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INDONESIA
Indonesian Journal of Cardiology
Published by Indonesian Heart Association
ISSN : 28303105     EISSN : 29647304     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
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
Arjuna Subject : Kedokteran - Cardiology and Cardiovascular Medicine
Articles 712 Documents
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Effects of High-Intensity Interval Training on Cardiovascular Function and Risk Factors, Functional Impairments, and the Quality of Life in Coronary Artery Disease Patients: A Narrative Review Nazir, Arnengsih; Biben, Vitriana; Gunanegara, Aggi; Clementius, Brandon
Jurnal Kardiologi Indonesia Vol 45 No 4 (2024): Online First - Indonesian Journal of Cardiology April-June 2021
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1751

Abstract

Background: Coronary artery disease (CAD) causes damage to the cardiovascular system that leads to functional and quality of life (QoL) deterrence. Cardiac rehabilitation (CR) aims to improve cardiorespiratory fitness (CRF) to prevent disease progression and its risk factors. Aerobic exercise (AE) causes different physiological effects depending on the applied intensity. High-intensity interval training (HIIT) is being developed because of better effectivity than moderate-intensity continuous training (MICT). Even so, HIIT has not been prescribed generally. This review aimed to describe the effects of HIIT on cardiovascular function and risk factors, functional impairments, and the QoL. Methods: Articles were searched using PubMed and CINAHL databases with the keywords “high-intensity interval training”, “cardiac rehabilitation”, “exercise-based cardiac rehabilitation”, and “coronary artery disease”. Results: Twenty-two articles were found and used to explain sub-topics. Discussion: HIIT improves ventricular function, LVEF, heart contractility, and endothelial function which further improve systolic and diastolic blood pressure. Improvement in cardiovascular risk factors was better in HIIT compared to AE in lower intensities. Studies recommend HIIT for CAD patients due to significant cardiovascular adaptation in this exercise. Compared to MICT, most studies found that HIIT is better at improving CRF. HIIT also positively affects cognitive and affective functions. Research on the impact of HIIT on functional activity and QoL is still limited. However, one study found no differences in physical activity level and QoL in groups given HIIT or MICT. Conclusion: In CAD patients, HIIT is considered an alternative exercise that is more time-efficient than continuous exercise.
Pemantauan Kesehatan Jantung secara Klinis, Ekokardiografik dan Laboratoris pada Pasien Kanker Payudara yang Menjalani Kemoterapi Agen Antrasiklin: Penelitian Perintis Algoritme Kardioproteksi di RSUP Mohammad Hoesin Palembang Puspita, Indah
Jurnal Kardiologi Indonesia Vol 46 No 1 (2025): January - March, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1772

Abstract

Objectives We analyzed echocardiography and laboratory results of breast cancer patients undergoing chemotherapy with anthracycline agents, to find cardiotoxicity risk and prevalence among South Sumatra population. Background Improved cancer therapy and early disease detection, increase the survival rate, also increase risk of CTRCD, range between 2 and 48% for patient with breast cancer treated by anthracyclines. There was limited data about prevalence of CTRCD in South Sumatra. Study of demographic factors and potential laboratory cardiac marker in specific population will give others additional important information. Methods In 2024, from March until November, 30 breast cancer patients were included in this analysis. Age 51,50 (41-69) years. All patients were in anthracycline chemotherapy treatment in Mohammad Hoesin General Hospital. Data of demography, laboratory and echocardiography was collected at baseline and after 3 cycles of treatment. Results Data collection and analysis was processed in outpatient department of Brain and Heart Installation Mohammad Hoesin General Hospital. From 30 patient, cardiovascular risk factors was detected: hypertension 30%, diabetes 10%, dyslipidemia 13,3%, body mass index 23,32 (13,30- 31,18), and almost all patients were not smoker (96,7%). Baseline to serial echocardiography showed that anthracycline did not affect the decrease of left ventricular ejection fraction (LVEF) (p=0,212), but correlated with the decrease of left ventricle global longitudinal strain (GLS) (p<0,05). There were 16 patients with >15% global longitudinal strain (GLS) reduction, without significant clinical heart failure signs and symptoms, known as mild asymptomatic cancer-therapy related cardiac dysfunction (CTRCD). Laboratory examination showed anthracycline agent was not correlated with Troponin T (p=0,093), NT-pro BNP (p=0,150), Serum Iron (p= 0,775), Total Iron Binding Capacity (TIBC) (p=0,692) and Transferrin Saturation (p=0,748). Ferritin level was affected by anthracycline agents (p= 0,026). Conclusion Higher prevalence of CTRCD in South Sumatra population was found. There was low incidence of cardiovascular risk factors in this population, indicated stronger isolated effect of chemotherapy agent for cardiac dysfunction progression. GLS by echocardiography measurement remain to be a good marker for cardiotoxicity related anthracycline agents. Ferritin level is potential parameter in guiding the stages and strategies in cancer treatment. Keywords: anthracycline, cardiac dysfunction, global longitudinal strain, ferritin
Comparison of right ventricular global longitudinal strain between pacemaker lead position in patients with permanent pacemaker Fakhri, Muhamad; Rasyid, Hauda El; Yanni, Mefri; Machmud, Rizanda
Jurnal Kardiologi Indonesia Vol 46 No 2 (2025): April - June, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1592

Abstract

Background: The implantation of a permanent pacemaker (PPM) can reduce right ventricular function. Echocardiography using speckle tracking can detect a decreasing in right ventricular function earlier. The value of right ventricular global longitudinal strain (RVGLS) based on the location of the pacemaker lead between the apex and non-apex was currently unknown, although the placement of the correct pacemaker lead location was very important for evaluating right ventricular dysfunction to prevent right heart failure. This study aims to determined the comparison of RVGLS between pacemaker lead position in patients with permanent pacemaker. Methods: This study was a nested case-control study to assess the comparison of RVGLS between pacemaker lead position in patients with permanent pacemaker, who were divided into the right ventricular apex group (RVA) and the non-right ventricular apex group (NRVA). This study used data from the pacemaker registry and medical records of patients who had undergone pacemaker implantation since June 2021. The shapiro-wilk normality test was performed before analyzing all numerical data, followed by an independent t-test or Mann-Whitney test to determine the differences between groups. Results: In this study, there were 38 patients with permanent pacemakers, consisting of 18 samples with RVA group and 20 samples with NRVA group. In this study, no significant differences were found in age, sex, diagnosis, comorbidities, therapy, pacemaker mode, baseline QRS duration, pacing burden, puncture site, and initial echocardiography between of two groups. There was a significant difference in paced QRS duration between the RVA and RVNA groups (160 + 20 ms vs 140 + 28 ms, p=0.024). Based on statistical analysis, there was a significant difference in the value of RVGLS in the RVA group compared to the RVNA group (-14.87+4.48% vs -18.40+3.21%, p=0.015). Conclusion: The position of the apex right ventricular lead resulted in a lower value of RVGLS compared to the position of the non-apex right ventricular lead.
Hemodynamic conundrum of thyroid storm induced acute heart failure: a challenging case in remote area. Andryan, Dya P; Oetama, Susandy; Lilysari, Oktavia
Jurnal Kardiologi Indonesia Vol 46 No 2 (2025): April - June, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1701

Abstract

Background Thyroid storm (TS) is an acute and critical presentation of hyperthyroidism. It can lead to multiple organ dysfunction and has high rate of mortality. Heart failure is one of grave complication of hyperthyroidism and thyroid storm. Rapid progression of TS can lead to hypoperfusion and shock even with normotensive blood pressure and normal hemodynamic parameter. Unfortunately, prevalence of hyperthyroidism majority in developing area who lack of advanced medical facility.1 This case presentation aims to present the rare condition of acute high output failure secondary due to thyroid storm with hypoperfusion and normotensive shock. Case Illustration A 28-year-old man came to the emergency department of private hospital in East Borneo with worsening dyspnea on effort since three days before admission. His blood pressure was 169/103 mmHg with irregular heart rate at 135-148 bpm. His axillary temperature was 37.9° C. ECG showed rapid atrial fibrillation with Ashman phenomenon. Chest x-ray revealed cardiomegaly with flattened cardiac waist and lung infiltrate. His echocardiogram has hyperdynamic LV with LVEF 70%, normal RV function, concentric LV hypertrophy, and increased LAVi (51.19 mL/m2). From initial echocardiogram hemodynamic assessment, eRAP was 15 mmHg, CO was 6.5 to 7.4 L/min, SVR was 1167 to 1329 dyne/sec/cm-5. His peak E wave velocity was 92-95 cm/s, His fT4 was increased (100 ng/dL) while TSH was reduced (0.007 mU/L). H2FPEF score estimated 38.7% probability of heart failure with preserved ejection fraction (HFpEF). Burch-Wartofsky score was 60, suggesting thyroid storm. He was diagnosed with acute high output heart failure secondary to thyroid storm due to uncontrolled Grave’s Disease, and AF rapid ventricular respond. During follow up in intensive care unit (ICU), patients underwent hypoperfusion with normotensive blood pressure (normotensive shock). norepinephrine was initiated. Patient keep deteriorating, and then passed away in our critical care unit at day of 7th Conclusion Thyroid storm induced acute heart failure might have conundrum presentation due normotensive and good cardiac output, give false impression of hemodynamic condition. Clinical presentation was very important to identify hypoperfusion and aggressive treatment was needed to stabilize patient condition.
Hemodynamic impairment of double culprit ST-elevation myocardial infarction, double the trouble: a case report Asaf, Mikhael; Afandy, Jonathan Edbert; Danny, Siska Suridanda
Jurnal Kardiologi Indonesia Vol 46 No 2 (2025): April - June, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1791

Abstract

Background: Multiple culprit artery involvement is rare (2.5%) among ST-segment elevation myocardial infarction (STEMI) patients undergoing primary coronary intervention (PCI). It can occur due to multiple factors and reflects a widespread pathophysiologic process. Most patients present with unstable hemodynamics and cardiogenic shock (CS), which results in a high mortality rate. Currently, there are no guidelines or consensuses on the management of multiple culprit arteries in STEMI patients. Case Illustration: A 51-year-old man with chest pain in the past 16 hours was referred to the National Cardiovascular Center Harapan Kita. ECG at presentation revealed sinus rhythm with ST elevation in the inferior, posterior, and right leads. He was diagnosed with late-onset infero-posterior STEMI + right ventricle infarction, Killip IV, and thrombolysis in myocardial infarction 6/14, then was prepared for early PCI due to ongoing chest pain and CS. The patient underwent complete revascularization with drug-eluting stents and thrombus aspiration due to the high thrombus burden of the lesion in the right coronary artery and first obtuse marginal artery. After early PCI, his hemodynamic condition improved, and epigastric pain was his only complaint. However, on the following day, the patient experienced acute pulmonary edema and rhythm conversion to total AV block. He was managed conservatively with heparinization, inotropes, vasopressors, diuretics, and noninvasive ventilation. After 14 days of hospitalization, the patient was discharged without any complaints. Conclusion: Double culprit STEMI is rare and associated with catastrophic hemodynamic impairment, including CS, at presentation. Individualized treatment with early and aggressive revascularization yields relatively good results.
Dyslipidemia management among patients with high and very high cardiovascular risk in Indonesia: a multi-center registry Ng, Sunanto; Santoso, Anwar; Sukmawan, Renan; Erwinanto, Erwinanto; Adam, Erika; Desandri, Dwita Rian; Zahra, Rita; Wicaksono, Sony Hilal; Putra, Magma Purnawan; Heriansyah, Teuku; Tiksnadi, Badai Bhatara; Pintaningrum, Yusra
Jurnal Kardiologi Indonesia Vol 46 No 2 (2025): April - June, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1880

Abstract

Background Indonesia, the world's largest archipelago, faces significant challenges in equitable healthcare delivery due to its geographical and infrastructural disparities. Atherosclerotic Cardiovascular Disease (ASCVD) remains the leading cause of mortality, with over 659,000 deaths recorded in 2019. Effective dyslipidemia management is crucial for preventing adverse ASCVD events. Unfortunately, the lack of implementation of an updated national lipid management registry might hinder optimal strategy for the adverse events. This study evaluated dyslipidemia cholesterol management practices among high- and very high-risk patients across the country. Methods The study recruited 322 patients from eight centers across six provinces in Indonesia between May 2022 and March 2023. Patients were stratified based on the ASCVD risk and followed over three visits. Baseline clinical characteristics, lipid profiles, and treatment regimens were analyzed. Descriptive statistics summarized continuous and categorical variables, and low-density lipoprotein cholesterol (LDL-C) achievement was assessed. Results Of the 322 patients, 98.8% were very high-risk, with only 4.9% achieving <55 mg/dL and 21.2% achieving <70 mg/dL. Moderate-intensity statins were the most prescribed (51.2%), followed by high-intensity (36.6%). LDL-C reduction was most pronounced in private insurance patients, achieving a mean LDL-C of 69.8 mg/dL at the third visit compared to 98.9 mg/dL in National Health Insurance (Jaminan Kesehatan Nasional/JKN) participants. Missed visit rates increased over time, with 57.5% of patients missing the third visit, predominantly among JKN participants and low-income groups. Conclusion Majority of the population failed to achieve the recommended target of LDL-C levels. Dyslipidemia management in Indonesia remains suboptimal, with disparities driven by socioeconomic factors. Improved policies addressing medication availability, national lipid registry establishment, and equitable healthcare access are essential to enhance lipid management and reduce the burden of ASCVD in Indonesia.
Predictors of prolonged use of mechanical ventilation in patients with acute respiratory failure and acute heart failure in the CVCU RSUD Dr. Saiful Anwar Malang Lestari, Puspa; Anjarwani, Setyasih; Kurnianingsih, Novi; Prasetya, Indra; Martini, Heny
Jurnal Kardiologi Indonesia Vol 46 No 3 (2025): July - September, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1335

Abstract

Background Acute respiratory failure (ARF) is a critical condition that often complicates hospitalization and commonly arises from cardiopulmonary dysfunctions such as acute heart failure. Prolonged mechanical ventilation (PMV) in these patients is associated with increased morbidity, mortality of about 30%, and greater healthcare resource utilization. Identifying predictors of PMV is essential to improve outcomes and optimize management strategies. Methods A retrospective cohort study was conducted on all patients who underwent endotracheal intubation in the Cardiovascular Care Unit (CVCU) of RSUD Dr. Saiful Anwar Malang from 2015 to 2021. Patients with incomplete medical records or who died within 14 days of mechanical ventilation were excluded. Univariate and multivariate logistic regression analyses identified independent predictors of PMV. Receiver operating characteristic (ROC) curves were generated to assess model discrimination using the area under the curve (AUC), with corresponding sensitivity and specificity. Data were analyzed using SPSS 22.0. Results Five independent predictors of PMV were identified: tachycardia (p = 0.013), metabolic acidosis (p = 0.002), impaired renal function (p = 0.009), shock (p = 0.006), and major bleeding (p = 0.002). Multivariate analysis showed the following odds ratios(OR, 95% CI): tachycardia 2.06 (1.09–5.99), metabolic acidosis 2.03 (1.09–6.33), impaired renal function 2.87 (1.28–6.46), shock 2.83 (1.13–7.06), and major bleeding 1.36 (1.18–2.15). The model demonstrated good discrimination with an AUC of 0.83 (95% CI 0.77–0.88), sensitivity 0.87, and specificity 0.73. Conclusion In patients with respiratory failure due to acute heart failure, tachycardia, metabolic acidosis, impaired renal function, shock, and major bleeding were independent predictors of prolonged mechanical ventilation. The predictive model showed high sensitivity and acceptable specificity, supporting its clinical usefulness for early identification of high-risk patients and targeted intervention.
The effect of a physical exercise program on functional capacity in patients with pulmonary arterial hypertension at Dr. M. Djamil Padang Hospital Soegistiono, Feiky Herfandi; Krevani, Citra K.; Hamdani, Rita
Jurnal Kardiologi Indonesia Vol 46 No 3 (2025): July - September, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1594

Abstract

Background: Pulmonary arterial hypertension (PAH) has been known to cause a decreases functional capacity. The underlying mechanisms include right ventricular dysfunction, chronotropic incompetence, ventilation abnormalities, and skeletal muscle dysfunction. Although exercise training programs are recommended, there is currently no standardized exercise training program that is easy to implement in patients with PAH. We aimed to investigate the effect of exercise training program on functional capacity in patients with PAH. Methods: This study was a non-randomized clinical trial in adult patients with PAH who were divided into intervention and control groups. Cardiopulmonary exercise test (CPET) results were assessed before and after a four-week supervised program (5 sessions/week).The program followed the FITT principle: frequency 5 times/week, intensity 60–85% of six minute walk test (6MWT) distance, time 25–30 minutes/session including warm-up and cool-down, type supervised indoor walking. Shapiro-Wilk normality test was performed before analyzing the numerical data, followed by the independent t-test or Mann-Whitney U test to determine differences between groups. Results: This study included 26 patients with PAH, 14 in the intervention group, and 12 in the control group, consisting of 17 women (65%) and 9 men (35%) aged 18-54 years. Statistical analysis showed no significant differences in the baseline characteristics between the two groups (p >0.05). Characteristics of the CPET examination results before and after the exercise program. At baseline, there was no difference in VO2 peak in the intervention group and the control group (888.29 ± 435.99 (95% CI: 314-1823) vs 641.92 ± 231.98 (95% CI: 408 – 1111), p-value >0.05). After the physical exercise program, theintervention group showed a significant increase in VO2 peak (1047.71 ± 456.05 (95% CI: 413-2175) vs 656.5 ± 223.85 (95%CI: 401–1105), p-value < 0.05). Therefore, ΔVO2 peak in the intervention group was significantly higher (159.42 ± 209.32 (95%CI: -92 – 707) vs 14.5 ± 60.4 (95%CI: -77 – 148), p-value < 0.05) Conclusion: A four-week structured walking exercise program significantly improved functional capacity in PAH patients.
Inverted U wave & de Winter pattern: under-recognized sign of acute coronary occlusion Maulana, Zaky Faris; Napu, Ramang
Jurnal Kardiologi Indonesia Vol 46 No 3 (2025): July - September, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1622

Abstract

Background: Interpreting ECGs for evidence of ischemia in patients with noticeable changes, such as ST-segment elevation and ST-segment depression, can be easily identified. However, identifying & recognizing atypical ECG patterns of acute coronary syndrome is essential in preventing significant mortality and morbidity. In thefollowing case report, we describe inverted U wave & de Winter pattern. Case Illustration: A 58-year-old male presented to the emergency department with pressure-like chest pain. His initial evaluation revealed normal blood pressure and elevated blood glucose levels, and an initial ECG was incorrectly interpreted as normal. Eight hours later, he returned with worsened chest pain. The new ECG revealed the de Winter ECG pattern, which indicates acute occlusion of the left anterior descending artery. Additionally, previously overlooked inverted U waves in the initial ECG suggested myocardial ischemia.Eventually, the angiography revealed a complete occlusion of the proximal left anterior descending coronary artery. The patient underwent stent placement and have a good outcome Conclusions: Inverted U wave and the de Winter pattern described in this case indicates an acute LAD occlusion. It’s a rare finding, but it is critical for emergency physicians to recognize it for urgent reperfusion therapy. Unfamiliarity with these high-risk ECG pattern may lead to delays in appropriate treatment, causing negative effects on morbidity and mortality.
Phrenic nerve stimulation as a novel therapeutic approach for heart failure with central sleep apnea: a systematic review Alverina, Clara; Kamila, Rizqi Apsari Fairuz; Rifa’I, Alfiani Zukhruful Fitri
Jurnal Kardiologi Indonesia Vol 46 No 3 (2025): July - September, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1745

Abstract

Introduction: Heart failure (HF) is a chronic condition associated with significant morbidity and mortality. Phrenic nerve stimulation (PNS) has emerged as a novel therapeutic approach aimed at improving outcomes in patients with heart failure, particularly those suffering from central sleep apnea (CSA). Objectives: This study aims to evaluate the efficacy and safety of PNS in HF patients with CSA, especially its impact on reducing CSA severity and improving the apnea-hypopnea index (AHI) and left ventricular ejection fraction (LVEF). Methods: A comprehensive search was conducted across multiple databases including Pubmed, Web of Science, Science Direct, and ProQuest, following PRISMA guidelines. The search strategy used the MeSH keywords (phrenic nerve stimulation) AND (heart failure). Inclusion criteria encompassed studies published in 2014 - 2023 that evaluated the effects of PNS on patients with HF and reported on relevant clinical outcomes. After a thorough screening process, five studies were identified as relevant and included in the review. Data extraction and quality assessment were independently conducted by three reviewers, with results synthesized using a systematic approach. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). The research protocol was registered at PROSPERO (ID: CRD42024604614). Results: The studies reviewed demonstrated that PNS significantly reduces the central apnea index (CAI), AHI and improves sleep quality in heart failure patients. Moreover, improvements in LVEF and reductions in heart failure-related hospitalizations were observed. Patient satisfaction was generally high, and adverse events were minimal, suggesting that PNS is a safe and effective treatment option for HF patients especially those suffering from CSA. Conclusion: Phrenic nerve stimulation presents a promising therapeutic option for improving cardiac and sleep outcomes in heart failure patients. Further large-scale, randomized controlled trials are warranted to establish the long-term efficacy and safety of PNS in this population.

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