ABSTRAK
Latar Belakang. Stenosis Mitral (SM) tinggi prevalensinya di negara berkembang karena erat terkaitdengan prevalensi penyakit jantung demam rematik (PJR). Pasien SM sedang-berat terdapatpeningkatan regio turbulensi dan shear stress mengakibatkan kerusakan endotel pembuluh darahsehingga meningkatkan resiko tromboemboli. P-selectin merupakan molekul adhesi berperan dalamproses inflamasi dan sebagai faktor protrombotik yang diekspresikan secara cepat. Indeks volumeatrium kiri (IVAK) merupakan parameter superior untuk mengukur fungsi atrium kiri denganekokardiografi.Metode. Penelitian potong lintang melibatkan 20 pasien SM sedang-berat dengan MVA <1.5 cm2yang menjalani Komisuratomi Mitral Transvena Perkutan (KMTP) yang diambil secara konsekutifpada bulan Mei 2013 sampai Oktober 2013 di Pusat Jantung Nasional Harapan Kita Jakarta. Pasiendiambil sampel darah pra dan pasca KMTP untuk diperiksa kadar P-Selectin. Kemudian hasilnyadianalisa secara statistik.Hasil. Dalam studi ini, tidak didapatkan asosiasi antara IVAK dengan ekspresi kadar P-selectin pradan pasca KMTP. Hal ini ditunjukkan dengan nilai pra KMTP β= -0.103 (95% CI -0.251,0.045)p=0.16 dan pasca KMTP β= 0.009 (95% CI -0.155,0.172) p=0.91. Setelah dilakukan regresilinier dengan penyesuaian (adjusted) terhadap variabel perancu yakni usia, jenis kelamin, dan atrialfibrilasi tetap tidak didapatkan asosiasi antara IVAK dengan kadar P-selectin dengan nilai pra KMTPβ= -0.154 (95% CI -0.340,0.032) p=0.09 dan pasca KMTP β= -0.049 (95% CI -0.250,0.152)p=0.61.Kesimpulan. Tidak ada perbedaan nilai P-selectin pra dan pasca KMTP. Nilai IVAK yang sudahjelek tidak berhubungan dengan kadar P-selectin pra dan pasca KMTP pada pasien SM.

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ABSTRACT
Background. The prevalence of Mitral stenosis (MS) remains significant in developingcountries related to prevalence of Rheumatic Heart Disease (RHD).In moderate-severe MSpatients enormous increase in turbulent region and shear stress causing dysfunction ofvascular endothelial, as consequence it increase the risk of thromboembolic complication. Pselectinis an adhesion molecule that play role in inflammation process, it express rapidly inminutes. Left Atrial Volume Index (LAVI) is superior parameter compare with otherechocardiography two dimension method to assess left atrial function.Methods. Study was designed as cross-sectional study involving 20 MS moderate-severepatients with MVA< 1.5 cm2 who performed successful Percutaneous transvenous BalloonMitral Valvulotomy (PBMV). Samples were taken consecutively from May 2013 to October2013 at the National Cardiovascular Center Harapan Kita Jakarta. Blood samples of Pselectinwere collected pre and post PBMV. The result was statistically analyzed by usingechocardiography data of LAVI prior PBMV to describe any association between expressionof P-selectin and atrial function.Result. In our study, we found no association between LAVI and expression of P-selectinlevel pre and post PBMV MS patient. This data describe in each of value of pre PBMV β= -0.103 (95% CI -0.251,0.045) p=0.16 and post PBMV β= 0.009 (95% CI -0.155,0.172) p=0.91After we performed linear regression with adjusted confounding variable including sex, age,and atrial fibrillation, still we found no association between LAVI and P-selectin level. Thisdata describe in each of value of pre PBMV β= -0.154 (95% CI -0.340,0.032) p=0.09 andpost PBMV β= -0.049 (95% CI -0.250,0.152) p=0.61.Conclusion. We found there is no difference in P-selectin level pre and post PBMV. There isno association between poor LAVI value and expression of P-selectin pre and post PBMV inMS.