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Mohammad Saifur Rohman
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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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Athlete's heart: how echocardiography can unveil the heart's hidden secrets in athletes? Abadi, Sahlan; Karolina, Wella
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.7

Abstract

 
Cardiac computed tomography beyond anatomical coronary artery disease assessment: A contemporary review Vori, Ira; Handari, Saskia Dyah
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.9

Abstract

Cardiac computed tomography (CT) has undergone a remarkable transformation over the past two decades, evolving from a purely anatomical imaging modality to a comprehensive cardiac assessment tool. This review examines recent technological advancements and expanded clinical applications of cardiac CT. Contemporary systems, equipped with dual-energy imaging, wide-detector arrays, and sophisticated reconstruction algorithms, now enable functional assessment through myocardial perfusion imaging and CT-derived fractional flow reserve (CT-FFR), alongside advanced plaque characterization. Technical developments have improved temporal and spatial resolution while optimizing radiation exposure through refined dose management protocols. The integration of anatomical and functional data has proven particularly valuable in triple rule out at emergency department and also a guide for revascularization decisions, as physiological significance often supersedes anatomical severity in clinical decision-making. Additionally, cardiac CT has emerged as an essential tool in pre-procedural planning for structural heart interventions, including transcatheter aortic valve replacement, left atrial appendage (LAA) closure, and mitral valve (MV) interventions. The modality also demonstrates significant utility in electrophysiology applications, particularly in planning pulmonary vein isolation procedures. Recent guidelines from major cardiovascular societies have incorporated these advances, positioning cardiac CT as a first-line diagnostic tool for stable chest pain and a cost-effective gatekeeper for invasive procedures. Future directions include expanded applications in quantitative plaque assessment, artificial intelligence integration, and personalized risk stratification, promising to further enhance the role of cardiac CT in clinical practice.
Successful unroofing of anomalous aortic origin of the left coronary artery with intramural course in patient with near syncope Firdaus, Achmad Jauhar; Handari, Saskia Dyah; Prasetya, Indra; Tjahjono, Cholid Tri
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.17

Abstract

BACKGROUND: Left Anomalous Coronary Artery from the Opposite Sinus of Valsalva (L-ACAOS) refers to a congenital heart defect in which the left coronary artery originates from the right coronary sinus of Valsalva. This condition may increase the risk of sudden cardiac death (SCD), especially for those participating in intense physical exertion. This paper presents a case of a malignant type L-ACAOS in a young male who underwent successful surgical correction. CASE: A 35-year-old male without any known coronary artery disease risk factors presents with angina and near syncope while competing in a marathon run. He regularly participates in endurance sporting events without any complaints. However, in the last two years, he has begun to complain of angina during exertion. The ECG examination showed early repolarization in the inferior and lateral leads with no significant lab abnormalities. This led to coronary computed tomography angiography (CCTA), which revealed that the left coronary artery originates from the right coronary sinus and runs between the pulmonary trunk and ascending aorta, indicating a malignant-type anomalous coronary artery. He then undergoes a surgical correction with unroofing of the left main coronary artery and relocate the LMCA orifice to the left sinus. The procedure proceeded uneventfully with satisfactory results. CONCLUSION: Anomalous coronary arteries are concerning because they are associated with increased risks of SCD. The intramural course is associated with a higher risk of SCD due to stenosis caused by lateral compression that leads to ischemia and potentially fatal arrhythmias, making early detection and intervention critical.
Massive saddle embolism in chronic thromboembolic pulmonary hypertension: The unresolved tale Firdaus, Achmad Jauhar; Karolina, Wella
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.18

Abstract

BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) represents a rare and severe variant of pulmonary hypertension (PH), leading to progressive damage to the cardiopulmonary system. The obstruction could happen anywhere from the small branches to the main pulmonary artery. A saddle-type emboli, a particularly severe type of pulmonary embolism that occurs in the main pulmonary artery and blocks both the right and left branches, has the highest potential to cause death. This article presents a case of progressive CTEPH with inoperable conditions that underwent catheter-directed thrombolysis (CDT) as a last resort given the limitations of other treatment modalities. CASE: A 53-year-old woman with worsening shortness of breath was diagnosed with CTEPH, but despite anticoagulant treatment, imaging evaluation showed a progressive saddle-type pulmonary embolism along with findings of interstitial lung disease (ILD). Multidisciplinary team discussions were conducted, and the decision to proceed with pulmonary endarterectomy (PEA) was influenced by various factors. CDT was then performed, however, there was no notable clinical improvement. The patient ultimately succumbed to the disease following 31 days of treatment. CONCLUSION: CTEPH is a rare type of pulmonary hypertension caused by pulmonary embolism. The treatment algorithm employs a multimodal strategy that addresses the different anatomical lesions. In proximal obstruction, surgical PEA remains the treatment of choice in operable patients. An experienced multidisciplinary team is mandatory. Without these requirements, other strategies can continue to be studied for their role in inoperable CTEPH.
WHO risk chart associated with the presence of coronary plaque on coronary computed tomographic angiography in asymptomatic indonesian population Indrihapsari, Pratiwi; Saskia Dyah Handari; Cholid Tri Tjahjono
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.11

Abstract

Background: Cardiovascular risk assessment tools, like the WHO Risk Chart, often categorize asymptomatic individuals as low risk, even when they have unmanaged cardiovascular risk factors. Among these patients, estimation of CAD is associated with significant differences in CACS; however, the relationship between WHO Risk Chart and CACS has not been studied. Objective: We studied WHO Risk Chart’s ability to detect for coronary plaque throughout CACS via CCTA. Methods: A total of 440 subjects aged 40 to 74 years old, who underwent CCTA for health checkup between January 2023 and December 2024 were enrolled. Clinical information was gathered from medical records, including risk factors, CACS, and CCTA results. Statistical analysis was performed using SPSS 24, applying univariate, bivariate, and multivariate regression analyses to identify correlations. Results: The WHO Risk Chart showed a significant correlation with CACS and the presence of coronary plaque (p <0.05). In total, 148 individuals were identified with normal coronary arteries, while 292 individuals presented with coronary plaque. Notable differences were found among genders, WHO Risk Chart, smoking status, hypertension, dyslipidemia, diabetes mellitus, and CACS levels between the two groups (p<0.05). The correlation coefficient suggests that an increase in the WHO Risk Chart is associated with a rise in CACS, indicating a bidirectional relationship between these two parameters. Conclusion: In an asymptomatic population from Indonesia, the WHO Risk Chart shows a strong positive correlation with CACS.
The effect of invasive strategy versus conservative strategy on mortality in patients with non-ST-elevation myocardial infarction at Sardjito Hospital Yogyakarta Pradhana, Aditya; Bagaswoto, Hendry Purnasidha; Saputra, Firandi; Setianto, Budi Yuli
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.14

Abstract

BACKGROUND: Acute myocardial infarction (AMI) causes high hospital admission rates and mortality in Indonesia. Previous studies showed that invasive strategies on non-ST-elevation myocardial infarction (NSTEMI) patients can provide more benefit in clinical outcomes, particularly in high- and very high-risk groups. However, this strategy cannot be implemented due to transportation limitations or a lack of available catheterization facilities in some regions. Recent meta-analyses suggested that early invasive strategies (≤24 hours), delayed strategies (>24 hours), or conservative showed no differences significantly in mortality rates from any cause, stroke or cardiovascular death in NSTEMI patients. OBJECTIVES: This study aims to define the impact of invasive strategies on in-hospital mortality in high and very high-risk NSTEMI patients at Sardjito Hospital. METHODS: A retrospective cohort study utilized data from 326 NSTEMI patients who satisfied the inclusion and exclusion criteria, obtained from the Sardjito Cardiovascular Intensive Care (SCIENCE) registry between January 2023 and June 2024. RESULTS: The invasive and conservative method groups did not substantially differ in in-hospital mortality among NSTEMI patients in either unadjusted (p=0.09) or adjusted analysis (p=0.071, OR 2.251, 95% CI [0.932–5.434]). However, a significant difference was found in the high-risk group (p=0.042) but not in the very-high-risk group (p=0.525). Multivariate analysis confirmed Killip classification (p=0.000, OR 4.449, 95% CI [2.195–9.016]) and hs-Troponin T levels (p=0.006, OR 1.000, 95% CI [1.000–1.000]) as independent mortality predictors. CONCLUSION: Invasive management gave high-risk NSTEMI patients a survival advantage over conservative therapy at Sardjito Hospital, but not in the very-high-risk population.
When coronary anomalies induce arrhytmias: A case of ventricular tachycardia due to left coronary artery-pulmonary artery fistula Saerang, Gebryel Dennis; Rizal, Ardian; Karolina, Wella
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.20

Abstract

Background: Coronary artery fistula (CAF) is a rare vascular anomaly involving an abnormal connection between a coronary artery and another cardiac or vascular structure. Although often asymptomatic, CAF can cause myocardial ischemia, presenting as angina, dyspnea, or ventricular arrhythmias, due to flow diversion, leading to a coronary stealing phenomenon that poses a serious clinical challenge. Case: An 81-year-old female presented with chest pain, palpitations, and syncope. Electrocardiography (ECG) showed monomorphic VT, successfully cardioverted and managed with amiodarone. Following initial stabilization, she experienced recurrent episodes of VT that were terminated with lidocaine. Physical examination revealed a continuous machinery murmur at the left upper sternal border. Transthoracic echocardiography showed left coronary artery dilation with turbulent flow into the pulmonary artery. Aortography and coronary angiography confirmed a dilated left main coronary artery with an aneurysmal segment and a tortuous fistulous tract to the pulmonary artery. Computed tomography coronary angiography (CTCA) with 3D reconstruction confirmed a left coronary artery fistula to the pulmonary artery. Conclusion: This case highlights CAF as an uncommon yet clinically important etiology of recurrent VT, likely attributable to the coronary stealing phenomenon. Multimodal imaging, especially CTCA, is crucial for diagnosis and treatment planning. In addition to immediate management with cardioversion/defibrillation and antiarrhythmic drugs, treatment of ischemia as the underlying cause is important in the management of ischemia-induced VT. CAF closure is recommended in symptomatic or hemodynamically significant CAF to alleviate ischemic symptoms and prevent complication.
Approaches to closure of very large atrial septal defects in older adults: Challenges, complexities, and technical strategies Akbar, Akita Rukmana; Yogibuana, Valerinna
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.21

Abstract

BACKGROUND: In adults, atrial septal defects (ASDs) may reach very large sizes (>40 mm), creating significant procedural challenges requiring precise imaging, including the combined use of transesophageal echocardiography (TEE) and fluoroscopy for real-time guidance during device deployment, specialized closure techniques, and close post-procedure follow-up. Adult ASD patients face hemodynamic impacts that necessitate lesion and chamber pressure measurements before closure, techniques like push-and-pull. Post-closure, antiplatelet therapy is essential to prevent thromboembolic complications. CASE: A 53-year-old woman experienced recurrent palpitations and forceful heartbeats, especially during emotional stress. Initially dismissed as normal, she later sought medical attention due to worsening shortness of breath. A pulmonologist found no lung abnormalities and referred her to a cardiologist. Transthoracic echocardiography (TTE) identified a secundum ASD with a left-to-right shunt, prompting transesophageal echocardiography (TEE) for detailed evaluation. TEE revealed a very large ASD (28–40 mm) with deficient rims: no aortic rim, minimal posterior rim, mitral rim 11 mm, IVC rim 10 mm, and SVC rim 7 mm. Transcatheter closure was guided by both fluoroscopy and transesophageal echocardiography (TEE) via left upper pulmonary vein (LUPV) approach. Fluoroscopy played a crucial role in visualizing catheter and device trajectory, ensuring precise deployment despite deficient septal rims. Transcatheter closure was planned using a 44 mm Amplatzer Septal Occluder (ASO) without any complications. CONCLUSION: Transcatheter closure is preferred for most secundum ASDs, but large defects with deficient rims increase procedural complexity and complication risks. Adequate rim evaluation is vital for device anchoring. While ASDs >38 mm or with deficient rims carry higher risks and sometimes warrant surgery, advancements in device technology allow successful percutaneous closure with careful planning. The case highlighted the critical role of TEE and fluoroscopy in accurate sizing, rim assessment, and real-time guidance, ensuring proper device selection, positioning, and minimizing complications.
Predictors of right subclavian artery tortuosity in trans-radial coronary angiography access Ermawan, Romi; Pintaningrum, Yusra; Rahmat, Basuki; Putra, AASM Meiswaryasti; Indrayana, Yanna
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.13

Abstract

BACKGROUND: Trans-radial access has become the new standard and is increasingly in demand in coronary angiography. However, this method can fail due to tortuosity of the right subclavian artery. OBJECTIVES: This study aims to identify the predictors of right subclavian artery tortuosity. METHODS: This retrospective case-control study was conducted at two of the largest hospitals in West Nusa Tenggara, Indonesia. All research data were obtained from secondary sources, including video recordings of coronary angiographies, angiography reports, and patient medical records. Predictors included age, gender, smoking, height, body mass index, hypertension, diabetes mellitus, systolic and diastolic blood pressure, and random blood sugar. RESULTS: The study involved 80 subjects, divided into right subclavian artery tortuosity and normal group, with 40 subjects each. The prevalence of tortuosity was 8.1%, while the success rate of trans-radial access was 70.0%. Four significant predictors were identified: smoking (adjusted OR 0.26; p = 0.019), hypertension (adjusted OR 4.83; p = 0.020), diastolic blood pressure (adjusted OR 1.05; p = 0.044), and body mass index (adjusted OR 1.16; p = 0.035). The optimal cutoff points were determined to be a body mass index of ≥ 24.4 (sensitivity 60.0%; specificity 60.0%; p = 0.006; AUC = 0.665) and diastolic blood pressure of ≥ 78.5 mmHg (sensitivity 67.5%; specificity 67.5%; p = 0.002; AUC = 0.685). CONCLUSION: This study has identified smoking, hypertension, diastolic blood pressure, and body mass index as significant predictors of right subclavian artery tortuosity in trans-radial coronary angiography access. 
Predicting lesion complexity in premature coronary artery disease: The utility of clinical risk scores Firdaus, Achmad Jauhar; Mohammad Saifur Rohman; Budi Satrijo; Cholid Tri Tjahjono; Anna Fuji Rahimah
Heart Science Journal Vol. 6 No. 3 (2025): Advancements in Cardiac Imaging : Unlocking New Perspectives on the Heart Visua
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.03.12

Abstract

Background: Premature coronary artery disease (PCAD) has been recognized as a significant global health issue, with its prevalence increasing due to earlier exposure to various risk factors. Emerging evidence suggests that PCAD may be as aggressive, if not more so, than in older populations. The clinical implications and angiographic characteristics for more aggressive management strategies remain poorly explored. Objectives: This study aims to develop and validate a clinical scoring system in predicting lesion complexity in patients with PCAD. Methods: A retrospective cohort study was conducted on 645 patients who underwent invasive coronary angiography (ICA) from January 2023 to December 2024 in Dr. Saiful Anwar General Hospital, East Java, Indonesia. Patients were divided into developmental (n = 322) and validation (n = 323) groups. Clinical information was gathered from medical records, including risk factors and angiographic results. Predictors of complex CAD (SYNTAX ≥ 33) were identified by multiple logistic regression analysis. A clinical scoring system was developed and validated. Results: This study found complex CAD in 252 (39.1%) of all PCAD patients. Smoking (OR 2.3; p 0.006), dyslipidemia (OR 2.8; p < 0.001), diabetes mellitus (OR 3.9; p < 0.001), history of previous myocardial infarction (OR 6.5; p < 0.001), and family history of CAD (OR 5.7; p < 0.001) were independent predictors of complex CAD. A clinical scoring system was developed with a cut-off score ≥ 4 predicting complex CAD, with an area under the curve (AUC) value of 0.836 (95% CI 0.791-0.880), sensitivity of 71.3%, and specificity of 85.0%. Conclusion: The PCAD population continues to represent a high-risk group of concern. While the short-term prognosis is optimistic, the long-term outlook for this cohort is less promising due to the high recurrence rate and prolonged complications, especially in individuals with complicated CAD, leading to impaired quality of life

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