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Abstrak :
Pendahuluan BNP adalah asam amino peptida yang disintesa dan dilepas terutama dan miokard ventrikel sebagai respon terhadap regangan miosit Kadar BNP dilepas juga saat iskemi maupun nekrosis miokard Pada NonSTEMI terjadi keadaan hipoksia iskemia sampat nekrosis di subendokard dalam berbagai derajat gangguan sehingga perlu adanya petanda yang bisa menggambarkan gangguan fungsi ventrikel mi Pada NonSTEMI terjadi lepasnya BNP dan terganggunya kontraktilmtas miokard dalam berbagai tingkatan. Tujuan Penelitian Mencari hubungan antara besarnya kadar BNP yang keluar akibat kerusakan subendokard dihubungkan dengan gangguan fungsi ventrikel kiri yang dmnilam dengan ekokardiografi. Metode Penelitian merupakan studi deskrmptif analitik yang bersifat cross sectional dilakukan di PJNHK antara bulan Nopember 2005-Juni 2006 Penelitian dilakukan pada 36 pasien NonSTEMI yang pertamakali mnfark tanpa ada riwayat gagal Jantung dan kelainan katup sebelumnya Sampel darah EDTA diambil saat pasien datang di UGD kemudian diekstraksi plasmanya untuk dmperiksa kadar BNP Fungsi sistolik ventrikel kin dinilai ekokardiografi dengan mengukur Wall Motion Score Index (WMSI) 16 segmen sistem dan ejection fraction (EF) metode Simpson Pemeriksaan ekokardiografi dilakukan setelah melewati fase perawatan intensif. Hasil Terdapat kenaikan kadar BNP pada subyek penelitian (278 71 ± 394 60) dan berbeda bermakna dengan kadar BNP populasi normal (20 00 ±23 73) dengan (p<0 00 1) pada uji TTest Dengan uji korelasi Pearson terdapat hubungan bermakna antara BNP (278 71 ± 394 60) dan EF Simpson (51 46 ± 10 62) dengan p trend = 0 024 r = 0376 maupun antara BNP (278 71 ± 394 60) dan WMSI (1 31 ± 0 37) dengan p trend = 0 013 r= 0 411 Dengan uji perbedaan Chi square Tidak ada perbedaan yang bermakna kadar BNP pada kelompok sampel dengan EF<40 dan kelompok sampel dengan EF>40 (c>O 05). Kesimpulan Kadar BNP meningkat pada pasien pasien Non STEMI Kenaikan BNP berhubungan dengan kecenderungan penurunan fungsi ventrikel kiri semakmn tinggi kadar BNP semakmn cenderung menurun fungsi ventrikel kiri. ......Background BNP is an aminoacid synthesized by myocyte in respons to myocardial stretching Myocardial ischemia and necrosis could also induced BNP production In NonSTEMI various degree of hypoxia ischemia and subendocardial necrosis occur to the myocardium and could compromise LV function Thus a marker that could predict LV dysfuction in this setting is very much needed Various degree of LV dysfunction and BNP production could be observed in NonSTEM. The Aim of Study To investigate the relationship between BNP level induced by subendocardial damage with LV systolic function assessed by echocardiography in NonSTEMI. Methods This is an analytical descriptive study cross sectional in design conducted in National Cardiovascular Center 1-larapan Kita between November 2005-June 2006 Subjects are 36 patients with NonSTEMI without previous history of infarction heart failure or valvular abnormality EDTA blood samples were obtained during examination in the Emergency Department then the plasma were extracted to measure BNP level LV systolic function assessed by echocardiography with 16 segments Wall Motion Score Index (WMSI) and Ejection Fraction (EF) Simpson Methode The echocardiographic evaluation was performed after the intensive care phase. Results There was a significant increase in BNP level among study subjects (278 71 ± 394 60) compared to normal population (20 00 ± 23 73) (Ttest with p40% with Chi-Square Test and found no significant difference (iO 05) Conclusion The BNP level was increased in patients with NonSTEMI The BNP level was correlated with tend the severity of LV systolic dysfunction The higher BNP level tend to the lower LV fuction.

Abstrak :
ABSTRAK
Latar Belakang: Obesitas merupakan salah satu masalah kesehatan utama yang banyak ditemukan di negara maju maupun negara berkembang. Obesitas menjadi salah satu faktor risiko timbulnya penyakit kardiovaskular. Diketahui bahwa populasi obesitas memiliki kadar plasma BNP yang rendah dibanding kelompok normal. BNP adalah suatu hormon yang disintesis oleh miosit atrium yang berperan dalam meregulasi hemodinamik tubuh. Selain itu BNP memiliki efek anti fibrosis dan anti hipertrofi pada jantung. Dipikirkan bahwa adanya gangguan sintesis BNP di miosit jantung sebagai salah satu penyebab. Maka, penelitian ini bertujuan untuk melihat profil ekspresi mRNA BNP, NPR-A dan NPR-C pada populasi obesitas. Metode: Studi potong lintang dilakukan di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita (RSJPDHK). Jaringan miosit tersimpan yang sudah dilakukan ekstraksi RNA dibagi menjadi 2 kelompok berdasarkan IMT, kelompok obesitas (IMT ≥27) dan kelompok normal (IMT <27) dan sesuai kriteria inklusi dan eksklusi. RNA kedua kelompok dilakukan sintesis cDNA, ekstraksi protein dan Real-Time PCR untuk mendapatkan mean ΔCt. Kemudian dilakukan penghitungan menggunakan metode Livak untuk mendapatkan nilai ekspresi relatif mRNA. Data kemudian di analisis statistik menggunakan SPSS 20. Hasil Penelitian: Sebanyak 48 pasien diikutsertakan dalam penelitian ini dengan jumlah kelompok normal 34 orang dan kelompok obesitas 14 orang. Hasil ekspresi mRNA BNP, NPR-A dan NPR-C lebih rendah pada kelompok obesitas dibanding kelompok normal. Namun, tidak didapatkan perbedaan bermakna ekspresi mRNA BNP (p 0,768), NPR-A (p 0,838) dan NPR-C (p 0,768) antara kelompok obesitas dibanding kelompok normal. Kesimpulan: Penelitian ini tidak menemukan perbedaan ekspresi mRNA BNP, NPR-A dan NPR-C yang bermakna antara kelompok obesitas dengan kelompok normal.

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ABSTRACT
Background: Obesity is presenting as a significant health problem across the world. Obesity is a risk factor for cardiovascular diseases. The plasma level of B-type natriuretic peptide (BNP) has been identified to be lower in obese people compare to normal. As we know, BNP is one of the cardiac hormones synthesized by atrial myocyte that plays a role in hemodynamic regulations. In addition, BNP exerts its anti fibrotic and anti hypertrophic effects in the heart. It has been hypothesized that one of the possible mechanism responsible for this inverse relationship is the impaired synthesize of BNP by cardiomyocytes. Therefore, the aim of our study is to evaluate the mRNA expression profile of BNP, Natriuretic peptide receptor type-A (NPR-A) and Natriuretic peptide receptor type-C (NPR-C) in cardiomyocytes of obese population. Method: A cross-sectional study was conducted in Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita (RSJPDHK). Cardiomyocytes that have been performed the RNA extraction proses were divided into 2 groups, Obese group (BMI ≥27) and Normal group (BMI <27), according to BMI and inclusion and exclusion criteria. Synthesize cDNA, protein extraction and Real-Time PCR were performed in order to have the mean of ΔCt. Livak method was used to determine the relative expression mRNA value. SPSS 20 for Windows was used for the purpose of statistical analyses. Results: 48 patients were included in this study that consist of 34 patients in normal group and 14 patients in obese group. The mRNA expression of BNP, NPR-A and NPRC were lower in obese group compared to normal group. However, there was no significant difference between groups. Conclusion: In conclusion, there is no significant difference of mRNA expression of BNP, NPR-A and NPR-C between obese and normal group.;Background: Obesity is presenting as a significant health problem across the world. Obesity is a risk factor for cardiovascular diseases. The plasma level of B-type natriuretic peptide (BNP) has been identified to be lower in obese people compare to normal. As we know, BNP is one of the cardiac hormones synthesized by atrial myocyte that plays a role in hemodynamic regulations. In addition, BNP exerts its anti fibrotic and anti hypertrophic effects in the heart. It has been hypothesized that one of the possible mechanism responsible for this inverse relationship is the impaired synthesize of BNP by cardiomyocytes. Therefore, the aim of our study is to evaluate the mRNA expression profile of BNP, Natriuretic peptide receptor type-A (NPR-A) and Natriuretic peptide receptor type-C (NPR-C) in cardiomyocytes of obese population. Method: A cross-sectional study was conducted in Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita (RSJPDHK). Cardiomyocytes that have been performed the RNA extraction proses were divided into 2 groups, Obese group (BMI ≥27) and Normal group (BMI <27), according to BMI and inclusion and exclusion criteria. Synthesize cDNA, protein extraction and Real-Time PCR were performed in order to have the mean of ΔCt. Livak method was used to determine the relative expression mRNA value. SPSS 20 for Windows was used for the purpose of statistical analyses. Results: 48 patients were included in this study that consist of 34 patients in normal group and 14 patients in obese group. The mRNA expression of BNP, NPR-A and NPRC were lower in obese group compared to normal group. However, there was no significant difference between groups. Conclusion: In conclusion, there is no significant difference of mRNA expression of BNP, NPR-A and NPR-C between obese and normal group.