Indonesian Journal of Cardiology
Indonesian Journal of Cardiology (IJC) is a peer-reviewed and open-access journal established by Indonesian Heart Association (IHA)/Perhimpunan Dokter Spesialis Kardiovaskular Indonesia (PERKI) [www.inaheart.org] on the year 1979. This journal is published to meet the needs of physicians and other health professionals for scientific articles in the cardiovascular field. All articles (research, case report, review article, and others) should be original and has never been published in any magazine/journal. Prior to publication, every manuscript will be subjected to double-blind review by peer-reviewers. We consider articles on all aspects of the cardiovascular system including clinical, translational, epidemiological, and basic studies. Subjects suitable for publication include but are not limited to the following fields: Acute Cardiovascular Care Arrhythmia / Cardiac Electrophysiology Cardiovascular Imaging Cardiovascular Pharmacotherapy Cardiovascular Public Health Policy Cardiovascular Rehabilitation Cardiovascular Research General Cardiology Heart Failure Hypertension Interventional Cardiology Pediatric Cardiology Preventive Cardiology Vascular Medicine
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712 Documents
Perubahan metabolisme dan peran radikal bebas pada iskemia miokard
Dyana Sarvasti
Jurnal Kardiologi Indonesia Vol. 36, No. 3 Juli - September 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i3.480
Myocardial ischemic results from severe impairment of coronary blood supply and produces a spectrum of clinical syndromes. It results in a characteristic pattern of metabolic and structural changes that leads to extremely complex situations, which have been extensively studied in recent years. A detailed understanding is now available of the complexity of the response of the myocardium to an ischemic insult. Reperfusion is the most effective way to treat the ischaemic myocardial. But, restoration of flow, however, might result in numerous other negative consequences, thus directly influencing the degree of recovery. Much evidence shows that during the period of myocardial ischemia and reperfusion can occur various changes both in terms of metabolic, electrical, histology, structural, and physiological. Pathological changes in the form of metabolic changes and the role of free radicals on the condition of ischemia and reperfusion injury will be discussed. There are several potential manifestations and outcomes associated with myocardial ischemia and reperfusion.
Defek Konotrunkal Jantung
Herlina Dimiati;
Silfia Yasmine Lubis
Jurnal Kardiologi Indonesia Vol. 36, No. 3 Juli - September 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i3.481
Conotruncal anomalies comprise a diverse group of congenital heart defects involving the outflow tracts of the heart and the great .They are a leading cause symptomatic cyanotic cardiac disease diagnosed in utero. Conotruncal anomalies can be diagnosed by prenatal echocardiography with a high degree of accuracy. The overall prognosis for fetuses with a conotruncal anomaly is poor
Parameter pengukuran ventrikel kiri (1) Update rekomendasi tahun 2015 dari American Society of Echocardiography dan European Association of Cardiovascular Imaging
Ario Suryo
Jurnal Kardiologi Indonesia Vol. 36, No. 3 Juli - September 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i3.483
Pemeriksaan dan pengukuran dimensi Ventrikel kiri (Vki) merupakan salah satu parameter utama dalam pencitraan kardiovaskular dalam hal ini ekokardiografi. Oleh karena itu diperlukan rekomendasi untuk menyamakan metodologi pengukurannya. American Society of Echocardiography (ASE) dan European Association of Echocardiography ( saat ini menjadi European Association of Cardiovascular Imaging/ EACVI) telah mengeluarkan rekomendasi yang diterbitkan sejak tahun 2005. Dikarenakan kemajuan teknologi di bidang ekokardiografi yang cukup pesat, maka diperlukan pembaharuan terhadap rekomendasi tersebut untuk mengakomodir teknik-teknik baru seperti 3 Dimensi ekokardiografi (3DE) dan pengukuran deformation imaging yang sudah banyak dipakai dalam praktek klinis sehari-hari. Tulisan ini merangkum rekomendasi terbaru yang dikeluarkan kedua asosiasi tersebut baru–baru ini.
LONG RP TACHYCARDIA: What is the mechanism?
Yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 36, No. 3 Juli - September 2015
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v36i3.484
Seorang anak perempuan, 11 tahun dikonsulkan ke poli Aritmia dengan keluhan sesak dan berdebar. Rasa berdebar sudah dirasakan sejak lebih dari satu tahun yang lalu. Akhir-akhir ini pasien juga mengeluh sesak dan mudah capek. Pada pemeriksaan fisik didapatkan batas jantung kiri yang membesar dengan fixed wide split bunyi jantung kedua. Tidak terlihat sianosis. Ekokardiografi menunjukkan sebuah atrial septal defek sekundum yang besar dengan diameter 2.5 cm. Pasien mengalami takikardia incessant yang tidak respon dengan beberapa anti-aritmia dengan rekaman EKG 12 sadapan diperlihatkan di bawah ini.Tampak suatu takikardia regular dengan laju 115 kpm. Durasi QRS sempit (110 mdet) dengan morfologi gelombang P di belakang setiap kompleks QRS. Jarak awitan kompleks QRS ke awitan gelombang P
Stratifikasi Risiko, Cost-Analysis dan Jaminan Kesehatan Nasional di Bidang Kardiovaskular
Suko Adiarto
Jurnal Kardiologi Indonesia Vol. 35, No. 4 Oktober - Desember 2014
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v35i4.491
Mulai berlakunya sistem kesehatan nasional di Indonesia menandai era baru di bidang pembiayaan kesehatan nasional, dimana pembiayaan kesehatan yang sebelumnya didominasi oleh pembayaran tunai secara pribadi kini secara perlahan tapi pasti telah bergeser pada sistem asuransi, dimana keikutsertaan seluruh warga negara merupakan salah kunci sukses terselenggaranya sistem pembiayaan ini dengan baik. Berkaca pada pendapat para ahli di bidang pembiayaan kesehatan dan pengalaman negara-negara maju, tidak disangsikan lagi, ketika telah berjalan dengan sempurna sistem ini merupakan sistem pembiayaan terbaik. Tentu saja pada tahap awal pelaksanaan sistem jaminan ini masih terdapat beberapa kekurangan mendasar yang perlu mendapat perhatian serius untuk dapat segera diperbaiki.Seperti mengkonfirmasi data statistik yang telah ada tentang mortalitas dan morbiditas, BPJS kesehatan baru-baru ini me release data penyakit dengan pembiayaan kesehatan tertinggi dimana penyakit jantung dan pembuluh darah, keganasan (kanker) dan penyakit ginjal kronik merupakan 3 penyakit yang memuncaki tabel pengeluaran keuangan BPJS kesehatan.1 Penyakit jantung dan pembuluh darah berada di urutan pertama dengan jumlah pengeluaran
Polimorfisme Gen UCP2 Dan Kadar H2O2 Terhadap Variasi CEC Sebagai Prediktor Aktivasi Endotel Pada Pasien Stroke
M.Nur FAFA;
Djanggan Sargowo;
Achdiat Agoes;
Wiwit Nurwidyaningtyas
Jurnal Kardiologi Indonesia Vol. 35, No. 4 Oktober - Desember 2014
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v35i4.492
Research Background. Stroke as brain vascular disorder that can be ruptured vascular commonly referred to as a bleeding stroke or ischemic stroke may be due to cerebral arterial thrombosis as a final impact the progression of atherosclerosis, especially in the area of branching blood vessels. Atherogenesis related to endothelial dysfunction as a consequence shear stress exposure leads endothelial cells undergo premature senescence and activation of endothelial than occur endothelial detachment from the basement membrane as a circulating endothelial cells (CEC). Mechanism shears stress on endothelial activation can not be separated from the increased production of hydrogen peroxidase (H2O2), which will activate the PPAR-? then increase levels of free fatty acids are capable of modulating the uncoupling protein 2 (UCP 2) gene as a compensation for lowering of free fatty acids.Reseach Methods and Results. Researchers used 40 subjects were classified into two categories on a range of healthy and sick, who then performed blood sampling edge for lipid profile analysis, CEC using flowcytometry, H2O2 measurement with ELISA techniques and DNA isolation followed by PCR procedures with the Genomic DNA that has been extracted from blood samples amplified with the 5’-GCT GCT CAC AGG TCT GCC AC-3’sebagai forward primer and 5’-AGG CGT CAG GAG ATG GAC CG-3’sebagai reverse primer (Sesti et al, 2003; Oktavianthi et al, 2012). Genotype (-866) AA is characterized by fragments of 363 bp cutting results Mlu1 sites, whereas genotypes (-866) GG marked on fragments of 295 bp and 68 bp. The equipment used was a thermal cycler (Gene Amp® PCR System 9700 [Applied Biosystems, Foster City, CA, USA]). Results showed thatConclusion. CEC in the group sick 3 times higher than the healthy group as well as the levels of H2O2, but the two groups are not found polymorfism in both groups. Similarly, from the analysis of UCP2 gene allele frequencies between groups of stroke was not significantly different from the control group, this means yet certain UCP2 gene predispose and contribute to the pathogenesis of stroke.
Pedoman Kepatuhan dalam Pengelolaan Pasien dengan stabil Angina/Non-STEMI tanpa PCI Prosedur (Registry Medis Dikelola)
Erwinanto Erwinanto;
Angke Widya;
Nahar Taufik;
Sri Diniharini;
Dolly Kaunang;
Arini Setiawati
Jurnal Kardiologi Indonesia Vol. 35, No. 4 Oktober - Desember 2014
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v35i4.493
Aim: To document current usage of antiplatelet therapy and the implementation of ACC/AHA 2007 guideline in the clinical management of unstable angina/ non-ST-elevation myocardial infarction (UA/NSTEMI) patients not undergoing PCI procedure in Indonesia (medically managed) and their risks according to Global Registry of Acute Coronary Events (GRACE) score as well as in-hospital mortality.Method: A multicenter observational, prospective disease registry, recruiting patients with UA/NSTEMI. No specific treatment will be recommended in this disease registry. Data will be collected based on Physician’s applicable daily practices without any intervention.Results: A total of 467 eligible patients, 246 patients with UA and 221 with NSTEMI, aged 18 years or older were recruited from 18 hospitals during December 2009 – January 2011. Most recruited patients were at low risk (63.9%) and only 0.9% patients were at high risk according to the GRACE score. Patients were treated with ASA (90.6%) and Clopidogrel (96.6%) when they reached the emergency department. Medical therapy instituted during hospitalization were injectable anticoagulant (91.4%), oral anticoagulant (0.9%), oral nitrate (82.7%), beta blocker (60.8%), ACE inhibitor (49%), angiotensin receptor blocker (20.3%), calcium channel blocker (19.9%), statin (13.1%), and other medications given according the presentation of complications or comorbidities. In-hospital mortality was documented in 3.2% of patients. At discharge ASA was given to 87.6% and clopidogrel to 94.2% patients.Conclusion: The result showed that most of the patients admitted with UA/NSTEMI were at low or moderate risk according to GRACE score. Although treatment with antiplatelet and anticoagulant largely followed the ACC/AHA guidelines, however, this registry documented under treatment of other medications such as ACE-inhibitors and beta blockers. Reinforcement of the guideline compliance and continuous medical education would provide better outcomes for the patients.
A Registry to regionalized treatment of Unstable Angina/Non-ST Elevation Myocardial Infarction
Otte J Rachman
Jurnal Kardiologi Indonesia Vol. 35, No. 4 Oktober - Desember 2014
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v35i4.494
multicentre Registry to access the current usage of antiplatelet therapy was conducted recently in Indonesia, that can be found in the current edition of this journal. 1 This was the only registry conducted in Indonesia and this was the only one that try to see the current compliance of the anti-platelet therapy in patients with Unstable Angina / Non-ST Elevation Myocardial Infarction not undergoing PCI procedure in Indonesia. This was very relevant since there is a surge of this diseases in the last decade and more cardiologist worked in the area and also there is more cath lab available to do invasive therapy. Such a facility should be used appropriately and efficiently as not to overburden the available resources both in time and economic aspect, especially in the era of BPJS (universal Health Coverage) which already use up much of these resources.The BPJS program is an ideal program which give treatment to the majority of people but since the resources is limited it is the duty of the government not to use it indiscriminately and as efficient as possible so it can be delivered to the right people according to its priority. As Indonesia is comprised of large area with thousands of Islands and many population that are devided of many subethnics that are different in many
Anomali Pangkal Arteri Koroner: Peran CT Angiografi
Isyana M Kurniawan;
Elen Elen;
Celly A Atmadikoesoemah;
Manoefris Kasim
Jurnal Kardiologi Indonesia Vol. 35, No. 4 Oktober - Desember 2014
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v35i4.495
Introduction: The anomalous origin of the right coronary artery (RCA) from the left coronary sinus coursing between the aorta and the pulmonary trunk is rare, but may cause myocardial ischemia and sudden death. Multislice CT coronaryangiography offers the possibility to visualize anomalous coronary artery origin non-invasively in details.Case Illustration: A 54-year-old man with a history of arterial hypertension, and hypercholesterolemia began to present with typical chest pain. After some non-invasive examination, he had coronary angiographythat revealed 70% stenosis at mid intermediate artery, normalLMCA, LAD and LCX. Ostium of RCA was found near the left valsava sinus afterrepeated cannulation attempts, no stenosis was found at RCA. After successful revascularization at intermediate artery, patient still had typical chest pain with positive ischemic response in treadmill test. Multislice CT coronary angiography was performedto evaluate the etiology of chest pain. The scan showed patent stent at intermediate artery and anomalous RCA origin from the left coronary sinus withacute angle take-off, luminal narrowing of the osteal-proximal part, as well as luminal compression between the ascending aorta and the pulmonary trunk (an interarterial course) while RCA appeared as dominant vessel. These features were considered as malignant coronary anomaly that could lead to the recommendation of surgical correction.Discussion: Accurate recognition and documentation of coronary artery anomalies are essential to determine the significance of such findings and to avoid furtherclinical complications. Multislice CT coronary angiography is a non-invasive imaging modality that can easily and precisely depict the origin and course of coronary artery anomalies as well as its relationship with adjacent structures.
Catheter Directed Thrombolysis pada Trombosis Vena Dalam Iliofemoral
Fadhil P. Apriansyah;
Suko Adiarto
Jurnal Kardiologi Indonesia Vol. 35, No. 4 Oktober - Desember 2014
Publisher : The Indonesian Heart Association
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DOI: 10.30701/ijc.v35i4.496
Background Iliofemoral deep vein thrombosis (IFDVT) is associated with more severe outflow obstruction which results in more severe DVT symptoms and late clinical sequelae. Despite anticoagulation therapy, IFDVT patients is still at risk to develop postthrombotic syndrome (PTS). Recent studies found that additional catheter-directed thrombolytic therapy may offer advantages in reducing PTS and maintaining venous patency. Several ongoing multi-center randomized controlled trials are expected to evaluate safety and efficacy of CDT in IFDVT patients, and define who will benefit most.Case Illustration A 59-year-old male was presented with numbness, pain, and movement limitation in the left leg that were preceded by left leg swelling. Peripheral edema was found in both patient’s leg but more prominent on the left side. Dupplex sonography revealed extensive soft thrombus from left iliac vein to left tibialis vein. Initial anticoagulation therapy took no effect to the thrombus. Catheter-directed thrombolysis was performed and provided satisfactory symptoms resolution as well as thrombus dissolution.Summary A case of iliofemoral DVT has been reported. The present therapeutic strategy of anticoagulation therapy has not been proven to prevent PTS. CDT is an effective way in achieving clot lysis in acute thrombosis, and this may help to prevent PTS and subsequent ulceration. The potential benefits of therapy must be weighed carefully against the risk of bleeding. There are several ongoing RCTs that are awaited to help provide evidence on functional outcome after CDT and define who will benefit most.