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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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The Role of Colchicine in Acute Coronary Syndrome Liemena Harold Adrian; Budi Satrijo; Djanggan Sargowo; Indra Prasetya
Heart Science Journal Vol 1, No 4 (2020): Acute Coronary Syndrome in Daily Practice : Diagnosis, Complication, and Managem
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2020.001.04.02

Abstract

Background: Despite the advances of current optimal treatment of atherosclerotic disease, the incidence of events after acute coronary syndrome (ACS) remains high. Colchicine, with its well-established pleiotropic anti-inflam- matory effects, may inhibit NLRP3 inflammasome, a key mediator in atherosclerosis-associated inflammation (AAI) thus reducing systemic inflammation. NRLP3 inflammasome activation inside leukocytes (mainly monocytes and neutrophils) is precipitated by cholesterol crystals that are present in all atherosclerosis stages. ???????????????????????????????????????? ???????????????????????????????????????? ???????? ???????????????????????????????????????????????????????????????? ???????????????????????????????????? ???????????????? ???????? ???????????????????????????????????????????????????????? ???????????? ???????????????????????????????????????????????????????? ???????????????? ???????????????????????????? ???????????????????? cytokines are the crucial inflammatory pathway mediators that promote the formation of plaque and instability in the inflammatory cascade.Objective: This review will elaborate on the function of immune cells in atherosclerosis, explain the mechanisms of NLRP3 inflammasome activation in the context of AAI, and address the possible role of colchicine specifically targeting NLRP3 inflammasome and its concomitant downstream mediators in ACS, and provide an overview of current or ongoing studies produced in this area.Discussion : NRLP3 inflammasome activation inside leukocytes (mainly monocytes and neutrophils) is precipitat- ed by cholesterol crystals that are present in all atherosclerosis stages. Subsequent activation of pro-inflammatory ???????????????????????????????????? ???????????????? ???????? ???????????????????????????????????????????????????????? ???????????? ???????????????????????????????????????????????????????? ???????????????? ???????????????????????????? ???????????????????? ???????????????????????????????????? ???????????? ???????????? ???????????????????????????? ???????????????????????????????????????????????? pathway mediators that promote the formation of plaque and instability in the inflammatory cascade. A potential advantage of a medication acting through an inflammatory milieu found in atherosclerotic lesions has recently become the need for novel therapeutic options. Colchicine, with its well-established pleiotropic anti-inflammato- ry effects, may inhibit NLRP3 inflammasome, a key mediator in atherosclerosis-associated inflammation (AAI) thus reducing systemic inflammation.Conclusion: Colchicine is a safe and reliable medication for ACS patients, alongside reveal various benefit in reducing inflammation through inhibition of NLRP3 Inflammasome`
Arteriovenous Fistula Stenosis: A Case Report Seprian Widasmara; Novi Kurnianingsih; Ardian Rizal; Sasmojo Widito
Heart Science Journal Vol 2, No 2 (2021): Dealing with Vascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.02.8

Abstract

BackgroundThe arteriovenous fistula (AVF) is the preferred hemodialysis access type because it has better patency rates and fewer complications than other access types. Dialysis vascular access failure is common, is rated as a critical priority by both patients and health professionals, and is associated with excess morbidity, mortality, and healthcare costs.Case IllustrationA 64 years old man with stage V CKD on routine HD was admitted to hospital with difficulty in cannulation during his last hemodialysis. He already had arteriovenous fistula for hemodialysis access in his left arm since 2 years ago. In the last month before admission, he went to surgery to make hemodialysis access via arteriovenous fistula in his right arm, but failed to mature. Vascular ultrasound on dialysis vascular access was ordered. The examination revealed there was stenosis in the juxta-anastomosis site and cephalic venous stenosis in his left arm. He underwent percutaneous angioplasty with POBA in the anastomose arteriovenous fistula and implantation stent in the left cephalic vein.DiscussionDysfunction of hemodialysis access is a major problem for patients undergoing hemodialysis. It is generally due to venous stenosis, which diminishes flow in the hemodialysis access arteriovenous, thereby leading to poor dialysis. Fistulas tend to develop stenosis most commonly either at the juxta-anastomosis site and the outflow vein. Peripheral venous stenosis is the most common cause of arteriovenous fistula dysfunction and may lead to access thrombosis. The first-line treatment of stenosis should be balloon angioplasty. Stent placement in the peripheral vein is generally not recommended except in special circumstances.ConclusionHemodialysis vascular access is the “lifeline” for patients on hemodialysis. Vascular access-related complications can lead to patient morbidity and reduced quality of life. Surgery often cannot be provided as rapidly as a percutaneous approach. Catheter-based interventions are successful in restoring flow in more than 80% of hemodialysis accesses that undergo stenosis and have replaced surgical revision as the treatment of choice for failing or stenosed accesses
Mortality Prevention in Pregnancy With Pulmonary Arterial Hypertension Olivia Handayani; Mohammad Saifur Rohman; Ardian Rizal; Setyasih Anjarwani
Heart Science Journal Vol 1, No 4 (2020): Acute Coronary Syndrome in Daily Practice : Diagnosis, Complication, and Managem
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2020.001.04.07

Abstract

Background : Pulmonary hypertension (PH) is a global disease that affects all age groups and progresses in later years. Pregnancy with PH has a poor prognosis, and it is because of delayed diagnosis or even undiagnosed. PH gives high-risk to the mother and fetus; therefore, arranging a multidisciplinary team for pregnancy and delivery management is required.Objective : This case report was structured to emphasize mortality prevention in pregnancy with PH.Case : A 23-year-old female was admitted to the hospital with a chief complaint of dyspnea at rest. She was 34-week pregnant pregnancy and previously had a history of abortion with similar symptoms. After conducting some examinations, the patient was diagnosed with pulmonary hypertension. We planned for lung maturation for the fetus, scheduled termination, delivery method, and post-delivery care. The fetus was dead intra-uterine on day 5 of care, and the mother passed away 24 hours later.Conclusion : In summary, pregnancy was not advised in women with pulmonary hypertension. The collaboration and management by a multidisciplinary team are essential to improve outcomes if the pregnancy was still wanted.
Profile of Pediatric Rheumatic Heart Disease Patients with Mitral Regurgitation Receiving Angiotensin-Converting Enzyme Inhibitor in dr. Saiful Anwar General Hospital Malang Faris Wahyu Nugroho; Muhammad Saifur Rohman; Ardian Rizal; Heny Martini; Indra Prasetya; Taufieq Ridlo Makhmud
Heart Science Journal Vol 2, No 2 (2021): Dealing with Vascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.02.3

Abstract

AbstractBackground : Rheumatic heart disease (RHD) remains the leading cause of heart failure in children worldwide. Long-term consequences and sequelae of acute rheumatic fever may further contributes to isolated mitral regurgitation (MR), unless promptly treated, may develop to extensive fibrosis and calcification leading to mitral stenosis.  ACE inhibitor through reverse remodeling mechanisms may encounter secondary LV changes due to rheumatic MR. Studies in the field of RHD remain limited, particularly in Indonesia. Method : This observational descriptive study recruited 69 pediatric patients diagnosed with RHD who went to Pediatric Cardiology Clinic of dr. Saiful Anwar General Hospital during November 2018 to June 2019. A total of 22 patients were excluded due to incomplete data or showing no MR during echocardiography. The remaining samples (47 patients) were divided into two groups i.e: captopril and no captopril group. Data regarding profile of baseline characteristics, parameter of LV remodeling (dimension, mass and geometry), and grading of MR  were collected then tabulated using descriptive statistical analysis. Results : In general, from total 47 of sample population, female sex was found to predominate (68%), with mean age of 12.1 years and body mass index (BMI) 17.2 kg/m2. Proportion of distribution among captopril and no captopril group demonstrated no significant difference (p>0.05). Captopril group revealed younger age, higher BMI and longer time of initial RHD diagnosis compared to no captopril group. Evaluation of LV remodeling parameter demonstrated that captopril group had smaller LVIDd, lower LVMI, higher fractional shortening (FS) and higher LVEF. LVPWd dan RWT were found to be relatively similar among both groups. Evaluation of MR grade revealed that captopril group showed lower value of MR VC, MR EROA and MR regurgitant volume. Conclusion : Profile of pediatric RHD patients with MR who had been receiving captopril for at least 12 months in dr. Saiful Anwar General Hospital during period of 2018-2019 demonstrated younger age, higher BMI, smaller LVIDd, lower LVMI, lower MR grade, higher FS and higher LVEF compared to patients who had not. Keywords: rheumatic heart disease, mitral regurgitation, ACE inhibitor, captopril, left ventricle remodeling
Management of Acute Uncomplicated Stanford B Aortic Dissection in The Era of Endovascular Repair: A Case Report Putri Annisa Kamila; Novi Kurnianingsih; Sasmojo Widito; Djanggan Sargowo; Budi Satrijo
Heart Science Journal Vol 1, No 3 (2020): Management of Coronary Artery Disease: From Risk Factors to The Better Long-Term
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2020.001.03.8

Abstract

Introduction:Uncomplicated type B aortic dissections have been traditionally treated with medication therapy. While it may provide good short-term results, longterm prognosis may be less favorable. With improvements in endovascular repair and the potential risk of disease progression, thoracic endovascular aortic repair (TEVAR) has been considered inpatients with uncomplicated type B aortic dissection. We present the case of 78-year-old gentleman who presented with acute uncomplicated type B aortic dissection managed by endovascular repair Case illustration:A 78 year-old hypertensive patient admitted to the hospital with persistent chest discomfort and cough for 2 weeks. The CT aortic angiogram showed type B dissection. Based on the recent guidelines, TEVAR should be considered in patients with uncomplicated type B aortic dissection, thus we prepared the patient for TEVAR procedure. First we established multidisciplinary vascular team for the pre-procedural preparation of the patient. We perform careful measurement through detailed CT angiography reconstruction from carotid to femoral arteries. We found proximal diameter was 30-35mm, distal diameter was 23mm and landing zone right after left brachial ostium, suitable for stent graft Valiant Captivia 36-32x150mm. The CT also showed that both femoral artery were normal, we decided to use right femoral artery as the access. We proceed to the procedure 2 days later, under general anaesthesia, digital subtraction angiography revealed dissection of descending aorta, and selected device was inserted. Subsequent contrast injection revealed total occlusion of the false lumen. Patient was transferred to ICU for postprocedural care, and extubated the day after. The hospital stay was uneventful, and one-month follow up CT shows no endoleak. Conclusion :Management of uncomplicated Stanford B dissections is very challenging. TEVAR has emerged as an alternative to surgery with lower morbidity and mortality rates that might offer good long-term results. 
Peripartum Cardiomyopathy (PPCM): How to Diagnose and Deal with? Monika Sitio; Cholid Tri Tjahjono; Heny Martini; Novi Kurnianingsih
Heart Science Journal Vol 2, No 1 (2021): How to Diagnose Heart Failure and Deal with The Treatment Complexity
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.01.08

Abstract

Peripartum cardiomyopathy (PPCM) is a diagnosis of exclusion, where patients present with heart failure (HF) secondary to left ventricular (LV) systolic dysfunction without any other cause of HF identified in the last month of pregnancy or within first five months after delivery, abortion, or miscarriage. PPCM is a life-threatening condition which frequently under diagnosed and inadequately treated, whereas the morbidity and mortality rate ranges between 7% and 50%. Early diagnosis is important to decrease morbidity and mortality. Therefore, it is necessary to report the case related to this condition.A 34-year-old woman was referred to RSSA with worsening shortness of breath (SOB). She has given birth about 2.5 months prior to admission. History taking and supporting findings form this case were supported to diagnosis of PPCM. She was treated with diuretic, aldosterone antagonist, ACE-I, beta blocker, anticoagulant, and bromocriptine. The symptoms were improved in the following days. She was discharged with better condition and educated to comply with medication.
Acute ST elevation myocardial infarction (STEMI) in Young Male with Nephrotic Syndrome: A case report Ratna Pancasari; Cholid Tri Tjahjono; Anna Fuji Rahimah; Indra Prasetya
Heart Science Journal Vol 2, No 3 (2021): The Science and Art of Myocardial Revascularization
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.03.6

Abstract

Background: In young males, an acute myocardial infarction is an uncommon event. Thrombolism caused by nephrotic syndrome (NS) is one of the pathophysiologies of their infarctions.Case Illustration: A-24-y.o male patient, presenting with prolong typical chest pain since 72 hours before admission. The chest leads on an electrocardiogram (ECG) indicated ST-Elevation. Cardiac troponin was significantly raised. Since the previous two weeks, he has been experiencing nephrotic syndrome symptoms including anasarca edema.It was supported by laboratory data which is obtained proteinuria, hyperlipidemia and hypoalbuminemia. A complete acute occlusion of the proximal portion of the left anterior descending artery was revealed by coronary angiography. Increased fibrinogen levels appeared to be a contributing factor for hypercoagulable state in this patient, implying a correlation between coronary thrombosis and nephrotic syndrome.Discussion: Myocardial infarction (MI) is rare in young males, but it occurs 8 times more often in patients with NS than in the general population. Clinicians should pay closer attention to the history of previous diseases with a high risk of thromboembolism in young patients with MI, and they should specifically promote thromboembolism prevention and care in patients with renal disease to decrease the incidence of thromboembolism complications.Conclusion: Nephrotic syndrome should be considered as a contributing factor in any patient presenting with acute STEMI, particularly in young males.
Multimodality Cardiovascular Imaging of Hyperthrophic Cardiomyopathy : A Review Article Veny Kurniawati; Ardian Rizal; Mohammad Saifur Rohman; Novi Kurnianingsih; Anna Fuji Rahimah
Heart Science Journal Vol 1, No 3 (2020): Management of Coronary Artery Disease: From Risk Factors to The Better Long-Term
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2020.001.03.2

Abstract

AbstractThe most common genetic cardiomyopathy, HCM has a prevalence about 0.2%. It is transmitted autosomal dominant inheritance pattern. The natural history is benign but adverse outcomes can be happened in some patients including sudden cardiac death, symptoms secondary to dynamic left ventricular outflow tract (LVOT) obstruction, diastolic filling abnormalities, atrial fibrillation, and LV systolic dysfunction.Imaging modalities can be used to evaluate cardiac structure and function, the presence and severity of dynamic obstruction, mitral valve abnormalities, mitral regurgitation, as well as myocardial ischemia and fibrosis. Echocardiography is the initial imaging modality for evaluation of cardiac structure. CMR is recommended when echocardiographic images is not adequate in selected patients with high index of suspicion for HCM. In case of contraindication to CMR, patients with ICDs or pacemakers, Cardiac CT is recommended. Imaging can be used to guide treatment, screening and preclinical diagnosis in patient HCM.
Role of LAVi/A’ and E/’ as A Predictor of Major Adverse Cardiac Event on Patient with Acute Myocardial Infraction with ST Segment Elevation Undergo Through Percutaneous Coronary Intervention Aditya Reza Pratama; Budi Satrijo; Anna Fuji Rahimah; Djanggan Sargowo; Cholid Tri Tjahjono; Muhammad Rizki Rizki Fadlan
Heart Science Journal Vol 2, No 1 (2021): How to Diagnose Heart Failure and Deal with The Treatment Complexity
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.01.05

Abstract

Introduction:STEMI is still a major health problem in industrialized and developing countries. The risk of adverse cardiovascular events remains substansial and may vary significantly across of STEMI patients. Echocardiography is recommended tool for diagnosis and predict outcomes. Increased LA volume index (LAVI) has been shown to be a powerfull predictor of mortality after AMI. The ratio of the  left atrial volume index (LAVI) and late diastolic mitral annular velocity (A’) is additional benefits in the assessment od advance diastolic dysfunction in ACS for predicting outcome.Methods:This study retrospective cohort was conducted in patient admitted to Saiful Anawar General Hospital with STEMI who undergo PCI from 2019-2020. All patient underwent echocardiography measurement within 24-48 hours and we follow-up patient for 6 months until 12 months. Echocardiography measurement that we conducted were LVEF, E/A, E/e’, LAVI/A’ and LV diastolic function were measured according to ASE guidelines. All of the patients were given standard medical therapy. Patients who did not adhere to medication were excluded. The study endpoints were hospitalisation and mortality because of cardiac problem. Result:We collected the data from 169 STEMI patients. However, about 39 STEMI patients were excluded because of incomplete data, lost follow-up, become atrial fibrillation, refused participation and death. Finally, a total of 130 patients were involved in the analysis process. The patients mean age was 61.48 ± 7 years, and 78% of them were male. The receiver operating characteristics curve indicated that LAVI/A’ ≥ 4.0 predicted these events (AUC 0.892, 95% CI 0.819-0.965) and E/e’  ≥ was 13.4 (AUC 0.874, 95% CI; 0.806-0.942). The MACE incident in 6 months with LAVI/A’ ≥ 4.0 was 40%, E/e’ ≥ 13.4 was 20% and LAVI/A’ ≥ 4.0 + E/e’ ≥ 13.4 was higher 60%. The incidence MACE incident was LAVI/A’ > 4.0 sensitivity 92% and specifity 88% (CI 95%), E/e’ > 13.4 sensitivity 80% and specifity 74% (CI 95%), LAVI/A’ > 4.0 + E/e’ > 13.4 sensitivity 92% and specifity 88% (CI 95%). Conlussion:The LAVI/A’ ratio is available as echo index which reflects LV chronic diastolic function in patient with STEMI. It can predict MACE, particularly in those with STEMI undergo PCI. Combined LAVI/A’ > 4.0 and E/e’ >13,4 ratio suggests MACE better than LAVI/A’ > 4.0 and E/e’ >13,4 alone.Keywords: ST-elevation Myocardial Infarction, Echocardiography, LAVI/A’, E/e’, Percutaneous Coronary Intervention
Myocardial Revascularization in COVID-19 Era Sasmojo Widito
Heart Science Journal Vol 2, No 3 (2021): The Science and Art of Myocardial Revascularization
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.03.1

Abstract

Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by the coronavirus 2 that causes severe acute respiratory syndrome (SARS-CoV-2). More discussion is required to achieve the balance between clinical benefit and risk in the treatment of acute coronary syndrome (ACS) patients with COVID-19. The current COVID-19 pandemic prompts the need to evaluate criteria for indication and efficacy of the general safety protocols and particular cardiac catheterization laboratory (CCL) procedures to safeguard the patient and healthcare professionals

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