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Mohammad Saifur Rohman
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Department of Cardiology and Vascular Medicine, Dr. Saiful Anwar General Hospital, 3rd Floor CVCU Jl. Jaksa Agung Suprapto No. 2, Malang, Indonesia
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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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Beyond the procedure: A call for precision in diagnosis, risk mitigation, and sustainability of endovascular intervention in peripheral artery disease Kurnianingsih, Novi
Heart Science Journal Vol. 6 No. 4 (2025): The Pursuit of Precision: Navigating Risks, Refining Diagnosis, and Securing Lo
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.04.1

Abstract

Endovascular interventions have made a lot of advancements in managing peripheral arterial disease (PAD). The interventions of PAD were limited only to medical therapy or surgery, but as for now, it has undergone changes because of improvements in the tools used for intervention and the improved operator skill, so the patients are able to gain benefits, even if the intervention is minimally invasive. The benefit does not stop at the technical success; it extends to the precision in diagnosing, extensive risk mitigation, and sustainable outcomes. Duplex ultrasonography is now popularly used because of its ease of use, following more advanced examinations such as CT or MR angiography, resulting in accurate, on-time, and precise interventions. But, there are several challenges left, such as the low rate of use of guideline-directed medical therapy that may lead to an increased number of mortality and amputation risk. Furthermore, multidisciplinary collaboration is deemed essential in optimizing sustainability. Patency or angiography, which are usually used as parameters traditionally, are not enough to measure the success of the therapy; instead, limbs preserved, improvement of the function, and the quality of life may define success in therapy, where endovascular interventions may directly affect those parameters mentioned. In order to achieve sustainable and meaningful outcomes affecting the long-term well-being of patients, patient-centered strategies, early detection, and maximizing the use of resources are a must.
Rapid degradation of left ventricular function after permanent right ventricular pacing in patients with high-grade atrioventricular block Setiawan, Dion; Prasetya, Indra; Anjarwani, Setyasih; Rizal, Ardian
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.22

Abstract

Background: Permanent right ventricular (RV) pacing is a standard for high-grade atrioventricular (AV) block treatment. However, it may result in left ventricular (LV) dilatation, systolic dysfunction, and heart failure (HF) as a consequence of ventricular dyssynchrony and an abnormal myocardial contraction pattern. Pacing-induced cardiomyopathy (PICM) can develop months or years after implantation of a permanent pacemaker (PPM) in patients who have long-term and high-burden RVP. Case Illustration: We reported a case of a 56 years old Asian female having a record of PPM on VVIR mode implantation due to a high grade AV block presented with shortness of breath and bilateral leg swelling. Conclusion: Echocardiography showed a significant decrease in LV systolic function less than two years after PPM implantation. Coronary angiography showed widely patent vessels; subsequently, His-Bundle Pacing (HBP) was scheduled on the patient.
Unprovoked transformation of saddle back to coved ST-segment elevation ECG pattern Firdaus, Muhammad; Ardian Rizal
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.23

Abstract

Background  Brugada syndrome (BrS) is a heritable arrhythmia that is clinically characterized by spontaneous coved ST segment elevation and a negative T wave in the right precordial lead. Some psychotropic medications, anesthetics, cocaine, excessive alcohol consumption, and fever have been identified as potential causes of VF and SCA in BrS. Case Illustration A 35-year-old man was hospitalized after experiencing unexplained syncope. It was felt 3 times within an hour and was preceded by lightheadedness, nausea, and vomiting. He did not experience palpitations, chest pain, or shortness of breath prior to the syncope. Prior to syncope, he had no history of fever, dehydration, drinking, or taking any medications. There was no family member died suddenly because of heart disease. The physical examination, CXR, laboratorium, and echocardiography were all within the normal range, but the electrocardiogram showed a coved ST segment elevation with an inverted T wave at V1-V2, as well as a saddle back ECG pattern two weeks later with a J point of 2 millimeters at V2. The combination of symptoms and ECG findings led to the BrS diagnosis. He underwent ICD implantation at RSUD Dr Saiful Anwar Malang for secondary prevention. After several months of ICD check-ups, there were no VT/VF events or ICD shock therapy. Conclusion A change in the ecg of the brugada pattern from type 2 to 1 is often accompanied by known ethiologies. But an unprovoked conversion of the BrS type is possible in rare cases.
Hemodialysis prophylaxis and renal replacement therapy in contrast associated acute kidney injury (CA-AKI): literature study Satwikajati, Sawitri; Novi Kurnianingsih
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.6

Abstract

Contrast associated acute kidney injury (CA-AKI) had been the main focus along the development of percutaneous invasive procedure. Contrast associated acute kidney injury (CA-AKI) increase risk of dead among hospitalized patient. The use of iodine based contrast along percutaneous procedure potentially induce contrast associated acute kidney injury (CA-AKI). Many potential hazardous effect may effect individual with CA-AKI such as myocardial re-infarction, stent thrombosis, dead, and major adverse cardiac event (MACE). Many strategies had been developed to prevent and treat CA-AKI such as risk stratification, hydration with normal saline, avoid nephrotoxic drug, use of statin, and N-acetilcystein but when all strategies failed, hemodialysis prophylaxis and renal replacement therapy had potential benefit in CA-AKI.
Hypothermia theraphy in patients post cardiac arrest Yudha, Tria; Prasetya, Indra; Tjahjono, Cholid Tri; Anjarwani, Setyasih
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.5

Abstract

Cardiovascular disease is the leading cause of death in several developing countries, and many of these deaths occur before reaching the hospital due to cardiac arrest. Most patients who return to spontaneous circulation (ROSC) and are brought to the hospital experience severe neurological damage during cardiac arrest, and this damage is the cause of in-hospital mortality. Improvements in survival and neurologic improvement of patients with CA have focused on two main therapy areas. The first area is improved education and skills of medical and paramedical personnel to improve perfusion post CA. The second area is a greater emphasis on post-resuscitation care which includes optimizing oxygenation and ventilation, avoiding hypotension, treating causes of CA such as acute coronary ischemia, and initiating hypothermia therapy if necessary, as in the 2020 guidelines and recommendations from the American Heart Association (AHA), International Liaison Committee of Resuscitation, and European Resuscitation Council covering the entire spectrum of post-resuscitation care.  The AHA guidelines 2020 recommend optimizing hypothermia therapy for 24 hours with a target temperature between 320C - 360C in ROSC patients to improve clinical outcomes of neurological status after cardiac arrest. This is contrast to the study of Martinell et al in their research which concluded that there was no significant difference in survival rates within 30 days after cardiac arrest in patients who received either hypothermia therapy or those who did not. Hypothermia therapy, which is currently part of the post-resuscitation care recommendations, has varied variables and remains controversial in its implementation. Based on this, this referent will discuss the effects of hypothermia therapy on post-cardiac arrest patients, the stages, and the practical aspects of implementing hypothermia therapy.
Challenge case of ventricular arrhythmia in young women Kaputrin, Nur; Rizal, Ardian; Karolina, Wella; Widito, Sasmojo
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.16

Abstract

Background: Torsade de pointes (TdP) and ventricular fibrillation can cause rapid mortality. The etiological cause the ventricular arrhythmia must be detected and treated early, especially in the ER. Objective: We report a patient with severe hypokalemia and TdP following the administration of Amiodarone in QT-interval prolongation Case Report: A 32-year-old girl with diarrhea and vomiting for two days arrived to the ED with a seizure with her hand flexed and leg straight down. Her family reported she didn't take prescriptions regularly. She was GCS 224, hemodynamically stable, typical ECG showed extended QTc and her head CT was normal. During observation at the ED, she had seizure and the monitor revealed a Torsade de Pointes (TdP) ) with a pulse rate of 160-180 bpm. She was given Amiodarone and peroral Bisoprolol 5 mg. She returned to sinus rhythm with PVC bigeminy and was admitted to the ICU Laboratory data showed hypokalemia (1.9) improved (2.9) after treatment. Eight hours later, she experienced a TdP without pulse palpability for less than 1 minute, then Ventricular Fibrillation, began CPR, and the doctor in charge gave her a defibrillation operation once. She returned with sinus tachycardia 110-130 bpm. The next day, she was having recurring TdP episodes without a pulse. The doctor conducted CPR and defibrillation and returned with 120-130 bpm sinus tachycardia. The patient consulted a cardiologist and was prescribed lidocaine 1 mg/hour and continued Bisoprolol 5 mg for long QT problem. Observation The seizure ended 12 hours later, the patient was alert, GCS 456, and the ECG showed sinus rhythm with extended QTc. Over the days before discharge, electrocardiography demonstrated reduced QT-interval prolongation. Conclusion: Life-threatening ventricular arrhythmia in a young female can be caused by QT-interval prolongation. It must be diagnosed and treated immediately to avoid mortality.
Continous renal replacement therapy: revisited Aryanugraha, Teguh; Prasetya, Indra
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.7

Abstract

Patients in condition of acute kidney injury (AKI) and critically ill often benefit from renal replacement therapy (RRT). Patient with hemodynamically unstable in cardiac intensive care, such as those with congestive heart failure, acute myocardial dysfunction, or excessive hemodilution during cardiac surgery, continuous renal replacement therapy (CRRT) is considered to be the suitable renal replacement therapy modality. This paper discusses indications, techniques, and CRRT in cardiac critical care.
Use of SAPS 3, APACHE IV, and GRACE as prognostic scores for acute coronary syndrome patients in the cardiovascular care unit Yudha, Tria; Prasetya, Indra
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.3

Abstract

A grading system based on disease severity has been widely used in intensive care units (ICUs) since around 1980. These systems are used to predict mortality and assess severity in clinical trials. Simplified Acute Physiology Score 3 (SAPS3) and Acute Physiology and Chronic Health Evaluation Score (APACHE IV) are prognosis ratings that can predict in-hospital mortality within the first hour of ICU care. Although these technologies have been widely employed in the ICU, they have yet to be commonly deployed in the cardiovascular care unit (CVCU) due to different patient populations. Intensive care doctors typically employ the standard prognostic scores, SAPS3 and APACHE IV, which were generated from diverse populations of critically ill patients. Although these scores are the most widely used early versions, APACHE IV and SAPS 3 do not include acute coronary syndrome patients. The Global Registry of Acute Coronary Events (GRACE) score has performed the best; this may be because of its straightforward design, which does not distinguish between individuals with SCA and those without ST-segment elevation. Our review article attempts to evaluate the performance of standard predictor scores, namely SAPS 3, APACHE IV, and GRACE, on patients with cardiovascular emergencies. Thus, these score systems can precisely assess the relationship between mortality prediction scores and outcomes of patients admitted to the CVCU rapidly and comprehensively.    
Proper management of pulmonary hypertension crisis Aziz, Indra Jabbar; Martini, Heny
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.4

Abstract

A pulmonary hypertensive crisis is characterized by a sudden increase in the pressure in the pulmonary arteries, leading to an excessive workload on the right ventricle of the heart and a decrease in cardiac output. Typically, individuals with pulmonary hypertension (PH) have a greater mortality rate after surgical procedures, which can range from 4% to 24%. Early recognition of pulmonary hypertensive crisis is crucial. There are a limited number of comprehensive guidelines or review articles that focus on the evaluation and treatment of pulmonary hypertension crises. Hypoxia in pulmonary hypertension crisis leads to a vicious cycle of decreased cardiac output, elevated pulmonary vascular resistance, right ventricular enlargement, restricted left ventricular filling, reduced blood pumping, systemic hypotension, and metabolic and respiratory acidosis. It is crucial to monitor clinical parameters, including systemic hypotension, hypoxia, tachycardia, reduced urine output, and complete absence of urine production. The main characteristics of a pulmonary hypertension crisis are increasing pulmonary and right atrial pressures along with a decrease in cardiac output. Echocardiography can be a useful additional tool that shows the deterioration of the right ventricular (RV) function and enlargement. Confirmation of a pulmonary hypertensive crisis is achieved with the use of invasive hemodynamics. Our current review aims to discuss the proper management of Pulmonary Hypertension Crisis.  
A follow-up approach to manage tachyarrhythmia and bradyarrhythmia in Ebstein’s anomaly patient Setyowati, Danti Utami; Ardian Rizal
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.17

Abstract

Background: Ebstein’s Anomaly (EA) is a rare heart defect that can cause a number of problems, including arrhythmias. They exhibit a greater rate of recurrence compared to those with normal hearts. High-definition (HD) mapping and three-dimensional (3D) ablation are new techniques that may be suboptimal, attributed to anatomical characteristics. The management tactics employed may necessitate modification in accordance with personal traits. Case Report: A 37-year-old male presented with intermittent palpitations over years. The electrocardiogram (ECG) is changing overtime such as supraventricular tachycardia (SVT), ventricular tachycardia (VT) and atrial fibrillation (AF). Echocardiography shown typical features of EA. During ablation, multiple atrial tachycardias were induced. Throughout the observation period, the patient exhibited complications related to several arrhythmia recurrence. In the end he suffered from total atrioventricular block (TAVB), leading to the decision to undergo a permanent pacemaker procedure. We postulated that specific characteristics of the right atrioventricular groove structure observed in pathological samples of EA could explain less than ideal results in ablation procedures. Conclusion: Managing arrhythmia in EA could be challenging. A prominent ridge alongside the lower atrioventricular groove is a typical characteristic in EA, and is associated with the clinical background of accessory pathways (AP). Understanding this anatomical aspect is important for electrophysiologists who work with this group of patients, since their management approaches may need to be adjusted.

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