Indonesian Journal of Cardiology
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Effects of High-Intensity Interval Training on Cardiovascular Function and Risk Factors, Functional Impairments, and the Quality of Life in Coronary Artery Disease Patients: A Narrative Review
Get PDFBackground: Coronary artery disease (CAD) causes damage to the cardiovascular system that leads to functional and quality of life (QoL) deterrence. Cardiac rehabilitation (CR) aims to improve cardiorespiratory fitness (CRF) to prevent disease progression and its risk factors. Aerobic exercise (AE) causes different physiological effects depending on the applied intensity. High-intensity interval training (HIIT) is being developed because of better effectivity than moderate-intensity continuous training (MICT). Even so, HIIT has not been prescribed generally. This review aimed to describe the effects of HIIT on cardiovascular function and risk factors, functional impairments, and the QoL.
Methods: Articles were searched using PubMed and CINAHL databases with the keywords “high-intensity interval training”, “cardiac rehabilitation”, “exercise-based cardiac rehabilitation”, and “coronary artery disease”.
Results: Twenty-two articles were found and used to explain sub-topics.
Discussion: HIIT improves ventricular function, LVEF, heart contractility, and endothelial function which further improve systolic and diastolic blood pressure. Improvement in cardiovascular risk factors was better in HIIT compared to AE in lower intensities. Studies recommend HIIT for CAD patients due to significant cardiovascular adaptation in this exercise. Compared to MICT, most studies found that HIIT is better at improving CRF. HIIT also positively affects cognitive and affective functions. Research on the impact of HIIT on functional activity and QoL is still limited. However, one study found no differences in physical activity level and QoL in groups given HIIT or MICT.
Conclusion: In CAD patients, HIIT is considered an alternative exercise that is more time-efficient than continuous exercise
Comparison of Left Ventricular Function after His Bundle Pacing vs Left Bundle Branch Area Pacing Implantation
Get PDFBackground: Right ventricular pacing may lead to deterioration of left ventricular (LV) function. Recent guideline suggests the use of conduction system pacing (CSP) with either his bundle pacing (HBP) or left bundle branch area pacing (LBBAP). This study aimed to investigate the difference of LV function between HBP and LBBAP.
Methods: This is a prospective cohort study enrolling patients age >18 years requiring CSP implantation from June 2020 to January 2024 in Hasan Sadikin General Hospital, Bandung. Data regarding QRS duration and several echocardiography parameters were obtained at baseline and during follow up within 1 year after CSP implantation.
Results: From 66 patients, 35 were included in the HBP group. There was no difference in QRS duration at baseline between both groups with higher left ventricular ejection fraction (LVEF) in HBP group (51.2 ± 13.9% vs 45.6 ± 11.1%, p=0.078). During follow up, HBP group showed narrower QRS duration (113.40 ± 17.06ms vs 120.81 ± 12.12ms, p=0.029). LV function was preserved in HBP group while there was a trend of LV function improvement in LBBAP group (53.1 ± 11.7% in LBBAP vs 53.9 ± 11.5% in HBP group, p=0.536). Further analysis in 33 patients with LV dysfunction showed a trend of LVEF improvement in both groups (35.3 ± 7.9% to 44.6 ± 11.28% in HBP and 38.7 ± 6.9% to 51.4 ± 13.1% in LBBAP group).
Conclusion: HBP resulted in narrower QRS complex. However, both HBP and LBBAP showed a trend of LV function improvement in patients with LV dysfunction
The Impact of Tricuspid Annular Plane Systolic Excursion (TAPSE) After Mitral Valve Surgery on Long Term Mortality
Get PDFIn “The Impact of Tricuspid Annular Plane Systolic Excursion (TAPSE) After Mitral Valve Surgery on
Long Term Mortality” (Indonesian Journal of Cardiology, 43(1), 1-8. https://doi.org/10.30701/ijc.1196),
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.1196. 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.119
A Rare Case of Ventricular Standstill and High-Grade AV Block in Patient with Thyrotoxicosis
Get PDFIn “A Rare Case of Ventricular Standstill and High-Grade AV Block in Patient with Thyrotoxicosis” (Indonesian Journal of Cardiology, 43(4), 159-67. https://doi.org/10.30701/ijc.1299), 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.1299. 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
Acute ST-Elevation Myocardial Infarction in a 25-Year-Old Female with Polycystic Ovary Syndrome: A Cardiometabolic Risk in Women of Reproductive Age
Get PDFBackground
Acute myocardial infarction is relatively rare in young patients. The age of onset gradually decreases due to multiple risk factors. The causes of Myocardial Infarction (MI) among patients aged less than 45 can be divided into four groups: atheromatous coronary artery disease, non-atheromatous coronary artery disease, hypercoagulable states, and MI related to substance misuse.
Case Illustration
A 25-year-old female came to the emergency department with chest discomfort for the past 40 minutes, has a history of diabetes for the past 3 years, and a Polycystic Ovary Syndrome (PCOS) history. Her vital signs show elevated Blood Pressure (BP) 150/100 mmHg. ECG showed sinus rhythm with ST elevation in the anterior leads. Random Blood Glucose (RBG) was 477 mg/dL, High Sensitivity (HS)-troponin 403 ng/L, and blood ketone3.1 mmol/L. She was initially treated with: ticagrelor 180 mg, Acetosal 320 mg, insulin 4 u/hour. She was diagnosed with ST-Segment Elevation Myocardial Infarction (STEMI) and Diabetic Ketoacidosis (DKA). Coronary angiography revealed 95% stenosis in proximalLeft Anterior Descending (LAD) and was treated as the culprit lesion, while 85% stenosis in mid Right Coronary Artery (RCA) was considered as the residual stenosis. Primary Percutaneous Coronary Intervention (PCI) was initiated at the proximal LAD, and post-PCIangiography showed a good result with TIMI 3 flow to the distal LAD.
Conclusion
PCOS increases cardiovascular risk primarily by promoting insulin resistance and metabolic dysfunction. Young individuals suspected of elevated cardiovascular risk should undergo acomprehensive cardiometabolic evaluation. PCI remains the cornerstone treatment for STEMI across all ages due to its well-established mortality benefit
Accuracy of the YEARS Algorithm Compared to Thoracic Imaging for the Diagnosis of Pulmonary Embolism in Pregnant and Postpartum Patients
Get PDFThe number of morbidity and mortality caused by Pulmonary Embolism (PE) has increased as of recent. Diagnosing PE during pregnancy and postpartum period is particularly challenging given the overlapping symptoms with physiological changes of pregnancy. Recent evidence suggests that the pregnancy-adapted YEARS algorithm, combining clinical probability assessment with D-dimer measurement, may exclude PE without the need for thoracic imaging, thereby reducing unnecessary radiation exposure. This systematic review and meta-analysis intends to evaluate the diagnostic accuracy of the pregnancy-adapted YEARS algorithm in comparison with thoracic imaging among pregnant and postpartum individuals that are suspected of PE. Three databases were searched systematically, including PubMed, Scopus, and Cochrane. Eligible studies included pregnant or postpartum women suspected of having PE who were assessed with the YEARS algorithm, using CT pulmonary angiography (CTPA) or ventilation–perfusion (V/Q) scan as the reference standard. Risk of bias was assessed meticulously using the QUADAS-2 tool. Pooled sensitivity, specificity, as well as the area under the curve (AUC) were calculated by Meta-Disc utilizing a random-effects model. Five studies comprising 1,036 patients, ultimately with low risk of bias were included. The pregnancy-adapted YEARS algorithm showed a pooled sensitivity of 1.00 (95% CI: 0.94–1.00), pooled specificity of 0.12 (95% CI: 0.10–0.14), and an AUC of 0.72, which indicated adequate rule-out ability but limited utility for ruling in PE. The YEARS algorithm that has been adapted for pregnancy may be safely used as a screening tool in excluding PE in pregnant and postpartum women, thereby reducing unnecessary maternal and fetal exposure to radiation. However, confirmatory thoracic imaging remains essential for positive cases
Impact of Acute Kidney Injury in Patients with Acute Decompensated Heart Failure: Cardiorenal Syndrome
Get PDFIn “Impact of Acute Kidney Injury in Patients with Acute Decompensated Heart Failure: Cardiorenal Syndrome” (Indonesian Journal of Cardiology, 44(2), 75-86. https://doi.org/10.30701/ijc.1561), there are an errors 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.1561. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.
An error was also found in the author's name, Sagar Tandel. We have corrected the author name from “Sager Tandel” to “Sagar Tandel”.The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.156
High Degree AV Block in Infants
Get PDFIn “High Degree AV Block in Infants” (Indonesian Journal of Cardiology, 43(3), 116-22. https://doi.org/10.30701/ijc.1244), there are errors 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.1244. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.
An error also appears in the affiliation section. In the original publication, the affiliation were incorrectly listed as “Faculty of Medicine, Universitas Surabaya, Surabaya, Indonesia”. The affiliations have been corrected to “Department of Clinical Medicine, Faculty of Medicine, Universitas Surabaya, Surabaya, Indonesia”.
The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.124
Controlled Resistant Hypertension Following A Successful Renal Artery Stenting: A Rare Case Report in A Developing Country
Get PDFBackground
Renal artery stenosis is among the etiologies of secondary hypertension in which the diagnosis and therapy are difficult. We report a case of a patient with uncontrollable hypertension with frequent episodes of malignant hypertension, treated with renal artery stenting.
Case Illustration
A 36-year-old female visited the cardiovascular polyclinic on a common control for her hypertension. She was diagnosed with hypertension two years, and she had several episodes of malignant hypertension. At the beginning of her treatment, she has prescribed an angiotensin-converting-enzyme inhibitor, yet her pressure was uncontrolled and worsened. By the visit, she was treated using two alpha-2-adrenergic agonists, a loop diuretic, a beta-blocker, a calcium-channel blocker, an angiotensin-receptor blocker, and an aldosterone-receptor antagonist without any satisfactory outcome on her blood pressure status. She had a blood pressure of 196/130 mmHg with tachycardia of 112 times/minute.
We found cardiomegaly on physical examination, which was proven by a chest x-ray. Echocardiography indicated hypertensive heart disease. Screening for secondary hypertension, including laboratory tests (complete blood count, potassium, sodium, creatinine, fasting glucose, lipid profile, urinalysis, thyroid-stimulating hormone, and 24-hour urinary-free cortisol), suggested normal results. Renal ultrasound and doppler were also conducted and showed a suspicion of right renal artery stenosis. Therefore, angiography of the renal artery was performed for diagnosis and therapy when indicated. The angiography suggested a normal left renal artery, while the right artery had a 95% stenosis on the proximal part. An intravascular ultrasound-guided percutaneous transluminal angioplasty on her right renal artery was conducted, and two vascular stents were implanted. The patient showed a remarkable development following her decreasing blood pressure on follow-up. After one week, her blood pressure is controllable on a single antihypertensive and antiplatelet therapy.
Conclusion
The diagnosis and management of a patient with resistant hypertension might be challenging, particularly in the setting of a developing country. Renal artery angiography, among other examinations, might be crucial in the diagnosis sequence, yet it was only sometimes readily available. We present a case in which a diagnosis of renal artery stenosis was made, followed by a definite treatment resulting in unprecedented hypertension control. An identifiable etiology is the key to a proper and the best treatment option for the patient