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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 363 Documents
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Renal function and potassium changes in HFrEF patients treated with ACEI vs. ARNI: A prospective cohort study among Acehnese, Indonesia Munawarah, Iffah; Heriansyah, Teuku; Syukri, Maimun; Purnawarman, Adi; Buchari
Heart Science Journal Vol. 7 No. 2 (2026): The Evolving Landscape of Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.02.10

Abstract

Background: Renin-Angiotensin-Aldosterone System (RAAS) acceleration commonly occur in Heart Failure (HF). Drugs such as Angiotensin-Converting Enzyme Inhibitors (ACEI) and Angiotensin Receptor-Neprilysin Inhibitors (ARNI) become essential part of HF treatment. Long-term consumption may impair kidney function and potassium imbalance, which could potentially limit the therapy, therefore we conducted this study to assess the effects of ACEI and ARNI on renal function and potassium level in Indonesian patients with heart failure with reduced ejection fraction (HFrEF), as no local studies exist. Method: A prospective cohort was performed in Banda Aceh, which comprise of 40 ACEI and 40 ARNI patients on standard therapy. Left ventricular ejection fraction (LVEF), serum creatinine level then converted into estimated Glomerular Filtration Rate (eGFR), and serum potassium level were measured at baseline and after 3 months into the therapy. Independent t-test was applied to compare groups. Result: Both ARNI and ACEI groups showed significant improvement in eGFR (p < 0.005). The intergroup difference was 11 mg/dL (p = 0.038) showed that ACEI had a better outcome in eGFR improvement compare with ARNI. Potassium rose slightly in both groups, with an intergroup difference of 0.082 mmol/L (p = 0.623), indicating no meaningful difference. Conclusion: Both ACEI and ARNI improved eGFR after 3 months, with a modest potassium increase.
Prognostic implications of pulmonary hypertension in heart failure preserved and reduced ejection fraction Rosyidi, Muhammad Azhar; Yogibuana, Valerinna
Heart Science Journal Vol. 7 No. 2 (2026): The Evolving Landscape of Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.02.3

Abstract

Pulmonary hypertension (PH) attributable to left heart disease (PH associated with left heart disease, PH-LHD) is the most common type of PH. PH-LHD is an important indicator of elevated morbidity and mortality in individuals with heart failure, both heart failure with preserved and reduced ejection fraction despite receive adequate therapy. Literature was sourced from major scientific databases and studies relevant to symptoms, examinations, management, and prognostic implications of PH-LHD. Pathophysiologically, PH-LHD is a gradual process that begins with increased left-heart pressure (postcapillary component), which triggers a series of biological changes in the pulmonary vasculature (precapillary component). This process ultimately places an excessive burden on the right ventricle, resulting in right ventricular dysfunction and failure, which are the main determinants of prognosis. Symptoms of PH-LHD are usually characterized by disproportionate dyspnea that is not consistent with left ventricular ejection fraction and other comorbidities. Echocardiography can noninvasively assess the probability of pulmonary hypertension in heart failure patients. A definitive diagnosis of PH-LHD requires confirmation through right heart catheterization. The most important prognostic factors are not only determined by the degree of hemodynamic severity, but also depend heavily on the degree of right ventricular dysfunction and the status of right ventricle–pulmonary artery coupling. Management of PH-LHD is through optimization of basic Guideline-Directed Medical Therapy (GDMT) to reduce mortality and morbidity.
Blood urea nitrogen as outcome predictor in acute coronary syndrome: A systematic review and meta-analysis Chandra, Graciela Natalia; Hendrawan, Fandi; Prasetyo, Hersati
Heart Science Journal Vol. 7 No. 2 (2026): The Evolving Landscape of Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.02.9

Abstract

BACKGROUND: Predicting outcomes in acute coronary syndrome (ACS) remains challenging, as established risk scores often require variables that are unavailable in low-resource healthcare settings. Blood urea nitrogen (BUN) has demonstrated prognostic value in predicting cardiovascular disease outcomes, such as heart failure and infective endocarditis. However, no meta-analysis has yet evaluated its predictive role in ACS. This study evaluated the prognostic utility of BUN for mortality and major adverse cardiac events (MACE) in ACS. METHODS: A systematic review and meta-analysis were conducted using literature from PubMed, Cochrane, and Web of Science. Risk of bias was assessed using the Risk Of Bias In Non-randomized Studies-of Exposures (ROBINS-E) tool. Pooled analysis of hazard ratios (HR) was calculated utilizing a random-effects model based on restricted maximum likelihood method. Subgroup analysis and meta-regression were performed. Sensitivity analysis was done using graphical display of study heterogeneity. RESULTS: Ten studies consisting of 7,238 participants were included. Elevated BUN was associated with heightened risk of MACE and mortality (HR: 1.05, 95% CI: 1.03–1.07, p=0.0011) and remained significant after excluding two outlier studies (HR: 1.04, 95% CI: 1.02–1.05, p=0.0002). Univariate meta-regression identified age, hypertension, and diabetes as potential covariates (p=0.112, 0.221, and 0.194). Multivariate analysis revealed no independent predictors. CONCLUSION: BUN may serve as a promising biomarker for predicting MACE and mortality in ACS, particularly in resource-limited settings. Further research is needed to compare its performance with established biomarkers or traditional scoring systems.
Improving patient outcomes : The pivotal role of guideline directed medical treatment Hasanah, Dian Yaniarti
Heart Science Journal Vol. 7 No. 2 (2026): The Evolving Landscape of Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.02.1

Abstract

Guideline directed medical therapy (GDMT) continues as the main pillar of management for heart failure with reduced ejection fraction (HFrEF). Numerous positive landmark trials and emergence of novel drugs provide strong evidence supporting the capability of GDMT in reducing cardiovascular mortality, hospitalization due to heart failure (HHF), and advancement of renal impairment. The introduction of a four-pill regimen comprising five specific pharmacological agents represents a major shift in disease-modifying care, significantly slowing symptomatic decline and improving long-term survival outcomes. Despite strong clinical recommendation, there is a huge gaps in the implementation of clinically-proven pharmacological strategies for eligible patients that further linked to relatively persistently flat mortality curves of HfrEF patients. Effective adherence to HF guidelines is often hindered by a multifaceted interplay of patient-related hurdles, clinical inertia, and systemic healthcare limitations. These challenges are further compounded by age-related complexities and multimorbidity, where concerns over pill burden and inadequate disease literacy frequently lead to suboptimal therapeutic outcomes.
Determinants of in-stent restenosis in coronary artery disease patients after percutaneous coronary intervention in Dr Saiful Anwar General Hospital, Malang Pramudya, Astrid; Rohman, Mohammad Saifur; Novi, Kurnianingsih; Djanggan, Sargowo; Setyasih, Anjarwani
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.9

Abstract

Background: In-stent restenosis (ISR) is common complication found following percutaneous coronary intervention. It can be caused by multifactorial such as patient related, lesion related and procedure related. Methods: A retrospective cohort study in Saiful Anwar general Hospital to know what are the characteristic of patient with ISR stated from clinical, lesion and procedural related. Result: From 3335 patients underwent PCI in our hospital, the incidence of ISR after PCI was 9.3%. Stent overlapped as one of the significant predictors of ISR (p=0.024). Multivariate analyses found significant correlation between Multivessel disease (OR = 1.76, 95%; [CI] [1.61 – 1.91], P 0.003), LAD lesion (OR=3.46, 95% CI [2.22 – 5.38], P<0.001), osteal lesion (OR=3.97, 95% CI [2.42-6.52], P<0.001], bifurcation lesion (OR=5.14, 95% CI [2.52-10.49], P<0.001), Calcified lesion (OR=1.86, 95% CI [1.62-2.15], P<0,001), LM disease (OR=2.16, 95% CI [1.36-3.41], P 0.001), Stent overlapped (OR 1.96, 95% CI [1.27-3.02], P 0.03), Stent length (OR=2.08, 95% CI [2.02-3.19] P 0.001). The multi-factor logistic regression analysis suggested that LAD lesion (p<0.001), stent overlapped (p 0.024) and calcified lesion (p<0.001) were independent risk factors for ISR. We evaluate subclinical analysis for stent length cut off >33.5 mm increased the risk of ISR with fair sensitivity but less specificity. Patient with DM type II had 3.013 times folded to become ISR rather than non DM group (1.995 – 4.552, 95% CI). By using ROC Curve, we evaluate subclinical analysis for HbA1C cut off <7.45 % with high sensitivity (81.2 %) and specificity (85.5 %). Conclusion: DM type 2, LAD lesion, stent overlapped and calcified lesion were the determinant of ISR.
Anemia incidence and nutritional status in children with uncorrected congenital heart disease at a teaching hospital in a developing country Amelia, Putri; Lubis, Nydia Akrami; Efendy, Elmeida; Amelia, Rina; Kannady, Johnson
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.10

Abstract

Background: Congenital heart disease (CHD) remains a major contributor to pediatric morbidity and mortality, accounting for an estimated 251,247 infant deaths globally in 2017. In Indonesia, the incidence is approximately 8 per 1,000 live births. Both cyanotic and acyanotic CHD can impair nutritional status, while malnutrition may predispose to anemia and worsen clinical outcomes. Objective: To compare anemia prevalence and nutritional status between children with cyanotic and acyanotic CHD and to identify factors associated with anemia. Methods: This retrospective study analyzed medical records of pediatric CHD patients at Adam Malik Hospital, Medan, Indonesia, from 2023 to 2024. Nutritional status was assessed using standard anthropometric indices. Group comparisons were performed using the Mann–Whitney U and chi-square tests. Multivariable logistic regression was used to identify independent predictors of anemia. Result: A total of 170 patients were included, equally distributed between cyanotic and acyanotic CHD. Tetralogy of Fallot (35.9%) was the most common diagnosis. Severe underweight was observed in 38.8% of patients, while most had normal height-for-age, weight-for-height, and BMI-for-age. Anemia was significantly less frequent in cyanotic than acyanotic CHD (22.4% vs 63.5%, p < 0.001). No significant differences in overall nutritional status were found between groups. However, weight-for-height was independently associated with anemia, indicating the role of acute malnutrition. Conclusion: Anemia differs between cyanotic and acyanotic CHD despite similar nutritional status. Acute malnutrition appears to be a key determinant, highlighting the importance of early nutritional assessment.
Diagnosis and management of vasovagal syncope: A comprehensive review Veliawan, Zhafran; Rizal, Ardian
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.2

Abstract

Syncope is a distinct type of  transient loss of consciousness characterized by rapid onset and complete spontaneous recovery. Syncope is categorized into three different kinds according to the 2018 European Society of Cardiology guidelines. Different types of syncope ultimately converge on a common pathophysiological occurrence: global cerebral hypoperfusion, resulting from the circulatory system's inability to maintain blood pressure at a level sufficient to provide adequate cerebral perfusion. Vasovagal syncope, often referred to as the "common faint," is the predominant etiology of syncope. Although classified as a benign condition, recurrent syncope incurs significant costs and adversely effects the quality of life for patients, particularly in the elderly. Typical vasovagal syncope predominantly manifests in young adults and is frequently identified based on medical history, provided there is no structural heart disease. Atypical vasovagal syncope frequently presents with a short or nonexistent prodrome, and inattention regarding the loss of consciousness is prevalent, leading to potential misdiagnosis, such as falls. This article provides an overview of the evaluation and management of vasovagal syncope.
Closing the gap in cardiomyopathy classification: A case report of the emerging non-dilated left ventricular phenotype Sekarsari, Calysta Citra; Handari, Saskia Dyah
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.12

Abstract

Background: In the latest ESC guidelines on cardiomyopathy management, the task force introduced several new concepts and recommendations, including a novel phenotype-based classification for cardiomyopathies, which refered Non-Dilated Left Ventricular Cardiomyopathy (NDLVC). This case underscores the critical importance of long-term follow up and adherence to the patient pathway approach, as emphasized in recently published clinical guidelines. Case Presentations: A young male patient was taken to the emergency room after he experienced a syncopal episode. An electrocardiogram (ECG) was performed, revealing multiple Premature Ventricular Contractions (PVC). Transthoracic echocardiography performed at the referral hospital revealed reduced systolic function, with a left ventricular ejection fraction (LVEF) of 37% and CT Angiography showed non-significant stenosis. A contrast-enhanced cardiac MRI was conducted, which identified hypokinesia and impaired systolic function. Neither fibrosis, sign of myocarditis nor other inflammatory diseases was detected. Based on these findings, a diagnosis of non dilated left ventricular cardiomyopathy is established. Importantly, despite the absence of a family history, genetic testing is needed to provide valuable insights for confirming the diagnosis and optimizing patient management through continuous monitoring and individualized treatment adjustments. Conclusions: In this case of a young patient with findings consistent with NDLVC, we highlight the importance of a cardiomyopathy-focused approach. This approach supports the selection of appropriate diagnostic tests, including genetic evaluation, to facilitate accurate risk stratification and phenotype-specific management.
Isolated congenital absence of left circumflex mimicking single coronary artery: A rare coronary anomaly case report Ramadhan, Fitri Febrianti; Saskia Dyah Handari
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.13

Abstract

Background: Congenital coronary artery anomalies (CAAs) occur in roughly 1% of the population and, while often incidental, are recognized contributors to sudden cardiac death, particularly in younger individuals. Many anomalies remain silent until adulthood. Case Presentations: A 59-year-old man with obesity, hypertension, and heavy tobacco use presented with exertional dyspnea and recurrent chest pain radiating to the left arm and neck. Initial evaluation showed normal high-sensitivity troponin, an unremarkable electrocardiography (ECG), and a normal transthoracic echocardiogram; his clinical likelihood of obstructive coronary artery disease was estimated at Chronic Coronary Syndrome (CCS) Risk Factor-weighted Clinical Likelihood (RF-CL) 27%. Coronary CT angiography (CCTA) demonstrated congenital absence of the left circumflex artery (LCx) with a super-dominant right coronary artery (RCA) coursing subaortically to supply the lateral wall. A non-obstructive calcified plaque was identified in the proximal left anterior descending artery, with an Agatston calcium score of approximately 145, indicating quantifiable but moderate atherosclerotic burden. The distinction between a single coronary artery (SCA) and an absent LCx is clinically important. In SCA, all coronary branches originate from a single aortic ostium, whereas in absent LCx, there is no separate LCx ostium, and the RCA (and occasionally enlarged diagonal branches) perfuses the LCx territory; CCTA is pivotal for depicting ostial origin and vessel course. The patient was treated with a beta-blocker, an angiotensin-converting enzyme inhibitor, a statin, and aspirin. Conclusions: Given persistent symptoms, functional testing is recommended to determine ischemic significance and guide management. Accurate identification of this subtle anomaly and comprehensive risk stratification are essential to optimize outcomes. 
Evaluating the MEDAN score: An alternative diagnostic instrument to acute myocardial infarction for resource-limited settings Napitupulu, Friendina; Lubis, Anggia Chairuddin; Teuku Bob Haykal; Lubis, Hilfan Ade Putra; Kamal Kharrazi Ilyas; Harris Hasan
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.7

Abstract

Background: Acute Myocardial Infarction (AMI) is one of the leading cause of death worldwide. Limited access to biomarker testing, especially troponin, poses a significant challenge for rapid and accurate diagnosis, particularly in resource-limited settings. We previously proposed Myocardial infarction Early DiAgnosis instrumeNt (MEDAN) score as a tool for predicting AMI. Objective: To conduct internal validation and assess the reproducibility of the MEDAN score in distinct patient cohorts. Methods: This study was conducted at Adam Malik Hospital in Medan, Sumatera Utara. A research form was used to gather data from electronic medical records. Data were collected retrospectively from January to December 2024 and prospectively since January 2025. Chi-square tests were applied to determine sensitivity values, specificities, negative predictive value (NPV), and positive predictive value (PPV). ROC analysis was used to compare MEDAN score to the HEART and GRACE scores. Result: This study included 685 patients: 417 with AMI and 268 without AMI. Patients with AMI had higher heart rate as well as HEART, GRACE, and MEDAN scores, but lower systolic blood pressure. The MEDAN score demonstrated a sensitivity of 78.2%, specificity of 60.7%, PPV of 71.2%, and NPV of 69%. The MEDAN score showed good diagnostic ability, outperforming the HEAR score and GRACE score without troponin point, but remained less effective than HEART and GRACE scores when troponin was included. Conclusion: The MEDAN score demonstrates good diagnostic ability for detecting AMI and may serve as practical alternative in healthcare facilities with limited access to biomarker testing.

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