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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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An alternative retrograde access puncture for EVLA: a case report Kurniawan, Catur Rizky; Kurnianingsih, Novi; 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.2025.006.01.18

Abstract

Background: CVI manifests with a variety of clinical symptoms, spanning from varicose veins to venous ulcers, significantly impacting patients' daily lives. While traditional treatments such as compression therapy and surgery remain options, on endovenous laser treatment (EVLT) has emerged as a viable alternative.  This article delves into the management of CVI, with a particular focus EVLT as a minimally invasive intervention. Through two case illustrations, it sheds light on the difficulties encountered when accessing the great saphenous vein (GSV) using the conventional antegrade approach, particularly in cases involving obesity and vasospasm. Consequently, a retrograde EVLT technique utilizing proximal GSV access, resulting in successful vein ablation with minimal complications. Overall, this approach presents a promising addition to the management of CVI, offering enhanced patient care and improved outcomes. Case Presentation: Two patients with CVI and challenging antegrade GSV access underwent retrograde EVLT using proximal GSV access. Despite initial difficulties, including obesity and vasospasm, successful vein ablation was achieved with minimal complications. Post-procedural evaluations demonstrated significant symptomatic improvement, highlighting the efficacy of the retrograde technique. Conclusion: Retrograde EVLT utilizing proximal GSV access proves to be a safe and effective alternative in cases where antegrade access is challenging. The technique offers simplicity, minimal complications, and high patient satisfaction, with outcomes comparable to traditional approaches. Extended follow-up studies are needed to confirm the long-term effectiveness of retrograde EVLT compared to antegrade methods. Overall, retrograde EVLT presents a valuable option for managing CVI, particularly in patients with anatomical complexities or vasospasm, contributing to improved patient care and outcomes.
The complex relationship between arterial carbon dioxide levels and acute heart failure: implications for prognosis and management Afifah, Yuri; Prasetya, Indra; Anjarwani, Setyasih; Pashira, Andranissa Amalia
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.2025.006.01.2

Abstract

Acute Heart Failure (AHF) can affect carbon dioxide levels in the body by altering the balance between ventilation and carbon dioxide production, leading to either hypocapnia or hypercapnia. Arterial carbon dioxide (CO2) levels are essential for maintaining respiratory function and acid-base balance. However, the relationship between arterial CO2 levels and AHF remains complex and not fully understood. Diverse factors affect arterial CO2 levels in patients with AHF, including neurohormonal activation, respiratory compensation for hypoxemia, and changes in pulmonary perfusion. Hypocapnia, characterized by low arterial CO2 levels (PaCO2 < 35 mmHg), is commonly observed in AHF due to hyperventilation-driven respiratory alkalosis secondary to pulmonary congestion. It showed a strong connection with the survival rates of patients following a cardiac arrest. Nevertheless, elevated levels of carbon dioxide in the blood, known as hypercapnia, with a partial pressure of arterial carbon dioxide (PaCO2) exceeding 45 mmHg, can also arise in the later phases of acute heart failure (AHF), indicating fatigue in respiratory muscles or deterioration in pulmonary edema. Abnormal arterial CO2 levels have been associated with increased morbidity and mortality in AHF patients, serving as a valuable prognostic marker.  
Reversible atrioventricular block during transcatheter ventricular septal defect closure – a serial case report Indrihapsari, Pratiwi; Putri, Valerinna Yogibuana Swastika
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.2025.006.01.20

Abstract

Background: The transcatheter ventricular septal defect procedure is a sophisticated intervention that carries potential complications, such as complete heart block. We report two cases of patients who experienced total AV block during transcatheter VSD closure and were successfully treated with steroids and atropine. Case Presentation: Perimembranous VSD was found in a 19-year-old military recruit. A baseline 12-lead EKG showed sinus rhythm and no conduction delays. Echocardiography revealed a 6-9 mm perimembranous VSD. Then the VSD was closed with a VSD Occluder No 10-8. ECG monitor and echocardiography showed a complete atrioventricular block during the procedure. Fortunately, 1mg atropine and 125mg methylprednisolone overcame this. Recurrent atrioventricular block and VSD were not found after the procedure. A 33-year-old male patient was diagnosed with a perimembranous VSD during routine screening. Initial 12-lead electrocardiography was unremarkable, while echocardiographic evaluation revealed a 3-5 mm perimembranous VSD. Transcatheter closure was performed using a VSD Occluder device (No. 10-8). Hemodynamic monitoring and echocardiography demonstrated a complete atrioventricular (AV) block intraoperatively. Pharmacological intervention with 1 mg atropine and 125 mg methylprednisolone resolved the conduction disturbance. Despite this transient complication, the procedure continued with successful device deployment. Post-procedural assessment confirmed complete VSD closure with no residual shunt or persistent AV conduction abnormalities. Conclusions: In the context of transcatheter closure of ventricular septal defects, there exists a risk of atrioventricular block, which can be precipitated by mechanical trauma or compression from the delivery system or device. Ensuring the appropriate sizing of the device is pivotal in minimizing this risk. Continuous heart rhythm monitoring is indispensable during both short-term and long-term follow-up periods.
When to consider takotsubo cardiomyopathy in menopausal elderly woman presenting chest pain Aziz, Indra Jabbar; Rohman, Mohammad Saifur
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.2025.006.01.21

Abstract

Background:  An elderly menopausal woman presenting with chest pain in the emergency department may have coronary artery disease (CAD), Takotsubo cardiomyopathy, or other conditions. It is crucial to conduct a thorough diagnostic evaluation in menopausal elderly woman. Case illustration: A 77-year-old postmenopausal woman presenting with first-onset chest pain after having familial issues and severe psychological stress was admitted to the emergency department. She had no identifiable risk factors for CAD, and her physical examination revealed no significant abnormalities. The electrocardiogram (ECG) indicated non-specific ST-segment elevation in leads V3-V6. Serial ECGs showed an evolution of ST-segment elevation that did not align with the typical pattern observed in STEMI. Despite the elevation in cardiac enzymes in the previous hospital, unfortunately, serial cardiac enzymes were inconsistently normal in our hospital. Therefore, these findings implied that the patient's condition might not be ACS, and we cannot rule out the possibility of Takotsubo syndrome. The patient underwent coronary angiography (DCA) and The DCA results revealed normal coronary with suspicion of apical ballooning of the left ventricle as observed from cine angiography. Subsequent echocardiography demonstrated apical akinesis with basal hyperkinesis, the large area of dysfunctional myocardium extending beyond the territory of a single coronary artery and characteristic apical ballooning resembling an octopus trap, consistent with the diagnosis of Takotsubo syndrome. The patient was managed conservatively with supportive care. Her symptoms improved, and she was discharged after five days. Conclusion: This case highlights the importance of considering takotsubo cardiomyopathy in menopausal elderly woman with no risk factor of CAD presenting with chest pain after having psychological stress.
Evaluating the health-related quality of life in Egyptian cardiac patients using the brief version of the World Health Organization Quality-of-Life Scale (WHOQOL-BREF): observational cross-sectional study Elbarbary, Mohammed Ahmed; Heba Safwat Mousa; Walid Roshdy; Amr Alkassas
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.2025.006.01.15

Abstract

Background: Health-Related Quality of Life (HR-QoL) reflects how a disease and its treatment may affect a person and serves as an important measure for assessing outcomes. This study aims to evaluate HR-QoL among Egyptian cardiac patients. Methods: This observational cross-sectional study enrolled 400 participants, divided into group I for cardiac patients and group II for non-cardiac participants (control group). The HR-QoL was measured by applying the brief version of the World Health Organization quality of life questionnaire (WHOQOL-BREF). Results: Compared to the control group, the physical and psychological domain scores for the cardiac patients were significantly lower (54.73 ± 21.59 vs. 63.89 ± 16.87, p = <0.001) and (41.72 ± 14.49 vs. 44.72 ± 12.69, p = <0.028), respectively. No statistically significant difference was found in the social and environmental domains. Elderly, women, unmarried, and low-educated individuals had poorer scores. Ischaemic heart disease patients treated with percutaneous coronary intervention (PCI) had better overall health scores. Additionally, patients with ejection fraction (EF) between 31-40% showed the lowest scores in physical and psychological domains. The scores in all QoL domains were reduced in cardiac patients with superadded concurrent chronic diseases. Conclusions: The WHOQOL-BREF scale is a crucial tool for assessing the quality of life (QoL) of cardiac patients, particularly in physical and psychological health. It is essential to conduct national and regional assessments, even in each country, to improve medical services and quality of life among cardiac patients.
Effects of early ivabradine therapy in patients with acute heart failure: A meta-analysis and systematic review Nuraini, Yulianna Cahya; Irnizarifka, Irnizarifka; Prameswari, Hawani Sasmaya; Simangunsong, Robby Martin
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.2025.006.01.10

Abstract

BACKGROUND: Although ivabradine is the agent of choice for reducing heart rate, its use in acute heart failure patients remains unclear. OBJECTIVES: To evaluate the potential of in-hospital ivabradine administration in reducing heart rate, the risk of rehospitalization, mortality, and clinical profile in acute heart failure patients using a meta-analysis approach. METHODS: The study was designed as a meta-analysis conducted from August to September 2024. We selected several database sources for the search strategy, including PubMed, Google Scholar, ProQuest, British Medical Journal, and American Journal of Cardiology. Data on the outcomes of ivabradine treatment compared to standard therapy were collected to determine cumulative point estimates. For statistical analysis, we used the Mantel–Haenszel test for categorical data or inverse variance for continuous data. RESULTS: We included 11 articles in the study. Our findings indicated that, in comparison to the standard therapy group, the ivabradine group was associated with improvements in resting heart rate, a reduction in the risk of rehospitalization, a decrease in cardiovascular mortality, a reduction in all-cause mortality, a shorter length of stay, improvements in New York Heart Association (NYHA) classification, better Left Ventricular Ejection Fraction (LVEF), and improved B-type Natriuretic Peptide (BNP) / N-terminal pro b-type Natriuretic Peptide (NT-proBNP) levels. CONCLUSION: In conclusion, this study has revealed the beneficial effects of using ivabradine for the treatment of acute heart failure.  TRANSLATE with x English Arabic Hebrew Polish Bulgarian Hindi Portuguese Catalan Hmong Daw Romanian Chinese Simplified Hungarian Russian Chinese Traditional Indonesian Slovak Czech Italian Slovenian Danish Japanese Spanish Dutch Klingon Swedish English Korean Thai Estonian Latvian Turkish Finnish Lithuanian Ukrainian French Malay Urdu German Maltese Vietnamese Greek Norwegian Welsh Haitian Creole Persian     TRANSLATE with COPY THE URL BELOW Back EMBED THE SNIPPET BELOW IN YOUR SITE Enable collaborative features and customize widget: Bing Webmaster Portal Back
Association of clinical manifestations, disease activity, and medications on premature atherosclerosis in systemic lupus erythematosus Pratama, Mirza Zaka; Kusworini Handono; Cesarius Singgih Wahono; Ahmad Bayhaqi Nasir Aslam; Syahrul Chilmi
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.2025.006.01.11

Abstract

Background SLE is distinguished by the development of multiple autoantibodies that lead to chronic inflammation and increased risk of cardiovascular diseases, especially atherosclerosis. Objective This examination sought to explore the association between the disease activity, clinical manifestations, and medication with the atherosclerotic lesion from SLE patients. Methods This inquiry investigated forty-two female SLE patients (18-45 years old) who met the 2019 EULAR/ACR assortment decency with matched healthy individuals as control A cross-sectional study was sanctioned at the Rheumatology Clinic of Saiful Anwar General Hospital Malang between July and November 2023. Demographic data, clinical manifestations, and medication history was documented in the medical records. Disease activity was stelled by the SLEDAI-2K score. Carotid Intima-Media Thickness (cIMT) and Flow-Mediated Dilation (FMD) (after brachial BP cuff inflation up to 200 mmHg for five minutes) examinations were used as atherosclerosis marker. Results Markedly higher of cIMT mean was demonstrated in SLE patients compared to healthy individual (0.51±0.11 vs 0.40±0.11 mm, p<0.001). FMD was subtancially curtailed in SLE patients set side to side to control (0.00 (0.00-0.10) vs 0.10 (0.00-0.28) mm, p=0.022). There was no statistical distinctness of the cIMT and FMD among SLE patients according to the presence of clinical manifestations. Neither cIMT nor FMD showed a statistically correlated with the disease activity. Patients who received hydroxychloroquine (0.57±0.02 vs. 0.50±0.09 mm, p=0.043) and cyclophosphamide (0.55±0.09 vs. 0.48 ± 0.10 mm, p=0.031) had higher cIMT. Higher cIMT was demonstrated in subjects who received steroid (p=0.045) and the dosage of steroid was essentially enforced to cIMT (R=0.418, p=0.034). Conclusion Our study unveil that early atherosclerosis was evidenced in patients with SLE and several medications might affect the progressivity of atherosclerosis.
Ascorbic acid and calcitriol as alternative preventive strategies for myocardial damage in type 2 diabetes mellitus: an in vivo study using diabetic and atherosclerotic rat models Saputra, Jefri Dwi; Heriansyah, Teuku; Sofyan, Hamny; Dimiati, Herlina; Mudatsir, Mudatsir
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.2025.006.01.14

Abstract

BACKGROUND: Type 2 diabetes mellitus can increase the production of reactive oxygen species (ROS) and genetic transcription factors, such as nuclear factor kappa beta (NF-κB). These phenomena may enhance the progression of atherosclerosis. Additionally, NF-κB can induce apoptosis of pancreatic beta cells and accelerate disease progression. OBJECTIVE: To investigate the role of calcitriol and ascorbic acid on NF-κβ expression in vivo in aortic and myocardial tissues of Wistar rats. METHODS: This randomized experimental study involved 24 male Wistar rats of the Rattus norvegicus strain, divided into four groups: NC (negative control), PC (positive control), AG (ascorbic acid group), and CG (calcitriol group). The study spanned 90 days, including a 30-day intervention period. Aortic and myocardial samples were processed into histological preparations and stained using immunohistochemical techniques. NF-κB expression was assessed using an intensity scoring method. RESULTS: The CG group demonstrated the lowest NF-κB immunoexpression in myocardial tissue (0.27 ± 0.08), followed by the AG (0.37 ± 0.05), NC (0.68 ± 0.08), and PC (1.13 ± 0.34) groups, with statistically significant 3sbetween the groups (p < 0.05). In aortic tissue, the CG group also exhibited the lowest NF-κB expression (0.30 ± 0.18), followed by the AG (0.50 ± 0.09), NC (0.97 ± 0.05), and PC (1.23 ± 0.38) groups, with statistically significant differences between the groups (p < 0.05).  Similar trends were observed in the immunohistochemical staining of the NF-κB antigen in myocardial and aortic tissue samples. Calcitriol administration was more effective than ascorbic acid in reducing NF-κB expression in both myocardial (p < 0.05) and aortic tissues (p < 0.05). CONCLUSION: Both ascorbic acid and calcitriol reduce NF-κB expression in the aorta and myocardium, with calcitriol showing greater effectiveness than ascorbic acid.
Periodontitis and venous thromboembolism risk: Investigating the connection through a systematic review and meta-analysis Pratama, Erlan Anugrah; Sadikaningtya, Lirasati; Indarto, Malik Jantra; Adi, Andi Wahjono; Siswanto, Bambang Budi
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.2025.006.01.8

Abstract

BACKGROUND: The relationship between periodontitis and venous thromboembolism (VTE) remains controversial. Some studies show an association, while others do not show an association between periodontitis and VTE. OBJECTIVES: This study aims to determine the relationship between periodontitis and the risk of VTE using a meta-analysis approach. METHODS: A meta-analysis study, registered in PROSPERO, was conducted from August to September 2024. The sources for article searches in this study were Scopus, Embase, and PubMed. Data on the proportion of VTE occurrences in the periodontitis and non-periodontitis groups were collected from each article, and pooled point estimates were calculated using the Mantel-Haenszel test. RESULTS: We identified 40,397 VTE cases and 2,215,063 controls from six articles. Among these six articles, three showed an association between periodontitis and an increased risk of VTE. Additionally, we identified one article reporting that periodontitis was associated with a decreased risk of VTE. Furthermore, two articles revealed that periodontitis had no association with VTE occurrence. Our calculations using the Mantel-Haenszel test showed that, overall, an increased risk of VTE was found in individuals with periodontitis compared to those without (RR: 1.61; 95% CI: 1.09 – 2.39; Egger's p: 0.7917; Heterogeneity p: <0.0001; p: 0.0200). CONCLUSION: We have identified that periodontitis is an important factor in the occurrence of VTE.
Predictive value of PaCO2 on mortality in patients with acute heart failure Afifah, Yuri; Prasetya, Indra; Baskoro, Shalahuddin Suryo; 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.2025.006.01.9

Abstract

Background: Patients with AHF may experience fluctuations in carbon dioxide levels, resulting in either hypercapnia or hypocapnia. Recent research has highlighted the significance of the relationship between CO2 fluctuation and patient outcomes. Objective: The aim of this study was to explore the relationship between arterial carbon dioxide pressure (PaCO2) upon admission to the ICCU in patients with AHF. Methods: A single centre retrospective observational study was performed, the patient were enrolled from patient medical record between 2021 and 2023. Participants were divided into three groups based on PaCO2 levels. The study end point was length of hospitalization, mortality at ICCU and mortality in hospital. Statistical analysis used various tests to compare outcomes, with significance set at p<0.05, and ROC analysis evaluated mortality prediction. Result: The study included 150 patients: 97 with hypocapnia, 33 with normal PaCO2, and 19 with hypercapnia. In-hospital mortality was 37.5%, and 1-month mortality was 33.3% in the hypercapnia group. PaCO2 >45 mmHg was linked to higher in-hospital mortality (OR 6.900, p <0.001) and 30-day mortality (OR 5.600, p <0.001), PaCO2 <35 mmHg showing a protective association in ICCU and in-hospital mortality (OR 0.202, p<0.001) and 30-day mortality (OR 0.237, p<0.001). Length of stay was not significantly affected by either hypocapnia or hypercapnia. The ROC for predicting in-hospital mortality was 0.648 and for 30-day mortality was 0.626 in the PaCO2 >45 mmHg group. Conclusion: PaCO2 levels at ICCU admission predict mortality in AHF patients. Hypercapnia is associated with higher in-hospital and 30-day mortality, while hypocapnia appears protective.

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