CARDIOLOGY

1. Unit Description

Cardiac Catheterization began at University Hospital (UH) now known as University Malaya Medical Centre (UMMC) in 1971 by Prof H.O.Wong, Dr. Singham and Dr.T.H.Goh investigating congenital and rheumatic heart disease patients.

This unit provides teaching, research and treatment of cardiovascular disease. The Invasive Cardiovascular Laboratory provides 24 hour services 7 days per week and collaborates with several hospitals in the Klang valley.

2. Services

2.1.1 Non-Invasive Cardiorespiratory Laboratory (NICL)
2.1.1.1 Echocardiography
a. Transthoracic (TTE)
b. Transoesophageal (TEE)
c. Intraoperative
d. Dobutamine stress (DSE)
2.1.1.2 ECG (Electrocardiogram)
a. Standard 12-lead ECG
b. Treadmill stress ECG
c. 24-hour ambulatory ECG
d. 24-hour ambulatory blood pressure monitoring
e. Rhythm card (event recorder)
f. King of Hearts (loop recorder)
2.1.1.3 Respiratory Function Tests
a. Spirometry
b. Lung volume
c. Carbon monoxide diffusion
2.1.1.4 Pacemaker clinic
follow-up and programming

2.1.2 Invasive Cardiovascular Laboratory (ICL)
2.1.2.1 Left and right heart catheterisation
2.1.2.2 Angiography
a. Coronary
b. Renal
c. Iliac and peripheral
2.1.2.3 Intra-vascular imaging
- intra-vascular ultrasound (IVUS)
- Optical Coherent Tomography (OCT)
2.1.2.4 Electrophysiology study
2.1.2.5 Percutaneous Transluminal Coronary Angioplasty and Stenting which includes
a. High-risk cases including Rescue PCI and Cardiogenic shock
b. Primary PCI service for ST elevation myocardial infarction
c. Complex cases (bifurcations, chronic total occlusions, left main stem PCI)
d. High risk patient (chronic kidney disease, diabetes, and patients with other comobilities ).
e. Bioresorbable scaffold
f. Drug eluting balloon
2.1.2.6 Rotational atherectomy
2.1.2.7 Angioplasty and stenting for peripheral vascular disease
2.1.2.8 Balloon Valvuloplasty for aortic, pulmonary and mitral valve stenosis
2.1.2.9 Intracardiac device implantation
a. Single chamber pacemaker
b. Dual chamber pacemaker
c. Implantable Cardioverter Defibrillator (ICD)
d. Cardiac Resynchronization Therapy (Biventricular pacemaker)
2.1.2.10 Patent ductus arteriosus closure using
a. Coil device
b. Amplatz ductal occluder
2.1.2.11 Atrial septal defect closure using Amplatz septal occluder
2.1.2.12 Left Atrial Appendage Occlusion
2.1.2.13 Use of intraaortic balloon pump for life support and high risk angioplasty
2.1.2.14 Coil embolisation for fistula
2.1.2.15 Endovascular Stenting of Aorta for Abdominal Aortic Aneurysm
2.1.2.16 Electrophysiological Study and Radiofrequency Ablation
2.1.2.17 Renal Denervation

2.1.3 Non-Invasive Therapeutic Treatment:
Extracorporeal Shockwaves Myocardial Revascularization (ESMR)

2.2.1.1 Cardiology ward ( Ward 4U/CCU)
2.2.1 Cardiology wards have intensive care facilities to receive patients from within and outside the UMMC and referrals from private hospitals and governments around the Klang Valley who require cardiac care and undergo invasive cardiac procedures
2.2.2 Health teaching program

2.3 Introduction of the New Procedure
2.3.1 Optical Coherent Tomography (OCT)
2.3.2 Functional Flow Reserve assessment (FFR)

3. Research focus, Research group

The Division of Cardiology is active in research in the field of Cardiology. We also supervise undergraduate and postgraduate students who are interested in pursuing projects related to our field. Our researchers have presented award-winning papers at national and international conferences, produced publications in various Cardiology journals.

Among the research articles published:-

• Ganiga Srinivasaiah Sridhar, Muhammad Athar Sadiq, Wan Azman Wan Ahmad, Chitra Supuramaniam, Timothy, Imran Zainal Abidin, Kok Han Chee. Unruptured Sinus of Valsalva Aneurysm Causing Right Ventricular Outflow Tract Obstruction Associated With Supracristal Ventricular Septal Defect: Rare Case Report. Texas Heart Institute Journal 2015; 42(5):462-4
• AS Zuhdi,a Wan Azman Wan Ahmada ,Jeevitha Mariapun,b Rafdzah Ahmad Zaki,b, Rosli Mohd Alic, Ashikin Md Sari,a Muhammad Dzafir Ismail,a Kui-Hian Simd . The elderly in acute coronary syndrome: the Malaysian National Cardiovascular Database Acute Coronary Syndrome (NCVD-ACS) Registry. Singapore Medical Journal 2015 1-19 doi: 10.11622/smdj.2015145
• Caryn Chan Mei-Hsien1, Wan Azman Wan Ahmad2, Mastura MD Yusof3, Gwo-Fuang Ho3 Edward Prevalence and characteristics associated with the default of treatment and follow-up in patients with cancer. European Journal of Cancer Care. (Q1, IF1.762)
• Mohd Aizat Abdul Rahim, Zubaidah Haji Abdul Rahim, Wan Azman Wan Ahmad, Onn Haji Hashim. Can Saliva Proteins Be Used To Predict The Onset Of Acute Myocardial Infarction Among High-Risk Patients? International Journal of Medical Sciences 2015; 12(4): 329-335. doi: 10.7150/ijms.11280
• Wan Azman Wan Ahmad1, MD; Koh Tian Hai2, MD; Teguh Santoso3, MD, PhD; Damras Tresukosol4, MD, PhD; Sunarya Soerianata5, MD; Gerard Wilkins6, MD; Dinesh Nair7, MD; Darren L. Walters8, MD; Rohan Jayasinghe9, MD, PhD; Ong Tiong Kiam10, MD; Adrian F. Low11, MD; Abdul Kahar Ghapar12, MD; Imran Zainal Abidin1, MD; on behalf of the BEACON II Long-term outcomes with Biolimus A9TM-eluting stents in real-world, all-comers Asia Pacific patients. Final 5-year report of the BEACON (Biolimus Eluting A9 Coronary Stent Obviating Luminal Narrowing) II clinical registry. Asia Intervention Journal Vol 1 No2 Sept 2015
• Zaman Huri H, Hui DLY, Ahmad WAW. Association between glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with cardiovascular complications. Drug Design, Development and Therapy. 2015:9 4735-4749 Q2 journal with impact factor 3.026
• Caryn Chan Mei Hsien, Wan Azman Wan Ahmad, Mastura MD Yusof, Ho Gwo Fuang, Edward Krupat. Patient-centredness, job satisfaction and psychological distress: a comparison between oncology nurses and doctors. Accepted for publication Asia Pacific Journal of Cancer Prevention. 21 Sept 2015
• Leschke M, Waliszewski M, Pons M, Champin S, Nait Saidi L, Heang TM, Maskon O, Wan Ahmad WA, Herberger D, Moulichon ME, Rischner J, Robin C, Leclercq F, Peyre JP, Faurie B, Schneider A. The use of thin strut bare metal stents in patients with atrial fibrillation: Is there still a need for BMS? Cardiac Catheterisation Intervention 2015
• W.A Wan Ahmad (Chief Editor), Sim K.H. Annual Report of National Cardiovascular Disease Database-Acute Coronary Syndrome Registry 2011-2013. National Heart Association of Malaysia and Clinical Research Centre Ministry of Health Malaysia; jointly published by the National Heart association Of Malaysia and the Clinical Research Centre. April 2015
• Anwar Suhaimi, Tan Yi Yan, Wan Azman Wan Ahmad, Timothy Watson, Lydia Abdul Latif. The Effects Of Cardiac Rehabilitation On Exercise Capacity In Post Myocardial Infarction Patients. Abstract Book pg. 43, Free Paper, Annual Scientific Meeting NHAM 2015. Malaysia 9th 12th April 2015
• Muhammad Dzafir Ismail, Maisarah Jalalonmuhali, Abdul Wahab Undok, Ahmad Syadi Mahmood Zundi, Lim Soo Kun, Wan Azman Wan Ahmad. Peripheral Arterial Disease In Renal Impaired Patients: A Problem Overlooked. Abstract Book pg. 43, Free Paper, Annual Scientific Meeting NHAM 2015. Malaysia 9th 12th April 2015
• Al Hafiz Ibrahim, Wan Azman Wan Ahmad, Timothy Watson, Lydia Abdul Latif, Anwar Suhaimi. The Effects Of Cardiac Rehabilitation On Erectile Dysfucntion In Men With Ischaemic Heart Disease A Prospective Cohort Study. Abstract Book pg. 50, Young Investigator Award, Annual Scientific Meeting NHAM 2015. Malaysia 9th 12th April 2015
• Watson T, Webster M, Ormiston J.Hard trial. Endpoints may mask important advantage. N Engl J Med 2015;373:681-2
• Menon M, Jaffe W, Watson T, Webster M. Assessment of coronary fractional flow reserve using a monorail pressure catheter: the first-in-human. ACCESS- NZ Trial. Eurointervention 2015;11:257-63
• Watson T, Pope A, van Pelt N, Ruygrok PN. Assessing the efficacy of previously cannulated radial arteries as coronary artery bypass conduits. Tex Heart Inst J 2015;42:555-555)
• Nur Adura Yaakup; Hooi Fang Phuah; Yang Faridah Abdul Aziz; Imran Zainal Abidin; Zhonghua Sun; Kwan Hoong. Dual-source computed tomography angiography in aortic stenosis: comparison with transthoracic echocardiography. Journal of Medical Imaging and Health Informatics 4(5). October 2015. DOI: 10.1166/jmihi.2014.1305
• Wan Ling Lee, Karuthan Chinna, Awang Bulgiba, Khatijah Lim Abdullah, Imran Zainal Abidin, Stefan H fer. Test retest reliability of HeartQoL and its comparability to the MacNew heart disease health- related quality of life questionnaire. Quality of Life Research. August 2015. DOI: 10.1007/s11136- 015-1097-1 Source: PubMed
• Jan Philipp Bewersclorf, Oliver Hautmann, Daniel Kofink, Alizan Abdul Khalil, Imran Zainal Abidin, Alexander Loch. The SPEED (Sepsis Patient Evaluation in the Emergency Department) Score: A Prospectively Derived and Validated Risk Stratification and Outcome Prediction Tool. European Journal of Emergency Medicine. Accepted June 2015
• Darishiani Paramasivam, Karuthan Chinna, Rajesh Qvist, Imran Zainal Abidin, Noran Naqiah Mohd Hairi, Safi Sher Zaman. Role of PPARG Pro 12Ala in Malaysian Type 2 Diabetes Mellitus Patients. Journal of Diabetes in Developing Countries (JDDC). Accepted Mei 2015
• Choon-Hian Goh, Siew-Cheok Ng, Shahrul B. Kamaruzzaman, Ai-Vyrn Chin, Philip J.H. Poi, Kok Han Chee, Imran Z. Abidin, Maw Pin Tan. The Evaluation of New Index for Blood Pressure Variability Using Posture Change among Older Fallers. Journal of Hypertension. 33:E3 June 2015 DOI: 10.1097/01.hjh.0000469728.67622.d6
• Liew Y, McLaughlin R, Chan B, et al. Motion corrected LV quantification based on 3D modelling for improved functional assessment in cardiac MRI. Physics in medicine and biology 2015;60:2715
• Z J, YM L, M B, et al. Regional assessment of LV wall in infarcted heart using tagged MRI and cardiac modelling. Phys Med Biol;60:4015-31
• Prasad M, Wan Ahmad WA, Sukmawan R, Magsombol EB, Cassar A, Vinshtok Y, Ismail MD, Mahmood Zuhdi AS, Locnen SA, Jimenez R, Callleja H, Lerman A. Extracorporeal shockwave myocardial therapy is efficacious in improving symptoms in patients with refractory angina pectoris. A multicenter study. Coronary Artery Dis 2015; 26(3): 194-200.

4. Staff