Indonesian Journal of Cardiology <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 Indonesian Heart Association en-US Indonesian Journal of Cardiology 0126-3773 <p>Authors who publish with this journal agree to the following terms:<br><br></p> <ol type="a"> <ul> <li class="show">Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="" target="_new">Creative Commons Attribution License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> </ul> </ol> <ol type="a"> <ul> <li class="show">Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> </ul> </ol> <ol type="a"> <ul> <li class="show">Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a href="" target="_new">The Effect of Open Access</a>).</li> </ul> </ol> Wire Crossing Time Correlate with Left Ventricular End-Diastolic Pressure in Patients with ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention <p>Backgrounds: Mortality and morbidity in acute myocardial infarction depend on the extent of the infarct area. Rapid recovery of coronary artery blood flow with primary percutaneous coronary intervention (pPCI) can limit the extent of infarction and improve left ventricular function. Acute myocardial infarction reduce diastolic function, which in the early stage of diastolic dysfunction, there is an increase in left ventricular end-diastolic pressure (LVEDP). The non-invasive marker of E/e’ ratio is an accurate parameter of increased LVEDP.<br>Methods: This was a cross-sectional study enrolled consecutive patients with ST Segment Elevation Myocardial Infarction (STEMI) who underwent pPCI at Dr. Sardjito Hospital. The wire crossing time was calculated from the onset of chest pain until the guidewire crossed the infarct-related artery during the pPCI procedure. The E/e’ ratio was determined by transthoracic echocardiography which performed within 48 hours after the primary PCI. Correlation between the wire crossing time and the E/e’ ratio was assessed by the Pearson correlation test. The value of p &lt;0.05 was considered statistically significant.<br>Results: A total of 40 patients were enrolled in this study. The mean wire crossing time was 12.73±5.22 hours. The median value of the E/e’ ratio was 8.36 (range: 4.71-22.00). There was a moderate strength and significant correlation between the wire crossing time and the E/e’ ratio (r = 0.572; p &lt;0.001). Patients with E/e’ ratio &gt;15 had significantly longer wire crossing time than in patient with E/e’ ratio ≤15 (20.21±2.5 hours vs. 11.41±4.39 hours; p &lt;0.001; respectively). The wire crossing time was independently associated the E/e’ ratio (r = 0.463; p = 0.003).<br>Conclusion: There was a moderate strength and significant positive correlation between the wire crossing time and increased LVEDP, an earlier marker of diastolic dysfunction, measured by E/e’ ratio using TTE in patients with STEMI underwent pPCI.</p> Indra Widya Nugraha Anggoro Budi Hartopo Nahar Taufiq ##submission.copyrightStatement## 2020-11-11 2020-11-11 41 2 10.30701/ijc.936 Improvement of exercise capacity after early phase II cardiac rehabilitation in patients who undergo rheumatic mitral valve surgery <p><strong><em>Background</em></strong><strong>: </strong>Rheumatic heart disease still become a major concern in developing countries. Recent studies showed the benefits of early phase II cardiac rehabilitation (CR) on improving the exercise capacity but the evidence in patients after rheumatic mitral valve surgery due to rheumatic heart disease is limited. This study aims to investigate the effects of early phase II CR program on increasing exercise capacity in the rheumatic mitral valve surgery patients.</p> <p><strong><em>Methods</em></strong><strong>: </strong>This is a cohort retrospective study. A review of medical records identified 254 patients who underwent early phase II CR after rheumatic mitral valve &nbsp;surgery between July 2009 – June 2019. Effects of CR was assessed by 6 Minutes Walking Distance (6MWD) pre and post early phase II CR and peak oxygen uptake (VO<sub>2 </sub>peak) calculated by Cahallin formula. In this study, we observed and analyzed the increasing of 6MWD and VO<sub>2 </sub>peak.</p> <p><strong><em>Results</em></strong><strong>: </strong>Our findings showed that 6MWD and VO<sub>2 </sub>peak increased significantly in these patients after early phase II CR program (p = 0.001). Mean of 6MWD increased from 316.3 ± 71.7 meters to 378.6 ± 60.3 meters and VO<sub>2 </sub>peak increased from 7.7 ±2.4 mL/kg/min to 8.9 ± 2.2 mL/kg/min. The mean difference of 6MWD was 62.3 meters and VO<sub>2 </sub>peak was 1.2 mL/kg/min. There was a strong correlation between VO<sub>2 </sub>peak and 6MWD (r = 71%; R<sup>2</sup> = 51%; p = 0.001).</p> <p><strong><em>Conclusion</em></strong><strong>: </strong>Early phase II CR in patients with Rheumatic Mitral Stenosis after mitral valve surgery improved the exercise capacity. Based on 6MWD, we can predict the value of VO<sub>2 </sub>peak patients with rheumatic mitral stenosis surgery patients.</p> <p>&nbsp;</p> <p><strong>Keywords: </strong>Cardiac rehabilitation, rheumatic mitral stenosis, 6MWD, VO<sub>2</sub> peak</p> Ade Meidian Ambari Budhi Setianto Anwar Santoso Basuni Radi Bambang Dwiputra Eliana Susilowati Fadila Tulrahmi Pieter A Doevendans Maarten Jan Cramer ##submission.copyrightStatement## 2020-11-11 2020-11-11 41 2 10.30701/ijc.1038 Pulmonary Doppler Notch Pattern in Relation with Pulmonary Vascular Resistance Index in Patients with Atrial Septal Defect <p><strong>Background: </strong>Atrial septal defect (ASD) potentially causes pulmonary hypertension (PH) and increased pulmonary vascular resistance (PVR). In previous studies, pulmonary Doppler notch was evident in patients with high PVR. There was a distinct notch pattern in different types of PH. This study aims to examine whether echocardiographic notch pattern could estimate PVR in secundum ASD patients.</p> <p><strong>Methods: </strong>Cross sectional study was conducted in secundum ASD patients ≥18 years old who underwent clinically indicated right heart catheterization. Association of notch presence and PVR index (PVRi) and correlation of notch ratio (NR), a parameter of notch location, and PVRi were analyzed. The best cut off of NR value was obtained using the receiver operating characteristics curve.</p> <p><strong>Results: </strong>Among 60 patients, the notch was present in 50 patients (83%) and significantly associated with PVRi ≥6 WU.m<sup>2</sup> (p&lt;0.0001). Notch ratio and PVRi had a moderate negative correlation (r=-0.410, p=0.003). Receiver operating characteristics curve with area under curve 0.709 showed that cutoff NR value of 1.635 was a good discriminator for PVRi ≥6 WU.m<sup>2</sup>, with 70% sensitivity, 70% specificity, 56.8% positive predictive value, and 14.9% negative predictive value. Patients were then classified into three groups of notch pattern based on its presence and location, which was significantly associated with PVRi (p&lt;0.0001).</p> <p><strong>Conclusions: </strong>Pulmonary Doppler notch pattern is associated with PVRi in secundum ASD patients. This may be used clinically to estimate PVR to aid patient selection for further invasive investigation.</p> <p>&nbsp;</p> <p><strong>Keywords</strong><strong>:</strong> atrial septal defect, Doppler echocardiography, notch, notch ratio, pulmonary vascular resistance</p> Nurnajmia Curie Proklamartina Radityo Prakoso Oktavia Lilyasari Rina Ariani Sisca Natalia Siagian Amiliana Mardiani Soesanto ##submission.copyrightStatement## 2021-03-07 2021-03-07 41 2 10.30701/ijc.1053 Colchicine as an Adjuvant Therapy for Coronary Artery Disease: A Systematic Review <p><strong>Background:</strong>Inflammation plays a significant role in atherosclerosis at all phases. Colchicine is a pleiotropic anti-inflammatory agent that may be beneficial in various stages of coronary artery disease (CAD).</p> <p><strong>Methods:</strong>We searched for literatures in PubMed, Cochrane Library, ScienceDirect, and Proquest regarding the use of colchicine on top of current optimal medical therapy for CAD.</p> <p><strong>Results: </strong>Twelve studies were identified: three studies in stable CAD patients and the remaining nine assessed in acute coronary syndrome (ACS) and post-ACS patients. The majority of studies used a colchicine dose of 0.5 mg/day. Adjuvant colchicine of 0.5 mg daily reduced the risk of developing ACS, cardiac arrest, or ischemic stroke in stable CAD: HR (hazard risk) 0.33 (95% CI 0.18-0.59), p&lt;0.001. Patients admitted with ACS who received a 2 mg loading dose of colchicine pre-percutaneous coronary intervention (PCI) showed smaller infarct size than control: 18.3 (IQR 7.6-29.9) ml/1.73 m<sup>2</sup>vs 23.2 (18.5-33.4) ml/1.73 m<sup>2</sup>(p=0.019).In post-ACS patients, adjuvant colchicine of 0.5 mg daily significantly reduced the rate of ischemic cardiovascular events: HR 0.77 (95% CI 0.61-0.96), p=0.02.</p> <p><strong>Conclusion: </strong>Stable CAD patients benefit from 0.5 mg daily dose of adjuvant colchicine to reduce the incidence of future cardiovascular events. For patients presenting with ACS, a loading dose of 2 mg of colchicine pre-PCI followed by a week of 0.5 mg colchicine twice daily on top of optimal medical care can reduce infarct size. This should be followed by consumption of 0.5 mg daily dose of adjuvant colchicine post-ACS for at least 20 months to prevent future reinfarctions.</p> Nobian Andre Patricia Renata Muhamad Hafiz Mahruzza Rony Marethianto Santoso ##submission.copyrightStatement## 2020-11-11 2020-11-11 41 2 10.30701/ijc.990 Modifiable Survival Factors of Out-of-Hospital Cardiac Arrest among Global Population: Systematic Review and Meta-Analysis <p>Out-of-hospital cardiac arrest (OHCA) is the most common type of cardiac arrest and causing much mortality and burden even preventive measure has been made. Therefore, we conducted study to reduce OHCA morbidity and mortality by finding modifiable survival factors in-order to interfere them. We did systematic review of large cohort studies (n&gt;100,000) on general population from four databases, then filtered 3,560 studies into 9 studies and appraised them using Newcastle-Ottawa scale for quality and Cochrane risk-of-bias before being synthesized. Among 486,012 subjects, we found out that age and shockable rhythm is unmodifiable but could be helped with lifestyle. Modifiable factors are grouped into two: bystander response including public location (OR=1.24; CI 95%=1.16–1.32), bystander witness (OR=1.45; CI 95%=1.36–1.56), bystander CPR (OR=1.45; CI 95%=1.36–1.56); and emergency service delivery including paramedic response &lt;10 minutes (OR=1.55; CI 95%=1.41–1.70), ambulance physician (OR=1.52; CI 95%=1.37–1.68). Having OHCA in public means bigger chance of being resuscitated. However, resuscitation by uneducated bystander shown harmful thus public education was needed. Emergency services were considered important to arrive with competent workers, especially physicians who was trained on defibrillator usage and management regiment. Therefore, increasing public awareness, provide more ambulance and district health center facility, and training of health care workers are essential. In conclusion, management of OHCA involved multidisciplinary action throughout the nation to increase outcome of OHCA and lessen the burden. More area-specified and factor-specified studies should be conducted to improve applicability.</p> Jeremy Rafael Tandaju Kareen Tayuwijaya ##submission.copyrightStatement## 2020-11-11 2020-11-11 41 2 10.30701/ijc.1014