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All Journal Smart Medical Journal Heart Science Journal
Widi, Vina Sari Nugrahaning
Unknown Affiliation
Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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The role of cardiac rehabilitation in heart failure: A review from an evidence-based approach Irmansyah, Yos Akbar; Widi, Vina Sari Nugrahaning; Martiana, Astri Kurniati
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.2026.007.01.6

Abstract

Heart failure (HF) is a complex global health challenge caused by a structural and/or functional cardiac abnormality. Pharmacological medication remains a cornerstone of its management, but most patients continue to experience limited exercise capacity, which leads to decreased quality of life. Those limitations have led to the emergence of cardiac rehabilitation (CR) as a crucial part of HF management. It is a non-pharmacological, multidisciplinary approach to heart failure that aims to improve a patient’s functional capacity, reduce the risk of hospitalization, and improve long-term survival. Cardiac rehabilitation integrates structured exercise training, lifestyle modifications, and psychosocial support, customized to meet each individual’s needs. Studies demonstrate that exercise capacity, muscle strength, and respiratory efficiency are enhanced with aerobic exercise, resistance training, and inspiratory muscle training. Despite the proven efficacy, there is a significant underutilization of cardiac rehabilitation due to limited availability, low awareness, and patient adherence to the programs. This review article synthesizes evidence from PubMed, Scopus, and reference lists of relevant studies published up to July 2025 highlights the necessity of integrating CR into standard heart failure management and focusing on individualized rehabilitation programs. Enhancing the availability of CR programs could significantly alleviate the burden of HF, improve outcomes, and reduce healthcare expenses associated with frequent hospitalizations. Future research should prioritize a multidisciplinary team approach and patient education to align evidence-based recommendations with practical application.
Predicting Acute Myocardial Infarction Severity Using Inflammatory Markers Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Baskoro, Abiseka Panji; Budiono, Enrico Ananda; Widi, Vina Sari Nugrahaning; Asrial, An Aldia; Irnizarifka, Irnizarifka; Chania, Hanimar
Smart Medical Journal Vol 8, No 2 (2025): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v8i2.105956

Abstract

 Introduction: Acute myocardial infarction (AMI) remains as one of major contributors to cardiovascular mortality worldwide. While Killip class and GRACE score are established tools for assessing AMI severity, evidence regarding prognostic potential of hematologic inflammatory markers, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) remains limited, particularly in Southeast Asia. This study aimed to see the correlation between NLR and PLR with Killip classification, GRACE score, and in-hospital mortality in AMI patients.Methods: This retrospective study included 47 AMI patients admitted to the Intensive Cardiovascular Care Unit of Universitas Sebelas Maret Hospital between September 2024 and June 2025. Data on clinical and laboratory parameters were extracted from medical records. NLR and PLR were calculated from complete blood count values. Killip class and GRACE score were assessed at admission. Statistical analyses included correlation tests, regression models, and outcome comparisons.Results: Higher NLR and PLR values were significantly associated with increasing Killip class (ρ = 0.897 and ρ = 0.921, respectively) and GRACE score (p < 0.001). PLR was independent predictor of Killip class (p = 0.020), while only troponin I was independently associated with in-hospital mortality (p = 0.040). The GRACE score regression model showed excellent explanatory power (R² = 0.919), with NLR, PLR, and clinical variables contributing significantly.Conclusion: NLR and PLR are significantly correlated with AMI severity and risk scores. PLR may serve as a simple adjunctive marker for early clinical stratification in AMI.
Co-Authors Asrial, An Aldia Baskoro, Abiseka Panji Budiono, Enrico Ananda Chania, Hanimar Irmansyah, Yos Akbar Irnizarifka Martiana, Astri Kurniati