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> <p>All articles published in the Indonesian journal of Cardiology are indexed in:</p> <ul> <li class="show">BASE</li> <li class="show">CiteFactor</li> <li class="show">CNKI</li> <li class="show">Crossref</li> <li class="show">DOAJ</li> <li class="show">GARUDA</li> <li class="show">Hinari</li> <li class="show">Embase</li> <li class="show">Google Scholar</li> <li class="show">WorldCat</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> Recent Echocardiography Parameters for Predicting Better Functional Result after Mitral Valve Correction Surgery in Patients with Primary Mitral Regurgitation <p><strong>Abstract</strong></p> <p><strong>&nbsp;</strong></p> <p><strong>Objectives </strong>We analyzed whether some echocardiographic parameters are good predictors of functional result after mitral valve correction surgery.&nbsp;</p> <p>&nbsp;</p> <p><strong>Background </strong>Ejection fraction was not the only parameter to decide optimal time for surgery, nor an indicator for a better functional result after surgery. Severity measurement being a main consideration in surgery decision. Reduced left ventricle dimension after surgery reflect a better functional result.</p> <p>&nbsp;</p> <p><strong>Methods </strong>In 2019, 67 patients was included in this analysis. Age 53 (17-67) years, male 52,2%. All patients are with severe primary mitral regurgitation and treated by mitral valve surgery (mitral valve repair or replacement). Retrospective echocardiographic analysis was performed, to find the best parameter for predicting better functional outcome after surgery.</p> <p><strong>&nbsp;</strong></p> <p><strong>Results </strong>Data was collected from January to December 2019. From 262 primary mitral valve surgery underwent in National Heart Center Harapan Kita, there was 67 patients included, the other was excluded due to probability of secondary mitral regurgitation mechanism, concomitant congenital heart disease and or other significant valves disease, missing post-surgery data due to referral flow to the prior hospital and less complete echocardiographic views for further analysis. In bivariate analysis, end-diastolic volume (EDV) and regurgitant volume (RV) were strong predictor of decreasing left ventricle diameter after surgery (<em>p </em>0.0001 and <em>p</em> 0.05). End-diastolic volume 133,5 ml or more is predictive for decreasing left ventricle diameter if surgery was conducted (sensitivity 87.3%, sensitivity 66.7%). &nbsp;</p> <p>&nbsp; &nbsp;</p> <p><strong>Conclusions </strong>EDV and RV found to be good predictors for functional outcome of primary mitral valve surgery than other echocardiographic parameters. Measuring EDV before deciding timing of surgery will be helpful in targeting better functional result after surgery.</p> <p>&nbsp;</p> <p><strong>&nbsp;</strong></p> Indah Puspita Amiliana M Soesanto Estu Rudiktyo Rina Ariani Ario Suryo Kuncoro ##submission.copyrightStatement## 2020-12-31 2020-12-31 42 1 10.30701/ijc.1060 Comparison of two smartphone based atrial fibrillation screening application in Indonesian population <p><strong>Background: </strong>Due to its adverse outcomes and thromboembolic complications, early detection of atrial fibrillation (AF) is advisable in the general population. This study aims to compare the diagnostic ability of two distinct method in smartphone application format, namely : AliveCor KardiaMobile and FibriCheck.</p> <p><strong>Methods: </strong>This study was conducted in Mohammad Hospital General Hospital Palembang with convenience sampling of 170 participants aged 18 years or older. The subjects underwent Fibricheck and KardiaMobile recordings followed by 12 lead electrocardiogram read by board-certified cardiologist as the diagnostic standard.</p> <p><strong>Results: </strong>After the exclusion of previous pacemaker implantation (n=7), 163 patients were included in the study. The mean age was 51±15 years with gender distribution of 74.8% men and 25.2% women. Most of the subjects were asymptomatic (87.1%) with mean blood pressure of 130/80 mmHg. The Fibricheck readings showed sensitivity of 73% and specificity of 93%, meanwhile Kardiamobile was able to detect AF with sensitivity of 77% and specificity of 98%.&nbsp;</p> <p><strong>Conclusion: </strong>In our study, KardiaMobile demonstrated overall greater sensitivity and specificity when compared to FibriCheck. However, KardiaMobile requires an external metal sensor that must be puchased separately. To the best of our knowledge, this is the first study to directly compare both methods in the Indonesian population.</p> Alexander Edo Tondas Rolando Agustian Halim Muhammad Rizki Felani Fianirazha Primesa Caesarani Indah Puspita Mangiring Lumban Toruan ##submission.copyrightStatement## 2021-03-24 2021-03-24 42 1 10.30701/ijc.1066 Simple and Short-term Inspiration Training Accelerates Recovery from Residual Pulmonary Hypertension after Mitral Valve Surgery: A randomized control trial <p><strong>Background</strong><strong>:</strong> Residual pulmonary hypertension after mitral valve surgery predicts a worse prognosis. This study aimed to explore the effect of inspiratory muscle training on functional capacity and pulmonary artery pressure in patients with residual pulmonary hypertension after mitral valve surgery.</p> <p><strong>Methods</strong><strong>:</strong> Forty-three patients with residual pulmonary hypertension soon after mitral valve repair or replacement surgery were consecutively enrolled in this randomised controlled trial. They were randomly allocated to either an intervention group (n=22) or a control group (n=21). Both groups participated in usual 10-12 sessions of supervised aerobic exercise training, with low to moderate intensity. The subjects in the intervention group participated in additional inspiratory muscle training using an incentive spirometer with a series of 10-12 inspiration repetitions of 50% of maximum inspiratory volume in each aerobic session. Echocardiography and the 6-minute walking test were performed before and after the programme.</p> <p><strong>Results</strong><strong>:</strong> The patients were 70% female, mean age 43.5+/-13 years. Both groups had similar baseline characteristics. The systolic pulmonary artery pressure declined from 51(43-68) mmHg to 35 (29-39) mmHg, p&lt;0.001 in intervention group, and from 46(43-55) mmHg to&nbsp; 43(40-51)mmHg, p&lt;0.01 in control group. The reduction was higher in the intervention group than in the control group, 16 (12-30) vs 3.5 (2-4) mmHg respectively, p&lt;0.001, and in patients with higher baseline systolic pulmonary artery pressure. The 6-minute walk test distance increased from 308(242-353) meters to 407(377-433) meter, p&lt;0.01 in intervention group, and from 353(334-381) meter to 391(376-429) meter, p&lt;0.01 in control group. The improvement was higher in the intervention group than in control group, 101 (93-131) vs 48 (35-53) meter respectively, p&lt;0.001.</p> <p><strong>Conclusion</strong><strong>:</strong> Adding inspiratory muscle training to a usual exercise programme resulted in faster recovery from residual pulmonary hypertension and higher increase in functional capacity.</p> Basuni Radi Radi Bima Suryaatmaja Ario Suryo Kuncoro Amiliana M Soesanto ##submission.copyrightStatement## 2021-03-04 2021-03-04 42 1 10.30701/ijc.1096 The Protective Effect of Vitamin E for Reducing Intra-Hospital Mortality in Acute Limb Ischemia Patients <p><strong>Background</strong></p> <p>Management of acute limb ischemia (ALI) is still a huge challenge. Current advances of endovascular therapeutic approach in management of ALI have decreased the overall amputation rate, nevertheless, mortality rate remains high which may be caused by metabolic consequences of reperfusion injury.</p> <p><strong>Aim</strong></p> <p>To understand the role of vitamin E to intra-hospital and 30-day mortality among acute limb ischemia patients.</p> <p><strong>Methods</strong></p> <p>This retrospective cohort study included all patients with ALI between 2015 to 2018. Vitamin E 2x400 mg orally for seven days was given based on physician preference after ALI diagnosis was confirmed. Data were collected from Vascular Registries of National Cardiovascular Center Harapan Kita (NCCHK), Jakarta, Indonesia. Univariate analysis and logistic regression models were used to explore factors that contribute to intra-hospital and 30-day mortality.</p> <p><strong>Results&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; </strong></p> <p>A total of 160 patients with ALI involving 192 limbs were admitted to our hospital. Mostly were male (63.1%) and mean age were 56±13 years old. Majority of the patients had unilateral lesion (80%), and were diagnosed with Rutherford stage IIA (36.3%), followed by stage IIB (33.8%), stage I (20%), and stage III (10%) respectively. Intra-hospital and 30-day mortality were 28.1% and 36.9%, respectively. Low treatment of vitamin E increased intra-hospital mortality (HR 5,6 95%CI 1.7-18.3), however, it did not affect 30-day mortality. Other factors including IABP insertion, arrhythmia, bleeding requiring transfusion and acute renal failure were associated with higher intra-hospital and 30-day mortality. In addition, menopause (HR 3.2; CI 1.16-8.85) was also a predictor of 30-day mortality.</p> <p><strong>Conclusion</strong></p> <p>Vitamin E administration reduced intra-hospital mortality but not on 30-day mortality in acute limb ischemia patients.</p> <p><strong>Keywords</strong>: <em>Acute Limb Ischemia, vitamin E, mortality, reperfusion injury</em></p> Suci Indriani Suko Adiarto Hananto Andriantoro Ismoyo Sunu Taofan Siddiq Iwan Dakota ##submission.copyrightStatement## 2021-03-04 2021-03-04 42 1 10.30701/ijc.1114 Complete Heart Block In Pregnancy : A Case Report <p><strong>Background</strong>: Complete heart block occurs due to various pathological conditions that cause an infiltration, fibrosis, or lose the connection from a part of the cardiac conduction system. Complete heart &nbsp;block&nbsp;in pregnancy&nbsp;is often&nbsp;caused by&nbsp;congenital anomalies.&nbsp;Around 30% cases, complete heart block remain asymptomatic and not detected until adulthood and may present in pregnancy state and puerperium. When the reversible cause of the AV&nbsp;Block cannot be found, the permanent pacemaker or temporary pacemaker may be indicated when the patients show the symptoms.</p> <p><strong>Case Illusration</strong>: A-21 year old female, G2P0A1 preterm pregnancy (27-28 weeks) with bradycardia. From electrocardiograph examination revealed Total AV Block with junctional escape rhytym. Transthoracic echocardiogram&nbsp;shows&nbsp;massive tricuspid regurgitation, early phase of peripartum cardiomyopathy&nbsp;and ejection fraction 36-40%. Caesarean section was peformed due to PPROM. A male baby was born with birth weight of 1100 grams, 32 centimeters of body length and APGAR score of 7/9. The baby was died in NICU on day care 4<sup>th</sup>, with suspected respiratory problem.</p> <p><strong>Conclusion</strong>: Complete heart block in pregnancy is a rare condition. This condition could remain asymptomatic and not detected until pregnancy. Multidisciplinary approach, close monitoring of the symptoms and cardiac functions are needed for patients with CHB.</p> Dhanang Ali Yafi Cloudia Noviani Rahmi Eka Saputri Adi Purnawarman Mohd. Andalas Yusmalinda Yusmalinda ##submission.copyrightStatement## 2021-03-24 2021-03-24 42 1 10.30701/ijc.1015