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Heny Martini

Department Of Cardiology And Vascular Medicine, Faculty Of Medicine, Universitas Brawijaya, Malang, Indonesia.

Author-ID : 3606284

Health Professions Immunology & microbiology Medicine & Pharmacology

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Case Report: Role of Rotational Atherectomy in Complex PCI Seprian Widasmara; Mohammad Saifur Rohman; Heny Martini; 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.2021.002.03.7

Background : One in three patients undergoing percutaneous coronary intervention (PCI) exhibits moderate or severe coronary artery calcification. Coronary calcification remains a major independent predictor of PCI failure and adverse outcomes. PCI of calcified coronary lesions remains challenging, despite significant improvements in the available tools and techniques. Rotational Atherectomy (RA) is a critical component to improve PCI success in these situations by producing lumen enlargement by physical removal of plaque and reduction in plaque rigidity, thus facilitating dilationCase Illustration: A 73-year-old man with exertional angina was referred to our hospital, with a history of hypertension, diabetes mellitus, ex-smoker and dyslipidemia. Physical exam, electrocardiogram, chest x-rays, and laboratory findings were unremarkable, but transthoracic echocardiogram revealed anterior wall hypokinesis. History of cardiac catheterization outside of our center with angiographic result of left anterior descending (LAD) lesion, highly calcified, non-dilatable on first several POBA attempts. Coronary angiography at our center, revealed diffuse calcification from proximal to distal of the LAD artery with about 90% maximum stenosis in mid LAD. RA (Rotablator, Boston) was then performed with A 1.50 mm burr gradually advanced at 150,000 rpm to passed the lesion. After deployments of stents, final angiogram showed well positioned stents with good distal run-off flow. The patient was uneventful during the procedure and was discharged following day. Discussion: In experienced hands, RA is as safe as standard PCI. RA is as a tool to make PCI possible in complex lesions with moderate or severe calcification when clinical variables make PCI appropriate. Rotablator is a catheter-based interventional cardiology procedure using a high-speed rotational device designed to ablate atherosclerotic plaque and restore luminal patency. This help to facilitate stent delivery, avoiding the barotrauma caused by repeated high-pressure balloon inflations that can lead to vessel dissection or perforation. Atherectomy can be performed safely with optimal burr selection and proper ablation techniques, and as a result, complication rates have been significantly minimized, with few changes in the acute complications reported in contemporary studies. Keywords: percutaneous coronary intervention, calcified lesion, rotational atherectomy.

Cardiomyopathy in Pregnancy: A Review Literature Ayu Asri Devi Adityawati; Anna Fuji Rahimah; Heny Martini; Cholid Tri Tjahjono
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.2021.002.01.03

AbstractBACKGROUND: Pregnancy is an experience that many women can achieve. Pregnancy is generally well tolerated in asymptomatic patients with cardiomyopathies but in restrictive form cardiomyopathy, pregnancy cannot be tolerated because of poor prognosis. Prior cardiac events, poor functional class (New York Heart Association class III or IV), or advanced left ventricular systolic dysfunction are present, the risk of maternal cardiac complications during pregnancy are markedly increased. Worsening of the clinical condition can occur during pregnancy, despite intensive medical treatment. Although the incident of cardiovascular disease is present 0.5-4% in developed countries, our knowledge about various of cardiomyopathy and pregnancy should be updateable.CONCLUSION: Our literature provide three types of cardiomyopathy in pregnancy with an example condition for each type that relevant during pregnancy. Peripartum cardiomyopathy is the most common form of cardiomyopathy occured in pregnancy therefore a thorough review is needed to give best outcome for pregnancy. Arryhtmia is the commonnest form in hypertrophic cardiomyopathy which need to be regularly monitored and measure should be taken if the arryhtmia is life threatening for mother and the child. Cardiac amyloidosis is the common form of restrictive cardiomyopathy in pregnancy.Keywords: Pregnancy; Cardiomyopathy; Peri Partum Cardio Myopathy (PPCM), Pregnancy, Heart Failure

Percutaneous Coronary Intervention as Clinical Outcome Predictor for in-Hospital Adverse Events in STEMI Patients Anita Surya Santoso; Mohammad Saifur Rohman; Ardian Rizal; Setyasih Anjarwani; Heny Martini; Indra Prasetya
Heart Science Journal Vol 3, No 2 (2022): Improving ST-Elevation Myocardial Infraction Patients Prognosis
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.02.3

Background : Limited resources and the concurrent COVID19 pandemic hinders the appropriate time to achieve reperfusion in Infarct-related artery (IRA). The number of patients receiving late primary PCI (PPCI) and without revascularization are steadily increase within 2 years into the pandemic. The impact of PCI timing in this setting has not been fully elucidated.Objective : This study was conducted to evaluate the effect of early PPCI vs late PPCI vs non revascularization groups towards in-hospital mortality and complications. This study also aimed to determine whether PPCI is the main predictor for in-hospital adverse events in STEMI patients.Method : Data of STEMI patients registered in Saiful Anwar General Hospiital ACS registry were collected between 2018-2021 Patients were subdivided into early PPCI if receiving PCI within the recommended time of the 2017 ESC STEMI management guideline, late PPCI if receiving PCI outside the timeframe provided by the guideline, and optimal medical therapy group if not receiving any means of revascularization. Patients undergoing thrombolysis were excluded. Afterwards, the incidence of in-hospital adverse event were calculated as primary endpoints, development of immediate complications during hospitalizations were analyzed as secondary endpoints. Stratification of baseline characteristics and PCI categorizations were performed using multivariate analysis to determine the main predictor of in-hospital mortality between STEMI patients.Results : 568 STEMI patients were included in the study with 387 in early PPCI, 107 in late PPCI, and 74 in optimal medical therapy group. Incidence of in-hospital mortality were significantly higher in optimal medical therapy group and lowest in early PPCI group (32.4% and 7.5% respectively, P 0.00). Mortality odds ratio between early PPCI group and optimal medical therapy group were significantly lowest (OR 0.17, 95% CI 0.13 – 0.41). Complications between each treatment groups were significantly different with early PPCI had the lowest incidence of in-hospital complications of cardiogenic shock, cardiac arrest, and VT/VF. Stratification of baseline characteristics and PCI category reveals that timing PPCI is the main predictor for in-hospital adverse events (HR 4.506, 95% CI 2.487-6.662, P 0.00). Conclusion : Percutaneous coronary intervention is the main predictor for the incidence of in hospital mortality and complications in STEMI patients.Keyword : STEMI, PCI, mortality, complications, in-hospital adverse events.

Right-Sided Heart Failure Presentation in Severe Valvular Aortic Stenosis: How to Deal with Diuretic Use? Fahmy Rusnanta; Cholid Tri Tjahjono; Anna Fuji Rahimah; Heny Martini
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.2021.002.01.07

BACKGROUND: Patients with right-sided heart failure and severe aortic stenosis (AS) have many clinical challenges to overcome fluid retention. Typical diuretic therapeutic approach can be recommended for the guidance of removing fluid overload in severe AS with right ventricular (RV) failure. The aim of this case review is to understand how to assess and manage RHF and severe AS. CASE SUMMARY: A 65-year-old female with worsening bilateral leg swelling and she aware of shortness of breath for 3 months. Physical examination revealed a grade 3/6 ejection systolic murmur at the aortic area radiating to the neck, a grade 2/6 diastolic murmur at the pulmonic area, and a grade 3/6 systolic murmur at the apex radiating to the axilla, increased jugular venous pressure, prominent bilateral leg swelling, and minimal rhonci at the base of the lungs. The chest X-ray showed worsening cardiomegaly in the last 3 months. Echocardiography revealed high gradient severe valvular AS, decreased systolic RV function, and other valvular dysfunctions including moderate mitral regurgitation, moderate pulmonary regurgitation, and mild tricuspid regurgitation. She was introduced high dose furosemide infusion. The average urine output production was 5 L/day and negative fluid balance was 3 L/day. Furosemide dose was adjusted daily according to urine output production and she was discharged after 6 days hospitalization. DISCUSSION: This case report provides an example of RV failure in severe AS patient. Hemodynamic monitoring and typical approach of diuretic therapies should be needed in the management of fluid overload in severe AS. KEYWORDS: right-sided heart failure, severe aortic stenosis, diuretic.

The Effect of Garcinia Mangostana Linn Extract to The Levels of Circulating Endothelial Cells and Endothelial Progenitor Cells in Patients with High Framingham Score Aditha Satria Maulana; Djanggan Sargowo; Ardian Rizal; Heny Martini; Mohammad Saifur Rohman; Anna Fuji Rahimah; Jonny Karunia Fajar
Heart Science Journal Vol 1, No 2 (2020): The Assessment of Diagnostic and Treatment Modality in Heart Failure
Publisher : Universitas Brawijaya

Background : Recently, studies have concerned on the use of xanthones for treating patients with cardiovascular diseases. In our country, xanthones were found in Garcinia Mangostana Linn.Objectives : To assess the effect of Garcinia Mangostana Linn Extract (GMLE) to the levels of Circulating Endothelial Cells (CEC) and Endothelial Progenitor Cells (EPC) in patients with high framingham score.Methods : A prospective cohort study was conducted from November 2018 to January 2019. The patients were divided into two groups. The first group was given 2520 mg/day of GMLE for 90 days and the second group was given placebo. In sub group analyses, patients were divided based on previous medication, including statin, statin and angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB), statin and oral antidiabetic drugs (OAD), and statin and ACEI or ARB and OAD. The outcome measures were CEC and EPC levels, measured at baseline and after 90 days of treatment. We used multiple linear regression to analyze the correlation and effect estimates.Results: A total of 72 patients was included in our study. All of the patients baseline characteristics were distributed homogeneously (p>0.05). Our findings confirmed that GMLE administration was associated with decreased CEC level compared to placebo. On other hands, increased EPC level compared to placebo was observed after GMLE administration. In sub-group analyses, our study found that the combination of GMLE with statin and ACEI or ARB and the combination of GMLE with statin and ACEI or ARB and OAD were associated with decreased level of CEC compared to placebo, with the odd ratios were 0.12 and 0.18, respectively. Conversely, increased level of EPC was observed in subjects receiving the combination of GMLE with statin and ACEI or ARB and the combination of GMLE with statin.Conclusion: Administration of GMLE as adjuvant therapy is associated with the improvement of CEC and EPC levels in patients with high framingham scores.

The Role of STEMI Communication Network in Malang with Major Adverse Cardiac Event (MACE) Incidence in STEMI Patients Hospitalized in Saiful Anwar General Hospital Malang Adhika Prastya Wikananda; Lenny Kartika; Dadang Hendrawan; Heny Martini; Mohammad Saifur Rohman
Heart Science Journal Vol 2, No 4 (2021): Management of Thrombosis in Covid-19 Patient with Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.04.3

Background: Patient with STEMI requires urgent reperfusion either with fibrinolytic or primary PCI. In Malang, a communication network of STEMI has been developed. It connects Saiful Anwar General Hospital with all of the PHC in Greater Malang to shorten system delay since 2015.Objective: To elucidate Malang’s communication network’s role in decreasing MACE (Major Adverse Cardiac Event) in STEMI patients.Methods : This is a retrospective cohort study. Study sample was taken from medical record. Non-network: 96 patients and 88 network patients. Statistical tests using SPSS and PLS, α value 0.05 and t-test is significant if more than 1.96.Results: Bivariate analysis shows network-group has a significantly lower MACE (p=0.001). Door-to-balloon time is also lower in network-group (p=0.026). Multivariate analysis without confounder shows that network-group has significantly shorter door-to-reperfusion time (p=0.032) and lower MACE (p=0.035) compared to non-network group. But multivariate analysis with confounder door-to-balloon and door-to-needle fails to explain lower MACE incidence. Network-group (p=0.005) and reperfusion with primary PCI (p=0.05) significantly decrease MACE incidence.Conclusion: Malang’s STEMI communication network and reperfusion with primary PCI reduce MACE in STEMI patients in Saiful Anwar General Hospital Malang.

Impacts of Residual SNYTAX Score on The Clinical Outcomes following Percutaneous Coronary Intervention in Chronic Coronary Syndrome Patients Wira Kimahesa Anggoro; Mohammad Saifur Rohman; Heny Martini; Pawik Supriadi; Cholid Tri Tjahjono; Yoga Waranugraha
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.2021.002.03.4

Background: The residual SYNTAX score (RSS) can be used to measure the residual stenosis severity and complexity. The prognostic role of RSS in CCS patients is still unknown. We purposed to investigate the impact of RSS on the clinical outcomes following PCI in CCS patients. Methods: A prospective cohort study was performed. Based on the residual SYNTAX score, patients were divided into three groups: RSS 0, RSS 0 to 9.5, and RSS >9.5. The primary outcome was patient-oriented composite endpoint (POCE), including repeat revascularization, myocardial infarction, and all-cause mortality. Results: After 1-year follow-up period, patients in RSS >9.5 group revealed the greater POCE (4.3% vs. 6.4% vs. 23.9%; p = 0.016) than others. The repeat revascularization rate also was greater in the RSS >9.5 group (0.0% vs. 6.4% vs. 19.6%; p = 0.012). However, the hospitalization due to angina rates in all groups was not significantly different (4.3% vs. 4.2% vs. 4.3%; p = 1.000). The multivariate analysis revealed that RSS >9.5 was the strong predictor for repeat revascularization during 1 year follow-up (Odds ratio [OR] = 9.605; 95% confidence interval [CI] = 1.207 - 76.458; p = 0.033). Conclusion: The greater RSS was associated with the higher 1-year POCE and repeat revascularization rate in CCS patients. The high RSS was also the strong predictor for 1-year repeat revascularization for CCS patients.

Responders vs Non-responders to Cardiac Resynchronization Therapy: A Review Article Aris Munandar Zulkifli Ismail; Ardian Rizal; Heny Martini; Novi Kurnianingsih
Heart Science Journal Vol 1, No 2 (2020): The Assessment of Diagnostic and Treatment Modality in Heart Failure
Publisher : Universitas Brawijaya

More than two decades after the introduction of cardiac resynchronization therapy (CRT) into clinical practice, respond to highly effective treatments for refractory drug heart failure (HF) approximately one-third of candidates persist to fail. This article will discuss indications for initiating a CRT, the definition of a response to a CRT, steps in response to a CRT, predictors of a CRT response, clinical judgment of patients who do not respond to CRTs, and elimination for possible reversible non-response causes. Here we have reviewed non-response CRTs in many ways. In short, multidisciplinary efforts are needed to overcome them because of the multifactorial causes of non-response (NR). So far, several factors has slowed the progress, such as limitations of NR consensus definitions and technology for therapeutic delivery.Keywords: Cardiac Resynchronization Therapy, Responder, Non-responder

Poor Adherence to Secondary Prophylaxis is Associated with More Severe Rheumatic Valve in Pediatric Patients: A Cross-Sectional Study Taufieq Ridlo Makhmud; Mohammad Saifur Rohman; Renny Suwarniaty; Djanggan Sargowo; Faris Wahyu Nugroho; Annisa Hasanah; Bambang Kusbandono; Citra Tarannita; Ratih Kusuma Wardani; Sasmojo Widito; Heny Martini
Heart Science Journal Vol 1, No 1 (2020): The Importance of Adherence to The Guidelines
Publisher : Universitas Brawijaya

Background : Rheumatic heart disease (RHD) contributed to a large number of proportion amoung cardiovascular problems in developing county, especially Indonesia. Secondary prophylaxis method using intramuscular injection of Benzathin Penicillin-G (BPG) has been known as the most effective strategy in the prevention of RHD. However, whether this prevention method also resulting in prevention of disease severity in Indonesian patients remained to be examined.Objectives : This study aimed to assess the difference of rheumatic valve severity in Indonesian pediatric patients between adequate and poor adherence to secondary prophylaxis by using intramuscular BPG injection.Methods : This cross-sectional study was conducted at Pediatric Cardiology Department of Saiful Anwar General Hospital from November 2018 to June 2019. Patients with documented history of RHD were included. Frequency of intramuscular BPG injection during the last one year was recorded. Adherence was measured using the proportion of days covered (PDC) and adequate adherence was defined as PDC ≥0.90. The severity of RHD was assessed based on the severity of the mitral and / or aortic valve using echocardiography. Bivariate analysis and multivariate logistic regression analysis was used to identify characteristics associated with rheumatic valve severity.Results : A significant difference of rheumatic mitral and/or aortic valve severity was observed between adequate adherence compared to poor adherence group (p = 0.016). Rheumatic mitral and/or aortic valve were found to be more severe in patients who has one or more episode of ARF recurrence (p = 0.003). Multivariate logistic regression analysis demonstrated that adherence to secondary prophylaxis within the last 1 year has the strongest influence on the severity of rheumatic mitral and/or aortic valve (p = 0.049; OR 7.20).Conclusion : The adherence to secondary prophylaxis has the strongest related the rheumatic valve severity compared to other factors.

Coronavirus Infection Induced Coagulopathy As A Trigger Factor Of Arterial Thrombosis In Patient With Atherosclerotic Risk Factor: A Case Report Irma Kamelia; Heny Martini; Novi Kurnianingsih; Indra Prasetya
Heart Science Journal Vol 2, No 4 (2021): Management of Thrombosis in Covid-19 Patient with Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.04.8

Background : A newly emerging pandemic of Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory coronavirus 2 is responsible for significant morbidity and mortality worldwide. As one of the effects is hematological changes related to the COVID-19 infection causing patient tend to thrombosis than hemorrhagic. Current review of evidence and statements on management of coagulopathy and thrombotic complications related to this novel disease is needs to be exploredCase : Male 53 years old referred from Private Hospital, due to Severe pneumonia due to COVID-19 and Acute Limb Ischemia. This patient was assessed as Pneumonia COVID-19 severe with acute limb ischemia bilateral grade IIB and performed bilateral surgical thrombectomy with antegrade approach using fogarty catheter with the result was thrombus 10cm along the left femoral artery and thrombus 2cm in the right femoral artery. Discussion : With consideration of atherosclerotic diseases in this patient, we decided to give rivaroxaban as an anticoagulant combined with aspilet and statin high dose. But due to lack of source in our hospital, and patient also denied for further management, treatment for the patient cannot be optimal, so the patient discharge with unresolved limb ischemia.Conclusion : This case showed that the increase risk of heparin resistance in SARS-CoV-2 patient, it is recommend- ed to monitor heparin activity of UFH treatment based on anti-Xa levels instead of aPTT alone

Co-Authors Adhika Prastya Wikananda Aditha Satria Maulana Anita Surya Santoso Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Anna Fuji Rahimah Annisa Hasanah Ardian Rizal Ardian Rizal Arif Wicaksono Aris Munandar Zulkifli Ismail Ayu Asri Devi Adityawati Bambang Kusbandono Budi Satrijo Cholid Tri Tjahjono Citra Tarannita Dadang Hendrawan Dea Arie Kurniawan Djanggan Sargowo Djanggan Sargowo Fahmy Rusnanta Fajar, Jonny Karunia Faris Wahyu Nugroho Indra Prasetya Indra Prasetya Indra Prasetya Indra Prasetya Irma Kamelia Lenny Kartika Lukitasari Ayu Galuh Lutfi hafiz zunardi Mohammad Saifur Rohman Novi Kurnianingsih Novi Kurnianingsih Oktafin Srywati Pamuna Pawik Supriadi Putri Annisa Kamila Ratih Kusuma Wardani Renny Suwarniaty Sasmojo Widito Seprian Widasmara Setyasih Anjarwani Taufieq Ridlo Makhmud Wira Kimahesa Anggoro Yoga Waranugraha

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