Indonesian Journal of Cardiology 2019-09-17T16:20:16+00:00 [] dr. Sunu Budhi Raharjo, Sp.JP(K), Ph.D, FIHA Open Journal Systems <p><strong>Indonesian Journal of Cardiology (IJC)&nbsp;</strong>is a peer-reviewed and open-access journal established by Indonesian Heart Association (IHA)/<em>Perhimpunan Dokter Spesialis Kardiovaskular Indonesia (PERKI)</em>&nbsp;[] on the year 1979. This journal is published to meet the needs of physicians and other health professionals for scientific articles in the cardiovascular field. All articles (research, case report, review article, and others) should be original and has never been published in any magazine/journal. Prior to publication, every manuscript will be subjected to double-blind review by peer-reviewers. We consider articles on all aspects of the cardiovascular system including clinical, translational, epidemiological, and basic studies.</p> <p>Subjects suitable for publication include but are not limited to the following fields:</p> <ul> <li class="show">Acute Cardiovascular Care</li> <li class="show">Arrhythmia / Cardiac Electrophysiology</li> <li class="show">Cardiovascular Imaging</li> <li class="show">Cardiovascular Pharmacotherapy</li> <li class="show">Cardiovascular Public Health Policy</li> <li class="show">Cardiovascular Rehabilitation</li> <li class="show">Cardiovascular Research</li> <li class="show">General Cardiology</li> <li class="show">Heart Failure</li> <li class="show">Hypertension</li> <li class="show">Interventional Cardiology</li> <li class="show">Pediatric Cardiology</li> <li class="show">Preventive Cardiology</li> <li class="show">Vascular Medicine</li> </ul> The Role of Ticagrelor in STEMI Fibrinolytic and Its Rationale to Utilize for Indonesian Patients 2019-09-17T16:20:16+00:00 Daniel Tobing Dafsah Juzar Achmad Fauzi Yahya Antonia Anna Lukito Doni Firman Sodiqur Rifqi Abdul Hakim Alkatiri Rurus Suryawan <p>Worldwide, ischemic heart disease is the most common cause of death and its frequency is increasing. ST-segment elevation myocardial infarction or STEMIis as form of ischemic heart disease with the highest mortality rate.</p> <p>Based on ESC (European Society of Cardiology) guideline 2017 for STEMI management, reperfusion therapywhich is primary PCI strategy is recommended over fibrinolysis within induced timeframes, but if timely primary PCI cannot be performed after STEMI diagnosis, fibrinolytic therapy is recommended within 12 hours of symptom onset in patients without contraindications. In fibrinolytic therapy, oral aspirin should be given, and Clopidogrel is indicated as an addition to aspirin. Although Clopidogrel is a recommended P2Y<sub>12</sub>receptor inhibitorin fibrinolytic therapy,PERKI guideline 2018 in ACS management also mention thatswitching to Ticagrelor can be considered in patients whowillundergo PCI treatmentafter fibrinolytic.</p> <p>In PLATO study, patients who have acute coronary syndrome with or without ST-segment elevation, treatment with ticagrelor as compared with clopidogrel significantly reduced the rate of death from vascular causes, myocardial infarction, or stroke. However, patients who received fibrinolytic therapy within 24 hours before randomization were excluded. WhileinSET-FAST study, Ticagrelor provides more prompt and potent platelet inhibition compared with Clopidogrel in patients undergoing PCI within 24 hours of receiving fibrinolysis for STEMI. TREAT study was conducted to evaluate the safety of ticagrelor in STEMI patients receiving fibrinolytic therapy within 24 hours.TREAT study concluded, at 30 days observation, in patients younger than 75 years with STEMI, delayed administration of Ticagrelor after fibrinolytic therapy was noninferior to Clopidogrel for TIMI major bleeding.</p> <p>Based on the result from PLATO study and preliminary TREAT study result on 30 days, the use of Ticagrelor within 24 hours after fibrinolytic therapy can be considered with comparable safety profile to Clopidogrel.</p> <p>&nbsp;</p> <p>Keywords: STEMI, fibrinolysis, ticagrelor</p> 2019-09-11T03:43:09+00:00 ##submission.copyrightStatement## Precordial ST Segment Depression on Admission Electrocardiogram as a Simple Noninvasive Tool for Predicting Coronary Artery Disease Complexity in Patients with Inferior Myocardial Infarction 2019-09-17T16:20:15+00:00 Jaya Suganti Anggia Chairuddin Lubis Abdullah Afif Siregar Andika Sitepu Cut Aryfa Andra Ali Nafiah Nasution Harris Hasan <p><strong>Precordial ST Segment Depression on Admission Electrocardiogram</strong></p> <p><strong>as </strong><strong>a Simple Noninvasive Tool for Predicting Coronary Artery Disease Complexity</strong></p> <p><strong>in Patients with Inferior Myocardial Infarction</strong></p> <p><strong>&nbsp;</strong></p> <p>Jaya Suganti<strong>, </strong>Anggia Chairuddin Lubis, Abdullah Afif Siregar, Andika Sitepu, Cut Aryfa Andra,</p> <p>Ali Nafiah Nasution, Harris Hasan</p> <p>&nbsp;</p> <p><em>Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Sumatera Utara, </em></p> <p><em>Haji Adam Malik General Hospital, Medan, Indonesia</em></p> <p><em>&nbsp;</em></p> <p><strong>&nbsp;</strong></p> <p><strong>Background:</strong> Whether a precordial ST segment depression (PSTD) is merely a benign electrical phenomena or a sign of multivessel coronary artery disease (MVCAD) in inferior myocardial infarction (MI) remains unclear. The objective of this study is to analyze the complexity of coronary artery disease (CAD) in inferior MI patients with PSTD and to investigate whether PSTD can be used as a predictor of MVCAD in inferior MI.</p> <p><strong>Methods:</strong> Patients with inferior MI were divided into two groups based on the presence of PSTD on admission ECG and were compared based on the patient’s coronary artery complexities.</p> <p><strong>Results:</strong> A total of 215 patients with inferior MI were found in this study period, with 102 patients meet the inclusion and exclusion criteria. Patients with PSTD had a higher incidence of MVCAD and SYNTAX score. Further analyzes showed PSTD on admission ECG was an independent predictor of MVCAD in inferior MI [45 (66%) vs 23 (34%); OR 4.097; 95% CI 1.638-10.247; p=0.003).</p> <p><strong>Conclusion:</strong> In daily clinical practice, PSTD on admission ECG may serve as a simple noninvasive tool for predicting MVCAD or a more complex CAD in inferior MI.</p> <p>&nbsp;</p> <p><strong>Keywords:</strong> Precordial ST Segment depression, inferior myocardial infarction, SYNTAX score</p> <p><strong>&nbsp;</strong></p> 2019-09-11T03:44:22+00:00 ##submission.copyrightStatement## LEFT ATRIAL STRAIN BY SPECKLE TRACKING ECHOCARDIOGRAPHY IS NOT PREDICTED FUNCTIONAL CAPACITY IN HYPERTENSIVE POPULATION WITH PRESERVED SYSTOLIC FUNCTION AND NORMAL RESTING LEFT ATRIAL PRESSURE 2019-09-17T16:20:14+00:00 Gilang Mauladi Rahman Muhammad Aminuddin Budi S Pikir <p><strong><em>Abstract</em></strong></p> <p><strong><em>Background:</em></strong><em> Hypertension is associated with diastolic dysfunction and impaired exercise capacity. LA has a substantial role to provides an optimal left ventricle diastolic filling. In this study, we aimed to assess the left atrial strain through STE as a predictor of functional capacity in the hypertensive population.</em></p> <p><strong><em>Methods: </em></strong><em>A total of 43 hypertensive women (mean age 50 </em><em>±</em><em> 5.2 y.o; BMI 28.5</em><em>±</em><em> 4.1 Kg/m2) consecutively enrolled in this study. </em><em>Patients with LVEF &lt;50% or significant valvular pathology exclude</em><em>d. Two-dimensional STE performed to asses LA strain parameters, including PALS , PACS, and conduit strain. Functional capacity assessed by treadmill stress test using Bruce protocol.</em></p> <p><strong><em>Result: </em></strong><em>Mean PALS, PACS, and conduit strain in this study was lower than reference normal value 25.8%&lt; 39%; 12.4% &lt;17%; 13.5% &lt;23%, respectively). All of the subjects had a preserved systolic function (mean LVEF 72.5 </em><em>±</em><em> 7.6%) and normal resting LA pressure (mean PCWP 11.96 </em><em>±</em><em> 2.09). Left atrial strain parameters value in the low-fair functional capacity group was not significantly different to average-good functional capacity group (p&gt;0.05). Left atrial strain parameters value was not significantly correlated to exercise duration and achieved METS (P&gt;0.05). </em></p> <p><strong><em>Conclusion: </em></strong><em>LA strain value in this study was below the standard reference limit. LA strain cannot predict functional capacity in the hypertensive population with preserved ejection fraction and normal resting LA pressure. </em></p> 2019-09-11T03:45:02+00:00 ##submission.copyrightStatement## Effect of Sweet Purple Potato (Ipomoea batatas L.) Extract and Vitamin C on Endothelial Progenitor Cell Migration in Stable Coronary Disease Patient 2019-09-17T16:20:13+00:00 Febryanti Hartono Yudi Her Oktaviono Djoko Soemantri <p><strong>Background</strong>: Number and function of <em>Endothelial Progenitor Cells </em>(EPC) are reduced incoronary artery disease (CAD) patient. EPC as progenitor of mature endothelial cell has important role for angiogenesis and neovasculogenesis. Dysfunctional EPC partly because of&nbsp; oxidative stress. Decreasing oxidative stress with antioxidant especially with sweet purple potato extract and vitamin as easily found in Indonesia, may improve EPC migration to ischemic organ in stable CAD patient.</p> <p>Purpose : To analyze effect of sweet purple potato (<em>Ipomoea batatas L.</em>) extract and vitamin C on Endhotelial Progenitor Cell in Stable Coronary Disease patient.</p> <p><strong>Method</strong>: This is experimental post-test control group study. Mononuclear cells (MNC) are isolated from peripheral blood of sample, and cultivated in medium for 3 days, immunofluorescence assay with CD34 as a marker for EPC. EPCs divided into sweet purple potato extract group (1 and 25 mcg/mL), vitamin C group (10 and 250 mcg/mL) and control, incubated for 2 days. 5x10<sup>5 </sup>cell taken from each group and place in upper chamber of Transwell system. EPC migration was assessed in lower chamber of Transwell system after 24 hours using automated cell counters. Statistic testing using ANOVA.</p> <p><strong>Results</strong>: EPC migration was increased significantly in sweet purple potato extract and vitamin C compared with control (3.03 ± 0.01, 2.15 ± 0.03 vs control 1.21 ± 0.04, p&lt;0.01). Increased dose of sweet purple potato extract and vitamin C shows significantly increased of EPC migration (1.81 ± 0.02 vs1.47 ± 0.04 and 3.03 ± 0.01 vs 2.15 ± 0.03, p&lt;0.01). There is significantly diferentiation between sweet potato purple extract and vitamin C (3.03 ± 0.01 vs 2.15 ± 0.03, p&lt;0.01).</p> <p><strong>Conclusion</strong>: Sweet purple potato extract and vitamin C increased EPC migration dose-dependently. Sweet purple potatao extract induces EPC migration better than vitamin C.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</p> <p><strong>Keywords</strong>: EPC migration, Stable CAD, sweet purple potato extract, vitamin C, antioxidant</p> <p><strong>&nbsp;</strong></p> <p><strong>&nbsp;</strong></p> <p><strong>&nbsp;</strong></p> <p><strong>&nbsp;</strong></p> 2019-09-11T03:45:41+00:00 ##submission.copyrightStatement## Advantages of Exercise Training In Hypertrophic Cardiomyopathy: Considering risks and benefits 2019-09-17T16:20:14+00:00 Deddy Tedjasukmana <p><strong>Background.&nbsp;</strong>Hypertrophic cardiomyopathy (HCM) is one of the most common cardiac genetic disorders. The prevalence of this disease is 1 in 500 live births. It is stated to be the most frequent cause of sudden death in young adults. Therefore, some guidelines recommend to restrict physical activity and exercise. On the contrary, latest data show that active lifestyle and exercise in HCM patient provide significant benefits in cardiovascular function with no significant adverse reactions. Following to that, some experts might be reveal that its benefits might be outweigh risks.</p> <p><strong>Summary.&nbsp;</strong>There is a paucity of studies that examine the effectiveness of exercise for HCM. American Heart Association (AHA) and (European Society of Cardiology) ESC established exercise recommendations for HCM individuals based on discussion and consensus of experts. &nbsp;We found three studies that investigate the efficacy of exercise in HCM individuals. Outcomes of our interest were differences in cardiovascular function, quality of life and safety issues. All studies found positive significant differences in main outcomes measure in which the HCM subjects on exercise had better or improved outcomes. None reported adverse reaction such as fatal arrhythmia or sudden death related to exercise.</p> <p><strong>Brief Conclusion.&nbsp;</strong>Old belief regarding exercise restrictions on HCM need to be reconsidered, given that at present exercise have been shown to provide significant benefits for reducing cardiovascular risk factors. Nevertheless, exercise in patients with HCM must be specifically considered regarding the risk and benefit. Practicing active lifestyle and exercise on HCM individual is an exciting possibility that need further study.</p> <p><strong>Keywords: </strong>hypertrophic cardiomyopathy, exercise training, risks and benefit, physical activity</p> 2019-09-11T03:45:18+00:00 ##submission.copyrightStatement##