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Anna Fuji Rahimah
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
Health Professions Immunology & microbiology Medicine & Pharmacology

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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (32.966 KB) | DOI: 10.21776/ub.hsj.2020.001.02.6

Abstract

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.
Arrhyhthmogenic Right Ventricular Cardiomyopathy: From Clinical Presentation to Diagnostic and Therapeutic Challenges - A Case Report Olivia Handayani; Ardian Rizal; Anna Fuji Rahimah
Heart Science Journal Vol 1, No 2 (2020): The Assessment of Diagnostic and Treatment Modality in Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (28.87 KB) | DOI: 10.21776/ub.hsj.2020.001.02.7

Abstract

The diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC) remains challenging. Detailed echocardiography is a sensitive tool for identifying structural and functional when ARVC is suspected. A thorough assessment of cardiac magnetic resonance imaging is required to further establish the diagnosis. This case illustration aimed to broaden the awareness of right ventricular cardiomyopathy among physicians, establishing the appropriate diagnostic approaches, and sensible use of implantable cardioverter-defibrillators may help to prevent unnecessary deaths.
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.
Secondary Hypertension due to Abdominal Coarctation; How do we identify and manage it?: A Case Report Oktafin Srywati Pamuna; Novi Kurnianingsih; Anna Fuji Rahimah; Heny Martini
Heart Science Journal Vol 3, No 3 (2022): Cardiovascular Disease in Young Adulthood: Who, When, and How to Screen?
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.03.6

Abstract

BackgroundCoarctation of the abdominal aorta (AoA) is a very uncommon condition, accounting for 0.5-2 percent of all aortic stenosis cases. We present an 11-year-old child who has been diagnosed with abdominal aorta coarctation. Case IllustrationAn 11-years old boy complained about dizziness since 1.5 years ago with hypertension. He underwent hypertension treatment for 1.5 years with a pediatrician but there is no improvement in his blood pressure. His current blood pressure was 150/95 mmHg in upper extremities and 120/80 mmHg in lower extremities with three antihypertensives drugs. We found bruit in the abdomen and decreases pulse in lower extremities. An echocardiogram shows no congenital defect. The first was on suspicion of renal stenosis and underwent ultrasonography of the abdomen but was not conclusive. Computed Tomography Angiographic (CTA) showed severe stenosis in the abdominal aorta on level thoracal 11-12. Aortogram shows significant stenosis in the abdominal aorta with a pressure gradient was 47 mmHg. He underwent percutaneous transluminal angioplasty with BMS self-stent implantation. At two months of follow up his blood pressure target was achieved with a minimal dose of oral antihypertensive drugs DiscussionHow to diagnose coarctation of the abdominal aorta is still challenging and often underdiagnosed. Patients with young age and persistent hypertension should be more careful in diagnosis. A  bruit in the abdomen with a weak pulse in the lower extremity raises suspicion of Coarctation of the Abdominal Aorta. An angioplasty procedure, either with or without a stent or a surgery might be used as the primary therapy. 
Neutrophil-Lymphocyte Ratio value as a predictor of Troponin Elevation in patients with Non-ST Segment Elevation Acute Coronary Syndrome Lutfi hafiz zunardi; Setyasih Anjarwani; Indra Prasetya; Anna Fuji Rahimah
Heart Science Journal Vol 5, No 1 (2024): Inflammation and Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.01.2

Abstract

Acute coronary syndrome (ACS) is a prominent contributor to mortality and morbidity on a global scale, consistently ranking within the top five primary causes. Inflammation is one of the many elements that have a role in the pathophysiology of the development and destabilization of plaque atherosclerosis in ACS. Troponin is a component of a biomarker that signals damage to the heart muscle in ACS patients; however, at the present time, not all medical facilities are able to perform troponin testing. An acute myocardial infarction begins with an initial inflammatory process that generates proinflammatory cytokines at the cellular level. This can be evaluated by the NLR through peripheral blood tests. The NLR as an indication of systemic inflammation has been demonstrated to be associated with poor clinical outcomes, an increased risk of complications, and mortality in ACS patients. In addition, several studies showed that the NLR has prognostic value in patients with ACS. The NLR is a mix of inflammatory markers, which can be a predictor of increased troponin in cases of non-ST segment elevation acute coronary syndrome (NSTEACS) in an emergency room.
Neutrophil-Lymphocyte Ratio (NLR) as A Predictor for Non-ST Elevation Myocardial Infarction (NSTEMI) in the Emergency Room Lutfi Hafiz Zunardi; Setyasih Anjarwani; Indra Prasetya; Budi Satrijo; Anna Fuji Rahimah
Heart Science Journal Vol 5, No 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.03.7

Abstract

AbstractBackground: The usefulness of the NLR as an approach to identifying cases of acute coronary syndrome (ACS) needs to be improved.Objective: This research was designed to determine the effectiveness of the NLR in identifying individuals who presented to the emergency room complaining of anginal due to ACS.Methods: The single-center cross-sectional study was performed at Saiful Anwar General Hospital in Malang, East Java, Indonesia, from July 2020 to December 2023. Patients were involved in this study with complaints of angina suspected of ACS. During further observation in the emergency room, based on the findings of the troponin I analysis, individuals were divided into unstable angina pectoris (UAP) and NSTEMI.Results: Study results were collected from 282 individuals diagnosed with Non-ST Elevation Acute Coronary Syndrome (NSTEACS), with 75.9% male and a mean age of 58.39 ± 10.27 years. The NLR threshold was 4.5 (AUC: 0.78, 95% CI: 0.765–0.867, P <.001) assessed during admission, which showed a sensitivity of 79% and a specificity of 78% in accurately predicting the probability of subsequent troponin positivity. Multivariate analysis revealed that the NLR at hospitalization remained an essential marker of troponin positivity during follow-up.Conclusions: In the end, NLR could be considered an initial test in emergency services to predict the diagnosis of NSTEMI in people experiencing angina. 
Validation of Self-Assessment-Based Chest Pain Algorithm (DETAK) as An Early Identification Tool for Acute Coronary Syndrome Krishna Ari Nugraha; Mohammad Saifur Rohman; Anna Fuji Rahimah; Setyasih Anjarwani; Ardian Rizal; Tri Astiawati; Andi Wahjono Adi; Lina Haryati
Heart Science Journal Vol 4, No 4 (2023): The Science and Art of Caring for Critically III Patients in Intensive Cardiac C
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.04.5

Abstract

BackgroundThe most common reason of prehospital delay in ACS patients is inability to pay attention to symptoms in order to act fast and effectively. Patient oriented machine learning algorithms has the opportunity to reduce the total ischemic time, that determines the clinical outcome of ACS patients.AimAssessing the accuracy of the chest pain self-assessment algorithm (DETAK) in identifying ACS.MethodThis study included seven hospitals, five PCI capable hospitals and two of non-PCI capable hospitals. The study was conducted from August 2021 to June 2022. The study included all patients with chest pain who visited the hospital and used the DETAK algorithm. Patients were interviewed after being confirmed hemodynamically stable. Patients with UAP, as well as those who died or declined to participate in this study were excluded. The area under the curve receiver operating characteristic (AUROC) was used to verify DETAK's performance in identifying SKA. We compare the DETAK algorithm's diagnosis with the definitive diagnostic based on ECG and/or troponin results.ResultsA total of 539 patients (mean age 58 years) with a higher proportion of male patients (n=424). An AUC value of 0.854 was obtained, where the cut of point accuracy of DETAK in identifying ACS for the entire sample had a sensitivity of 89.5% and a specificity of 81.2%. The algorithm's specificity decreased in certain subgroups, including type 2 diabetes (79.4%), women (77.3%), and hypertensive patients (80.9%). Algorithm reliability test obtained moderate to strong level of agreement values.ConclusionDETAK's self-assessment-based chest pain algorithm offers an excellent diagnostic performance in early identification of ACS.
Clinical Features and Multimodality Diagnostic Tools of Pulmonary Hypertension Lukitasari Ayu Galuh; Anna Fuji Rahimah; Heny Martini; Ardian Rizal
Heart Science Journal Vol 5, No 2 (2024): Challenges in the Management of Congenital Heart and Structural Heart Diseases
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub/hsj.2024.005.02.4

Abstract

Pulmonary hypertension (PH) is characterized by an increase in mean pulmonary artery pressure (mPAP) above normal, which is > 20 mmHg and an increase in pulmonary vascular resistance (pulmonary vascular resistance / PVR) above normal, in resting conditions.The pathophysiology of PH involves remodeling of the pulmonary vessels, from the main pulmonary arteries, lobar arteries, segmental arteries, distal arteries, pulmonary arterioles, capillaries to the postcapillary pulmonary veins. In general, the epidemiological figures for PH are not known with certainty. The UK reported a PH prevalence of 97 cases/1,000,000 population with a female:male ratio of 1.8. The diagnostic approach to PH is mainly focused on two things. The primary goal is to raise the initial suspicion of PH and ensure fast-track referral to a PH center in patients with a high probability of PAH, CTEPH, or other forms of severe PH. The second aim is to identify the underlying disease, particularly left heart disease (Group 2 PH) and lung disease (Group 3 PH), as well as comorbidities, to ensure appropriate classification, risk assessment, and treatment. The Gold Standard diagnosis and classification of pulmonary hypertension is by examining the right heart catheterization (RHC). Clinical scoring in the form of shortness of breath without any obvious cause accompanied by physical examination, ECG and Thorax X-ray images which depict an enlarged right heart have good sensitivity and specificity for the diagnosis of pulmonary hypertension in patients with congenital heart disease. A high right ventricular pressure, mean PAP, and BNP values during observation, as well as heart size on chest X-ray can be predictors of a poorer prognosis in this population.
Co-Authors Aditha Satria Maulana Andi Wahjono Adi Ardian Rizal Budi Satrijo Djanggan Sargowo Fajar, Jonny Karunia Heny Martini Indra Prasetya Krishna Ari Nugraha Lina Haryati Lukitasari Ayu Galuh Lutfi Hafiz Zunardi Lutfi hafiz zunardi Mohammad Saifur Rohman Mohammad Saifur Rohman Novi Kurnianingsih Oktafin Srywati Pamuna Olivia Handayani Setyasih Anjarwani Tri Astiawati Veny Kurniawati