Indonesian Journal of Cardiology
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Could Cardiac Shockwave Therapy be the Breakthrough Solution for Refractory Angina? A Systematic Review and Meta-Analysis
Get PDFBackground: Refractory angina (RA) is a chronic condition unresponsive to standard treatments like PCI or CABG, leaving limited options for many patients. Cardiac shockwave therapy (CSWT) is a novel, noninvasive approach that enhances myocardial perfusion through microvascular regeneration. This systematic review and meta-analysis evaluate the effectiveness of CSWT in managing RA. Methods: A comprehensive literature search was conducted using electronic databases (Cochrane, PubMed, and ScienceDirect), including comparative studies with controls that evaluated CSWT in RA patients between 2010 and 2024. Studies not in English, with irrelevant outcomes, or lacking full-text access, were excluded. Data were extracted and analyzed using a random-effects model to address heterogeneity. Results: Seven studies, including 3 randomized controlled trials (RCTs) and 4 observational studies, with a total of 417 patients were analyzed. CSWT demonstrated significant improvements in multiple clinical outcomes. CSWT reduces angina severity in CSWT reduces angina severity in CCS grade (MD -0.76, 95% CI -0.97, -0.55, P < 0.00001) and in NYHA class (MD -0.62, 95% CI -0.95, -0.30, P = 0.0002), increased the 6- Minute Walk Test (6MWT) distance by 57.63 meters (MD 57.63, 95% CI 16.71, 98.54, P = 0.006), increased SAQ scores by 10.96 points (MD 10.96, 95% CI 1.66, 20.26, P = 0.02), improved LVEF by 4.43% (MD 4.43, 95% CI: 2.66 to 6.21, P< 0.01), and decreased nitroglycerin usage by 1.62 intake per week (MD -1.62, 95% CI -2.61, -0.62, P = 0.001). However, there was no significant difference in LVEDD between the two groups. Conclusion: CSWT appears to be a promising therapeutic option for patients with RA, demonstrating improvement in CCS angina class, NYHA class, 6-min walk test distances, SAQ score, LVEF, and reduces nitroglycerin usage.
Keyword: Cardiac Shockwave Therapy, Refractory Angina, Non-invasive Cardiac Therapy, Chronic Angina Treatment, Innovative Angina Therapies
 
Mayo Cardiac Intensive Care Unit Admission Risk Score (M-CARS) validation test to assess mortality during treatment in Cardiovascular Care Unit (CVCU) patients at Haji Adam Malik Hospital
Get PDFIn “Mayo Cardiac Intensive Care Unit Admission Risk Score (M-CARS) Validation Test to Assess Mortality During Treatment in Cardiovascular Care Unit (CVCU)Patients at Haji Adam Malik Hospital” (Indonesian Journal of Cardiology, 43(4), 137-43. https://doi.org/10.30701/ijc.1261), there is an error noted.
An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1261. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.126
Transcatheter Closure for Ventricular Septal Defect (VSD): Unveiling Key Predictors in Pediatric Interventions
Get PDFIn “Transcatheter Closure for Ventricular Septal Defect (VSD): Unveiling Key Predictors in Pediatric Interventionse” (Indonesian Journal of Cardiology, 44(3), 95-102. https://doi.org/10.30701/ijc.1571), there is an error noted.
An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1571. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.
The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.157
Breaking Bad News to a Terminally-Diseased Physician in ICCU: A Case Study of Ethical and Cultural Dilemma
Get PDFBackground: Breaking bad news is one of the most problematic tasks for physician. Moreover, local guidelines or recommendations about this is not well established in Indonesia and its practice still varies between physicians.Case Illustration: This paper presents a case of a fellow physician admitted to ICCU with terminal cardiac condition whose family wished to keep the bad news away from the patient. The physician team were in a difficult situation when the patient asked about his condition, but they decided to respect and commit to the family’s decision to not giving information about his terminal state.Conclusions: In performing such problematic task, balancing non-maleficence and autonomy principle is the key. Cultural background differences should also be considered when dealing with such cases. Other important factor that can affect this practice is lack of legal support in Indonesia. Combination of all those factors should always be considered for the best interest of both parties
PEACH Score Validation of Postoperative In-Hospital Mortality in Adult Congenital Heart Disease Patients at Haji Adam Malik General Hospital Medan
Get PDFIn “PEACH Score Validation of Postoperative In-Hospital Mortality in Adult Congenital Heart Disease Patients at Haji Adam Malik General Hospital Medan” (Indonesian Journal of Cardiology, 44(2), 61-7. https://doi.org/10.30701/ijc.1546), there is an error noted.
An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1546. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.154
Utility of Ischemic Signs from Initial ECG in Detecting Culprit Vessels in NSTE-ACS Patients
Get PDFIn “Utility of Ischemic Signs from Initial ECG in Detecting Culprit Vessels in NSTE-ACS Patients” (Indonesian Journal of Cardiology, 44(3), 111-9. https://doi.org/10.30701/ijc.1321), there is an errorsnoted.
An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1321. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.132
From Benign Origins to Final Moments: Right Ventricular Outflow Tract Premature Ventricular Complexes Culminating in Asystole on Holter Monitoring
Get PDFBackground: Premature Ventricular Complexes (PVCs) are a common cardiac arrhythmia typically of benign nature. Their origin, the right ventricular outflow tract (RVOT), is often a point of interest due to its implications in treatment strategies. While the vast majority of PVC RVOT cases remain uneventful, there are isolated incidents that challenge this common perception. Continuous monitoring methods, such as the Holter monitor, have provided invaluable insights into the real-world dynamics of arrhythmias, capturing rare events that can be of paramount clinical significance.
Case Illustration: A 60-year-old female, presented to Harapan Kita Hospital Jakarta in May with palpitations. Over several visits, physical examinations consistently indicated a heart within normal parameters, absent of murmurs or gallop. Successive ECGs revealed persistent PVCs of RVOT origin. Despite medical intervention, her arrhythmic pattern persisted. By September, her symptoms had diversified, including occasional chest pain, nausea, and dyspnea. An ECG, yet again, confirmed PVCs with RVOT origin. During a Holter monitoring session on September, a distressing sequence of events was captured. The monitor initially registered a non-sustained Ventricular Tachycardia (VT). which escalated to sustained VT, ventricular fibrillation, and culminating in asystole, marking the patient's final moments.
Conclusions: The pathophysiological journey from benign PVCs of RVOT origin to a fatal arrhythmic event underscores the unpredictability and inherent dangers of cardiac arrhythmias. This case is a reminder of the critical importance of persistent monitoring, timely interventions, and the nuanced understanding of conditions conventionally deemed 'benign'
Usefulness of The CHADS2 and CHA2DS2-VASc Scores in Predicting In-Hospital Mortality in Acute Coronary Syndrome Patients: A Single-Center Retrospective Cohort Study
Get PDFIn “Usefulness of The CHADS2 and CHA2DS2-VASc Scores in Predicting In-Hospital Mortality in Acute Coronary Syndrome Patients: A Single-Center Retrospective Cohort Study” (Indonesian Journal of Cardiology, 44(1), 17-27. https://doi.org/10.30701/ijc.1294), there is an error noted.
An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1294. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.The publisher apologizes for any inconvenience caused by this error.
DOI of original article: https://doi.org/10.30701/ijc.129
Exploring Clinical and Echocardiographic Factors in EHRA Type 2 Atrial Fibrillation for Predicting Ischaemic Stroke: A Search for Unrevealed Insights
Get PDFIn “Exploring Clinical and Echocardiographic Factors in EHRA Type 2 Atrial Fibrillation for Predicting Ischaemic Stroke: A Search for Unrevealed Insights” (Indonesian Journal of Cardiology, 44(3), 87-94. https://doi.org/10.30701/ijc.1562), there is an error noted.
An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1562. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.156
Peran Skor Kalsium Arteri Koroner sebagai Penanda Sistemik Aterosklerosis: Studi Pencitraan Potong Lintang
No full textBackground. Coronary Artery Calcium Score (CACS) is widely used to assess coronary atherosclerosis. However, its utility in reflecting systemic atherosclerosis burden remains limited. Notably, no prior study has investigated the relationship between CACS and plaque morphology in the lower extremities. This study aimed to address this gap by examining the association between CACS, ankle-brachial index (ABI), and peripheral arterial plaque morphology as assessed by duplex ultrasonography.
Methods. This single-center, cross-sectional study enrolled 100 consecutive patients who underwent coronary CT angiography and lower extremity Doppler ultrasound between November 2024 and May 2025. CACS was calculated using Agatston method. ABI and Doppler-based plaque morphology were evaluated to determine the presence, severity, and complexity of peripheral artery disease (PAD).
Results. A moderate inverse correlation was found between CACS and ABI (r = -0.628, p < 0.001), while a moderate positive correlation was observed between CACS and plaque morphology (r = 0.619, p <0.001). CACS showed good discriminatory power for detecting peripheral plaque (AUC = 0.765), and excellent performance in identifying advanced plaque types (III-IV) at a threshold of 478.5 HU (AUC = 0.852; sensitivity 68%; apecificity 91.7%).
Conclusion. This is the first study to demonstrated a direct association between coronary calcium burden and plaque morphology in the lower extremities. These findings highlight the potential role of CACS as a surrogate marker for systemic atherosclerosis and a valuable tool for identifying asymptomatic individuals who may benefit from peripheral arterial evaluation.Latar Belakang. Skor Kalsium Arteri Koroner (Coronary Artery Calcium Score / CACS) banyak digunakan untuk menilai aterosklerosis koroner. Namun, pemanfaatannya dalam mencerminkan beban aterosklerosis sistemik masih terbatas. Hingga kini, belum ada penelitian yang menyelidiki hubungan antara CACS dan morfologi plak pada ekstremitas bawah. Penelitian ini bertujuan untuk mengisi kesenjangan tersebut dengan mengkaji hubungan antara CACS, ankle-brachial index (ABI), dan morfologi plak arteri perifer yang dinilai dengan ultrasonografi dupleks.
Metode. Penelitian potong lintang di satu pusat ini melibatkan 100 pasien berturut-turut yang menjalani angiografi CT koroner dan ultrasonografi Doppler ekstremitas bawah antara November 2024 hingga Mei 2025. CACS dihitung menggunakan metode Agatston. ABI dan morfologi plak berbasis Doppler dievaluasi untuk menentukan keberadaan, tingkat keparahan, dan kompleksitas penyakit arteri perifer (Peripheral Artery Disease / PAD).
Hasil. Ditemukan korelasi negatif sedang antara CACS dan ABI (r = -0.628, p < 0.001), sedangkan korelasi positif sedang ditemukan antara CACS dan morfologi plak (r = 0.619, p < 0.001). CACS menunjukkan kemampuan diskriminasi yang baik untuk mendeteksi plak perifer (AUC = 0.765), dan kinerja yang sangat baik dalam mengidentifikasi tipe plak lanjut (III–IV) pada ambang 478,5 HU (AUC = 0.852; sensitivitas 68%; spesifisitas 91,7%).
Kesimpulan. Penelitian ini merupakan yang pertama menunjukkan hubungan langsung antara beban kalsium koroner dan morfologi plak di ekstremitas bawah. Temuan ini menyoroti potensi peran CACS sebagai penanda pengganti aterosklerosis sistemik dan sebagai alat berharga untuk mengidentifikasi individu tanpa gejala yang mungkin mendapatkan manfaat dari evaluasi arteri perifer