-significant (53.1 to 51.7 mmHg, p=0.061). Both groups improved 6MWT distances significantly after 12 weeks from 306.5 ± 72.7 meters to 318.3 ± 74.0 meters in the control group (p=0.041) and from 363.8 ± 63.6 meters to 382.9 ± 64.7 meters in the treatment group (p=0.000). No significant correlation was found between mPAP decrease and 6MWT increase in either group Conclusion : This study demonstrates improvements in mPAP and functional capacity following exercise training as an adjunctive therapy. However, no correlation was observed between the enhancement in functional capacity and the reduction in mPAP.  
Effects of exercise training on C-reactive protein (CRP) levels and 6-minute walk distance: A preliminary study Aziz, Indra Jabbar; Martini, Heny; Anna Fuji Rahimah; Valerinna Yogibuana; Cholid Tri Tjahjono
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.2025.006.04.11

Abstract

Background Mortality rates increase among those with intermediate to high-risk pulmonary arterial hypertension, demonstrating the importance of improved diagnostic methods, treatment algorithms, and the development of new approaches to therapy for severely ill patients. Inflammation contributes to pulmonary hypertension progression, and exercise has been shown to suppress this process. Objective This study evaluated the relationship and differences between CRP levels and functional capacity after a 12-week exercise training program. Methods A clinical prospective cohort preliminary study was conducted with 26 consecutive patients who had already received pulmonary hypertension treatment and were enrolled in the LET-SHINE registry. Patients were divided into two groups: one control group (PH therapy only) and one treatment group (receiving adjuvant physical exercise). The study was conducted for 12 weeks, 6MWT and CRP tests were performed both before and after the study. Result This study found that the majority of cases were ASD, consistent with the fact that ASD is the most common congenital heart defect. The analysis of C-reactive protein levels showed non-significant changes in both groups after 12 weeks. The treatment group exhibited a modest reduction from 0.8 ± 2.4 mg/dl to 0.5 ± 1.0 mg/dl (p=0.514), while the control group maintained stable levels, ranging from 0.7 ± 1.0 mg/dl to 0.7 ± 0.8 mg/dl (p=0.166). An intergroup comparison revealed a non-significant greater mean decrease in the treatment group (-0.3 ± 1.5 mg/dl vs -0.1 ± 0.2 mg/dl, p=0.514). There was no significant correlation between the reduction in CRP levels and improvements in 6MWT distance in either the treatment group (correlation coefficient: -0.367, p=0.240) or the control group (correlation coefficient: 0.021, p=0.948). Conclusion This study showed that exercise training had no statistically significant impact on C-reactive protein levels, indicating a limited effect on systemic inflammation. No significant correlation was found between decreases in CRP levels and improvements in 6MWT distance in either the treatment or control groups.        
Atrial septal defect with pulmonary arterial hypertension in pregnancy : A case series Valerinna Yogibuana; Martini, Heny; Gultom, Yosafat Hasiholan Marthin
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.14

Abstract

Background: Congenital heart disease (CHD) ranked among the most frequently encountered structural abnormalities in humans. Acyanotic congenital heart disease (CHD) persists as a global issue, with atrial septal defect (ASD) constituting the second most prevalent form, accounting for around 10% of all CHD cases and occurring more frequently in females than in males. Pregnancy physiologically modifies the cardiovascular system and may exacerbate the clinical condition of people with atrial septal defect and pulmonary hypertension, potentially resulting in heart failure. Case Presentations: We documented five examples of pregnant patients with ASD and pulmonary hypertension (PH).  Two patients had established medical records and attended regular follow-up, one of whom underwent ASD closure.  All patients had dilation of the right atrium and ventricle, with two individuals presenting right ventricular (RV) systolic dysfunction.  All patients exhibited normal left ventricular (LV) systolic function.  Notwithstanding the oversight of a multidisciplinary heart team and intensive care management, one of our patients succumbed following cesarean section delivery.  The patient exhibited diminished right ventricular systolic function, a bidirectional shunt lesion, a significant maximal pressure gradient, and lacked any documented cardiovascular or obstetric medical history, presenting with a poor mWHO classification.   She experienced unresolved postoperative shock and bleeding. Conclusions: Managing PH secondary to CHD among pregnant patients presents significant challenges for multidisciplinary teams. Intensive perioperative care is essential to minimize mortality and morbidity in pregnant women with PH. Careful planning of optimal medical therapy, timing and delivery method, and post-natal approach is vital to improve outcomes.
To seal or to vent? Hemodynamic-guided decision-making in an older patient with borderline large secundum atrial septal defect and pulmonary hypertension Tambunan, Daniel; Valerinna Yogibuana
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.18

Abstract

Background: Determining whether an atrial septal defect (ASD) should be closed in older patients who already have pulmonary hypertension may present a clinical dilemma. This is particularly true when pulmonary vascular resistance (PVR) approaches commonly used operability thresholds. Case Illustrations: A 59-year-old woman was referred to our center because of progressive exertional dyspnea and declining functional capacity. Echocardiography evaluation showed a large secundum ASD with a significant left-to-right shunt and right-sided chamber enlargement. Right heart catheterization revealed a mean pulmonary artery pressure of 46 mmHg and a pulmonary vascular resistance of 7.1 Wood units. Following oxygen test, PVR decreased to 3.4 Wood units and the Qp/Qs ratio increased from 1.5 to 2.65, suggesting preserved pulmonary vascular responsiveness. Based on these findings,  transcatheter ASD closure without fenestration was performed successfully. The intervention was completed without complications, and early follow-up showed improvement in symptoms along with more favorable hemodynamic findings. Conclusions: This case highlights how comprehensive hemodynamic and physiological assessment, including dynamic vasoreactivity testing, can guide operability decisions in older patients with ASD and elevated PVR. Reassessment of pulmonary vascular responsiveness may refine risk stratification and support individualized management.
Co-Authors Anna Fuji Rahimah Aziz, Indra Jabbar Cholid Tri Tjahjono Gultom, Yosafat Hasiholan Marthin Heny Martini Martini, Heny Muhammad Firdaus Tambunan, Daniel Wella Karolina