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Heart Science Journal
Published by Universitas Brawijaya
ISSN : 27219976     EISSN : 27219984     DOI : http://dx.doi.org/10.21776/ub.hsj.2020.001.01
Core Subject : Health, Science,
Health Professions Immunology & microbiology Medicine & Pharmacology
HEART SCIENCE is the official open access journal of Brawijaya Cardiovascular Research Center, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. The journal publishes articles three times per year in January, May, and September. The journal is a peer reviewed publication and accepts articles for publication from across the world. HEART SCIENCE accepts and publishes articles in the English language only. The primary goal of this journal is to publish clinical and basic research relevant to cardiovascular medicine. The journal covers the following topics: clinical cardiology, interventional cardiology, intensive and acute cardiovascular care, vascular diseases, non-invasive cardiology, pediatric cardiology, cardiac nuclear medicine imaging, arrhythmia, cardiac prevention and rehabilitation, and cardiac surgery. Animal studies are also considered for publication in HEART SCIENCE. To serve the interest of both practicing clinicians and researchers, the journal provides platform or forum for research scholars, intellectuals, and cardiologists to reveal their views and research work for dialogue, education, and interaction to the entire world. HEART SCIENCE publishes original research, reviews, brief reports, case reports, case series, editorial, and commentary. HEART SCIENCE also publishes the special issues and abstracts of papers presented at the annual meeting of the Cardiological Society of Malang.
Arjuna Subject : Kedokteran - Cardiology and Cardiovascular Medicine
Articles 302 Documents
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Acute Myocardial Infarction in a 25-Years-Old Male: Understanding the Risk and Comprehensive Management Ardhani Galih; Cholid Tri Tjahjono; Sasmojo Widito; Evit Ruspiono
Heart Science Journal Vol 4, No 1 (2023): Optimizing Outcome in Acute Cardiac Care
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.01.8

Abstract

Acute coronary syndrome (ACS) in young adults is a rare entity, yet it occurs. We present a case of a man 25 years old with no history of certain diseases, suddenly come up with ST elevation myocardial infarct. Young patients have different risk factors, clinical features and prognosis as compared to elderly patients. The diagnosis of ACS is also often overlooked in this subset of population. Furthermore, it constitutes an important problem because of the devastating effect of this disease on the more active lifestyle of young adults. This case report was an attempt to look for the risk factors most prevalent in young patients and its management prior and during the hospital stay.
Correlation Between NT pro-BNP, Troponin I and Inhospital Mortality in Miokard Akut Patients Who Have Already Undergone Percutaneous Coronary Intervention: a Report from ONE ACS Registry Subarea dr. Saiful Anwar Malang Hospital Diah Ivana Sari; Setyasih Anjarwani; Ardian Rizal; Mohammad Saifur Rohman; Indra Prasetya
Heart Science Journal Vol 4, No 1 (2023): Optimizing Outcome in Acute Cardiac Care
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.01.3

Abstract

Introduction. Many research have looked into the potential of various biomarkers as predictors of intrahospital mortality in patients with STEMI. Patients with a history of heart failure, patients with STEMI with cardiogenic shock, and patients with heart failure all had a similar association between pro-BNP NT and intra-hospital mortality. In STEMI patients, troponin is another biomarker that can be utilized to predict intrahospital mortality with NT pro BNP.Objective. This study looked into the correlation between NT pro BNP and troponin I and intrahospital mortality in STEMI patients who had had PCI at RSUD dr. Saiful Anwar Malang.Material and Methods. A retrospective cohort research with an observational analysis design, targeted 391 STEMI patients who underwent PCI at RSUD dr. Saiful Anwar Malang between January 2018 and August 2022.Result. With AUC NT pro BNP 0.840 (95% confidence interval [CI]: 0.789 – 0.892) and troponin I AUC 0.818 (95% CI: 0.753 – 0.882), the ROC curve demonstrated a high degree of discriminating. The NT pro BNP 4390 cutoff value was also derived from the ROC analysis with a sensitivity of 0.882 and a specificity of 0.882. The threshold for troponin I was 7.9, with a sensitivity of 0.725 and a specificity of 0.80. From the examination of the connection, it was determined that there was a high link between NT pro BNP and intrahospital mortality in AMI EST patients who had had PCI, with a R value of 0.70; OR 10,484 (95% confidence interval [CI]: 7,731–19,366). With a R value of 0.4, there was a moderate connection between troponin I and intrahospital mortality in STEMI patients who had had PCI; the odds ratio was 6,167 (95% confidence interval: 2,286–16,637).Conclusion. There were a strong and moderate correlation between NT pro BNP and troponin I, respectively, with inhospital mortality in STEMI patient. 
The Current Concept and Role of Intensive Cardiovascular Care Units Siska Suridanda Danny
Heart Science Journal Vol 4, No 1 (2023): Optimizing Outcome in Acute Cardiac Care
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.01.1

Abstract

Since its first establishment in the early 1960s, intensive care for the critically ill cardiac patients had transformed substantially. From a unit designed only to monitor cardiac rhythm and administer electrical therapy to patients with myocardial infarction (MI), the Intensive Cardiovascular Care Units (ICVCU) now provide care for a wide array of patients with cardiovascular conditions needing close observation and hemodynamic support. This shift in role is accompanied with the development of cardiac critical care as an emerging subspecialty of cardiovascular medicine. Cardiac intensivists should have proper training in general cardiology, combined with additional competency in critical care, including mechanical ventilation, renal replacement therapy, mechanical circulatory support and general preventive measures for infections. A high-intensity medical staffing in a closed care system had shown to improve mortality in critically ill cardiac patients in the contemporary ICVCUs. As interventional cardiology, structural heart disease, electrophysiology, advanced heart failure and transplantation continue to offer new treatment options for complex high-risk patients, cardiac critical care is of utmost importance to provide collaborative care among these disciplines. 
Risk Factors for Acute Kidney Injury in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention Yudi Putra; Budi Satrijo; Setyasih Anjarwani; Indra Prasetya; Anna Fuji Rahimah
Heart Science Journal Vol 4, No 1 (2023): Optimizing Outcome in Acute Cardiac Care
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.01.5

Abstract

BackgroundAcute kidney injury (AKI) is a frequent complication of ST-Elevation Myocardial Infarction (STEMI). AKI occurs in about 10% to 20% of patients with STEMI, which significantly impacts both short-term and long-term clinical outcomes.ObjectivesWe purposed to identify the risk factors for AKI among STEMI patients undergoing Primary PCI.MethodsThis retrospective cohort study analyzed 568 STEMI patients who underwent Primary PCI from 2017 to July 2022 at Saiful Anwar General Hospital Malang. We conducted both univariate and multivariate studies to determine AKI risk factors.ResultsThe risk factors for AKI among STEMI patients undergoing primary PCI were identified. The OR values for each were as follows: Shock condition (OR = 1.41; 95% CI = 1.18 – 1.92); Killip ≥3 (OR = 3.54; 95% CI = 2.14 – 4.26); and total contrast volume> 145 ml (OR = 1.61; 95% CI = 1.13 – 1.92). Based on the ROC curve analysis, total contrast volume >145 ml with an area under the curve (AUC) of 0.75 (95% CI = 0.65-0.85) with a specificity of 0.66 (95% CI = 0.61 – 0.71) and a sensitivity of 0.71 (95% CI = 0.65-0.76).ConclusionOur study revealed that the risk factors for AKI among STEMI patients undergoing primary PCI were shock condition, Killip class ≥3, and total contrast volume >145 ml.
Left Ventricular Hypertrophy and Clinical Outcomes in Heart Failure Patients Based on Hypertension Subtypes: Insights from a Tertiary Hospital Heart Failure Registry in Malang, Indonesia Budi Satrijo; Andona Murni Maharani; Muhammad Rizki Fadlan; Shalahuddin Suryo Baskoro
Heart Science Journal Vol 4, No 2 (2023): Dealing with the Complexity of the Wide Spectrum of Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.02.4

Abstract

BackgroundLeft ventricular hypertrophy (LVH) is a maladaptive response to chronic pressure overload and an important risk factor sudden death in patients with heart failure. Previous studies show that LVH is a risk factor for systolic heart failure. It’s interesting to examine whether Isolated Systolic Hypertension (ISH) in the presence of LVH contribute to clinical outcome.Objective: The aims of this study to examined association of  ISH with cardiovascular outcomes and to examined associations of ISH and LVH  in Heart failure registry patientMethods: A total of 120 subject’s were collected from Saiful Anwar Heart Failure Registry from January 2019 to December 2019. All participants were individually interviewed with a structured questionnaire  for collecting baseline characteristic. Subject were classified into 2 group of hypertension (ISH and Systolic Diastolic Hypertension (SDH)). ISH based on the criteria of SBP ≥ 140 and DBP < 90 mmHg and SDH based on SBP ≥ 140 and DBP ≥ 90 mmHg. The EF and volumes were measured with 2D-biplane Simpson's method by measured as a standart mannerResult’s: ISH commonly found among older hypertensive patients than SDH (Mean age 61,23±11,2 yo  vs  53,52±11,1 yo, respectively, p<0,04)). LVH was more prevalence among ISH  than SDH. No difference in clinical outcome such as in hospital mortality, Rehospitalization, and Lengt of stay were observed in both groups. Complication of hypertension was similar in both groups such as stroke, Myocardial Infarct, and Chronic Kidney Disease. Intrestingly, no difference also observe in compliance to the drug between ISH and SDH. We also examined subgroup analysis of subject’s with ISH. There was no statistically significant difference in clinical outcome between ISH with LVH and ISH without LVH.Conclusion: In this study, we suggest that ISH more common in older patient with HF than SDH  but had similar associations with cardiovascular mortality and rehospitalization. ISH was associated with a higher prevalence of left ventricular hypertrophy than SDH.
Aortic Intramural Hematoma Mimicking Acute Coronary Syndrome Zainal Fathurohim; Novi Kurnianingsih; Djanggan Sargowo; Heny Martini
Heart Science Journal Vol 4, No 2 (2023): Dealing with the Complexity of the Wide Spectrum of Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.02.5

Abstract

Abstract :Type A Aortic intramural haematoma (IMH), a variant form of classic aortic dissection, has been accepted as an increasingly recognised and potentially fatal entity of acute aortic syndrome.It is a very dangerous, fatal, and emergency condition. It is very important to recognize the symptoms of acute aortic syndrome related to appropriate management Case IllustrationA 52 year old man patient  suffered from chest pain with moderate intensity while he was working at home. It was sharp , tear-like sensation, in the middle of the chest radiated to the back, accompanied with cold sweating, and did not relieve by rest. Because of this condition he brought to hospital. From examination at Emergency room, he had cardiomegaly, aortic dilatation. From the Electrocardiography an st elevation at V1-V2 and T inverted V4-V6 precordial lead,I aVL extremities lead  and slightly elevated cardiac enzymes with risk factors for active smoking and uncontrolled hypertension. Initially he was suspected of having acute coronary syndrome with differential diagnose acute aortic syndrome. To exclude the diagnose he had underwent cardiac catheterization, the cardiologist in charge suspicious this patient with aortic dissection because of trapping contrast durante procedure and coronary minor disease. For a better diagnosis, transtransthoracic echocardiography and Aortic Computed Tomography angiography was performed on the patient which confirmed the evidence of dissection. After being diagnosed, we treat the patient as an acute aortic syndrome and we stabilize the patient's condition. The patient was planned for cardiac surgery DiscussionAcute aortic syndrome, which includes Acute Aortic Dissection, Intramural Hematoma and penetrating aortic ulcer, is difficult to diagnosed. Aortic intramural hematoma, which is one of the acute aortic syndromes, is characterized by the presence of a hematoma in the medial layer of the aortic wall without the appearance of an intimal tear. The incidence of intramural hematoma differs slightly from that of aortic dissection syndrome. Patients with intramural hematomas often occur in older patients, more often with aortic aneurysmsThe patient  receive treatment aggressively to control blood pressure by administering a non-dihydropyridine calcium channel blocker intravenously and then beta blocker, angiotensin II receptor blockers, was also needed. Acute aortic syndrome, where an intramural aortic hematoma can present with varying symptoms of varying severity, which can lead to misdiagnosis and delay in cases of life-threatening disease. In the case of our patient, who had strong cardiac risk factors, His initial presentation described an acute myocardial infarction; the diagnosis was made after CT scan was performed and the patient remained stable  ConclussionComplaints of chest pain due to symptoms of acute aortic syndrome are very important to be recognized immediately because they need proper management. Complaints in this syndrome have similarities with complaints in acute coronary syndrome, pulmonary embolism and others. Patients with aortic intramural hematoma are at high risk for developing periaortic hematoma and hemorrhagic pericardial effusion. In patients with an intramural aortic hematoma, Stanford A, the most appropriate management is surgical technique. Initial management of blood pressure control, heart rate and anti-pain can be given. In this case, the choice of a combination of surgery with endovascular may be a logical choice of therapyKeywordAortic Intramural Hematoma, Acute aortic syndrome
How to deal with LM Disease in NSTEMI patient: PCI or CABG? Lutfi Hafiz Zunardi; Mohammad Saifur Rohman; Budi Satrijo; Adriawan Widiya Nugraha
Heart Science Journal Vol 4, No 2 (2023): Dealing with the Complexity of the Wide Spectrum of Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.02.6

Abstract

 Background: The left main coronary artery (LMCA) with acute coronary syndrome have been associated with significant morbidity and mortality. Urgent CABG is recommended for patients with LM disease accompanied by ACS, but requires special preparation and adequate facilities. not all hospitals are ready. PCI on left main coronary artery is a high risk procedure which requires special preparation like IVUS and FFR. Meanwhile, the ACS case is an emergency that needs to be treated immediately. Interventional management is mandatory in this setting, but the concern is whether the action is carried out in an emergency or an elective procedure.Objective: This study aimed to describe the management of LM disease in NSTEMI patients.Case presentation: We will discuss a 69-year-old male brought to our hospital because of chest pain while doing moderate activity. The patient was previously referred from a private hospital and was assessed as NSTEACS. from angiography there was Stenosis dd Thrombus at LM, the cardiologist suggest him to be referred to RSSA for CVCU admission and will be underwent Urgent revascularisation. Clopidogrel and aspirin were routinely consumed as dual antiplatelet therapy. We treat the patient with an unfractionated heparin (UFH) bolus, continued with continuous infusion until revascularization. No event of subsequent acute coronary syndrome was observed.Conclusion: Although the management of patients with LM disease requires some preparation before action is taken, urgent revascularization in Acute coronary syndrome cases must still be carried out immediately.
Coronary CT Angiography for Coronary Artery Disease: The Current Status and Future Challenges Saskia Dyah Handari
Heart Science Journal Vol 4, No 2 (2023): Dealing with the Complexity of the Wide Spectrum of Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.02.1

Abstract

Coronary computed tomographic angiography, often known as CCTA, is quickly becoming the diagnostic technique of choice for determining the existence of coronary artery disease (CAD). In the future, CCTA may play an essential part as a "one-stop shop" in the screening, diagnosis, decision making, and treatment planning processes. Plaque burden, high-risk plaque, non-invasive angiography, perfusion with hyperemia, fractional flow reserve (FFR), percent of myocardium at risk, inflammation, myocardial scar, wall motion analysis, and risk scores are some of the many measures that are utilized.
The Experience of Using Plain Balloon Percutaneous Venoplasty in Central Vein Stenosis in Hemodialysis Patient; Insight for Future Better Development Strategy Sawitri Satwikajati; Novi Kurnianingsih
Heart Science Journal Vol 4, No 2 (2023): Dealing with the Complexity of the Wide Spectrum of Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.02.7

Abstract

Background :Central vein stenosis is a most complication among hemodialysis patient who inserted catheter or access for dialysis. The proper management is still challenging because venoplasty as the main recommendation but it had potential complication. The comparable datas of plain vs drug coated balloon were still exist. In this case presentation we will discuss about the use of plain ballon venoplasty as an urgent strategy to relieved central vein stenosis in hemodialysis patient and it’s outcome after procedure in our hospital. Case :Female, 56 years old came to Saiful Anwar Hospital with unilateral upper extremity edema, she felt heavy to move her arm, a litte bit numbness, and no history of pain on her arm. She had been undergo routine hemodialysis and had history of AV shunt inserted for 3 months ago. She came with compos mentis, GCS 456, BP 160/92 mmHg, HR 68 bpm, RR 20 tpm, SpO2 98% RA, temp 36.4oC, Hb 8.0 mg/dL, Ur 53.6 mg/dL, Cr 5.4 mg/dL, eGFR 1.73. From physical examination we got good peripheral oxygen saturation, we suggested this patient with central vein stenosis. We performed venography resulted stenosis 95% at brachiocephalic vein and undergo plain balloon percutaneous venoplasty. After procedure her right upper extremity was getting better. We observes this patient, but in the next three months after procedure of plain balloon percutaneous venoplasty she complained that her right upper extremity became swollen again. We performed re-venography and resulted with restenosis of brachiocephalic vein. She underwent percutaneous venoplasty again and the evaluation untik now was better, the diameter of upper right extremity became smaller and she can do her daily activity. Conclusion :Central vein stenosis was one of the most complication after dialysis catheter insertion. We performed percutaneous venoplasty and observed the outcome of this patient. After 3 months, the symptom was recurrent and we performed percutaneous venoplasty again. Keywords : Central vein stenosis, venoplasty, plain balloon.
Arterial Stiffness as A Predictor of Future Cardiovascular Events: Methods of Measurement and Clinical Implications Ardani Galih; Cholid Tri Tjahjono; Mohammad Saifur Rohman; Novi Kurniningsih
Heart Science Journal Vol 4, No 2 (2023): Dealing with the Complexity of the Wide Spectrum of Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.02.2

Abstract

Arterial stiffness has recently emerged as strong predictor of cardiovascular events, including coronary heart disease. The cardio-ankle vascular index (CAVI) is a novel index that measures the overall stiffness of the artery all the way from the point where it branches off from the aorta to the ankle. CAVI's ability to provide accurate results regardless of the patient's blood pressure at the moment of measurement is without a doubt its most valuable characteristic. CAVI is related to many cardiovascular risk factors, including hypertension, diabetes mellitus, dyslipidemia, and smoking. It also increases with age and in many arteriosclerotic diseases, such as coronary artery disease, carotid arteriosclerosis, chronic kidney disease, and cerebrovascular disease. CAVI also increases in patients who have cerebrovascular disease. Controlling conditions such as diabetes mellitus and hypertension, in addition to quitting smoking, may also reduce the risk of CAVI. This indicates that CAVI is a physiological surrogate measure of atherosclerosis, and it also implies that it might be a signal of lifestyle change. Recent research has shown that CAVI and numerous functions of the left ventricle are linked to one another, which points to a linkage between the heart muscle and vascular function. This study discusses the fundamentals of CAVI as well as our present understanding of the measurement, with a particular emphasis on its functions and potential future use.  

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