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All Journal Heart Science Journal Jurnal Klinik dan Riset Kesehatan
Rosyidi, Muhammad Azhar
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Optimalisasi Hasil pada Ruptur Septal Ventrikel : Strategi Integratif dan Tantangan Modern Rosyidi, Muhammad Azhar; Anjarwani, Setyasih; Yogibuana, Valerinna
Jurnal Klinik dan Riset Kesehatan Vol 5 No 1 (2025): Edisi Oktober 2025
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.05.1.5

Abstract

Acute Myocardial Infarction (AMI) requires immediate management to prevent serious complications, one of which is Ventricular Septal Rupture (VSR). This complication necessitates a multidisciplinary approach due to the complex interaction between ischemic injury, mechanical stress, and inflammatory processes within the heart. Post-AMI VSR leads to a left-to-right shunt, resulting in hemodynamic changes that affect both cardiac function and systemic circulation. Echocardiography serves as the primary modality for assessing the size and location of the rupture, although other imaging modalities are also employed for a more detailed evaluation of hemodynamic alterations. Initial management of post-AMI VSR focuses on hemodynamic stabilization through medical therapy. However, mechanical circulatory support, such as Intra-Aortic Balloon Pump (IABP) or Extracorporeal Membrane Oxygenation (ECMO), is often required in more severe cases. Surgical closure remains the gold standard of treatment, although the optimal timing for surgery is still debated among experts. As an alternative, transcatheter closure using occluder devices can be employed as acute, subacute, or definitive therapy, depending on the patient's condition. The management of post-AMI VSR involves hemodynamic stabilization and a decision between surgical or transcatheter closure, which must take into account the patient's clinical profile and the expertise of the medical team involved.
Prognostic implications of pulmonary hypertension in heart failure preserved and reduced ejection fraction Rosyidi, Muhammad Azhar; Yogibuana, Valerinna
Heart Science Journal Vol. 7 No. 2 (2026): The Evolving Landscape of Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.02.3

Abstract

Pulmonary hypertension (PH) attributable to left heart disease (PH associated with left heart disease, PH-LHD) is the most common type of PH. PH-LHD is an important indicator of elevated morbidity and mortality in individuals with heart failure, both heart failure with preserved and reduced ejection fraction despite receive adequate therapy. Literature was sourced from major scientific databases and studies relevant to symptoms, examinations, management, and prognostic implications of PH-LHD. Pathophysiologically, PH-LHD is a gradual process that begins with increased left-heart pressure (postcapillary component), which triggers a series of biological changes in the pulmonary vasculature (precapillary component). This process ultimately places an excessive burden on the right ventricle, resulting in right ventricular dysfunction and failure, which are the main determinants of prognosis. Symptoms of PH-LHD are usually characterized by disproportionate dyspnea that is not consistent with left ventricular ejection fraction and other comorbidities. Echocardiography can noninvasively assess the probability of pulmonary hypertension in heart failure patients. A definitive diagnosis of PH-LHD requires confirmation through right heart catheterization. The most important prognostic factors are not only determined by the degree of hemodynamic severity, but also depend heavily on the degree of right ventricular dysfunction and the status of right ventricle–pulmonary artery coupling. Management of PH-LHD is through optimization of basic Guideline-Directed Medical Therapy (GDMT) to reduce mortality and morbidity.
Co-Authors Anjarwani, Setyasih Yogibuana, Valerinna