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Abstrak :
The chief complain of chronic peripheral arterial occlusion disease is intermittent clodication, or calf pain during exercise that is relieved by resting. As the disease advances, pain occurs even during resting. The main cause for this disease is atherosclerosis. Clinical evaluation of patients comprise of questionnaire, exploration of atherosclerosis risk factors such as smoking, hyperlipidemia, diabetes mellitus, hypertension, etc. Pulse examination, ankle-brachial pressure index (ABPl) measurements and leg segmenta! blood pressure assessments are integral examinations in such patients. Another important test is functional assessments using the treadmill, or other tests to cause hyperemia. The chief management is to prevent common morbidity and mortality due to atherosclersosis such as coronary heart disease and its complications, as well as cerebrovascular disease and its complications. Management is also targeted towards preventing the progress of peripheral arterial occlusion disease. Specific management for peripheral arterial occlusion disease that is clearly beneficial to improve symptoms is physical exercise. Drugs such as pentoxyphylline, naftidrofuryl, buflomedil, and cilostazol are of little benefit only. Aspirin is useful to prevent cardiovascular, but is useless to improve symptoms. Prior to offering interventional procedures (angiopfasty and for stent insertion) or surgery, the following issues should be contemplated: I) the patient does not respond to physical exercise and risk factor modification, b) there is severe disability, c) there is no longer other disease that limits activity, and d) the morphology of the lesion is in line with the intervention, with a low risk and high probability for initial and long-term success

Abstrak :
ABSTRACT
Atherosclerosis is a chronic inflammatory disorder involving innate and adaptive immunity process. Effector T cell (Teff) responses promote atherosclerotic disease, whereas regulatory T cells (Tregs) have been shown to play a protective role against atherosclerosis by down-regulating inflammatory responses which include multiple mechanisms. Compelling experimental data suggest that shifting the Treg/Teff balance toward Tregs may be a possible therapeutic approach for atherosclerotic disease, although the role of Tregs in human atherosclerotic disease has not been fully elucidated. In this review, we discuss recent advances in our understanding of the roles of Tregs and Teffs in experimental atherosclerosis, as well as human coronary artery disease.

Abstrak :
Aterosklerosis sebagai penyebab terjadinya PJK merupakan proses multifaktorial karena banyak sekali faktor-faktor yang menyebabkannya dengan mekanisme yang saling terkait. Saat ini proses aterosklerosis dianggap sebagai proses inflamasi. Inflamasi terbukti berperan penting pada inisiasi, progresi maupun destabilisasi plak aterosklerosis. High sensitivity C-reactive protein (hs-CRP) merupakan salah satu petanda inflamasi yang penting pada penyakit jantung koroner (PJK) yang berhubungan dengan tingkat keparahan aterosklerosis, iskemi miokardium dan nekrosis miokardium. Tujuan penelitian ini adalah untuk mengetahui dan membandingkan kadar hs-CRP pada pasien sindroma koroner akut (SKA), PJK kronik dan bukan PJK, serta untuk mengetahui apakah terdapat hubungan antara kadar hs-CRP dengan kadar enzim CKMB pada pasien infark miokard akut (IMA). Penelitian bersifat observasional deskriptif dan analitik dengan pendekatan potong lintang. Dilakukan pemeriksaan kadar hs-CRP dengan metode chemiluminescent pada 21 pasien SKA, 20 pasien PJK kronik dan 20 bukan PJK. Didapatkan kadar hs-CRP rerata pada pasien SKA, PJK kronik dan bukan PJK sebesar 8,40 (SD 5,53) mg/l, 2,81 (SD 2,09) mg/l dan 1,07 (SD 0,81) mg/l. Analisis statistik didapatkan perbedaan kadar hs-CRP yang bermakna antara pasien SKA, PJK kronik dan bukan PJK (p 0,000). Kadar hs-CRP mempunyai korelasi positif yang bermakna dengan kadar enzim CKMB pada pasien IMA (p 0,004). Sebagai kesimpulan, kadar hs-CRP pada pasien SKA secara bermakna lebih tinggi dibanding PJK kronik dan bukan PJK. Terdapat hubungan yang bermakna antara peningkatan kadar hs-CRP dengan peningkatan kadar enzim CKMB. (Med J Indones 2004; 13: 102-6)

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Coronary heart disease (CHD) due to atherosclerosis is a multifactorial process with multiple interdependent factors. At present time, atherosclerosis is considered to be an inflammatory process. It has been proven that inflammation plays a mayor role in the initiation, progression as well as the destabilitation of the atherosclerosis plaque. High sensitivity C-reactive protein (hs-CRP) is one of the most important inflammatory marker in CHD and directly related to the extent and severity of atherosclerosis, extent of myocardial ischemia and myocardial necrosis. The purpose of this study is to determine hs-CRP levels in patients with acute coronary syndrome (ACS), chronic CHD and non CHD. And, to determine the correlation between hs-CRP levels and CKMB enzyme level in patients with acute myocardial infarction (AMI). This is a descriptive observational analytic study with cross sectional design. hs-CRP levels were measured by using chemiluminescent method on 21 ACS patients, 20 chronic CHD patients and 20 non CHD patients. The mean hs-CRP level in ACS, chronic CHD and non CHD patients were respectively 8.40 (SD 5.53) mg/l, 2.81 (SD 2.09) mg/l and 1.07 (SD 0.81) mg/l. A statistically significant difference in hs-CRP level was found between ACS, chronic CHD and non CHD (p = 0.000 ). A positive correlation was found between hs-CRP level and CKMB enzyme level in AMI patients (p = 0.004). In conclusion hs-CRP level is consistently higher in patients with ACS compared to patients with chronic CHD and non CHD. A positive correlation was found between the increased level of hs-CRP and CKMB enzyme level. (Med J Indones 2004; 13: 102-6)

Abstrak :
Penyakit kardiovaskular merupakan penyebab kematian nomor satu di dunia dengan prevalensi yang semakin meningkat dari tahun ke tahun. Aterosklerosis merupakan penyebab utama dari penyakit kardiovaskular, dapat dideteksi dini dengan pemeriksaan ultrasonografi ketebalan intima-media KIM karotis. Salah satu faktor risiko aterosklerosis yang dapat dimodifikasi adalah dislipidemia, dapat dipengaruhi dari asupan makanan antara lain diet tinggi fruktosa. Fruktosa selain dalam bentuk alami juga banyak digunakan secara komersial sebagai pemanis makanan/minuman. Penelitian dengan desain potong lintang ini bertujuan untuk mengetahui korelasi asupan fruktosa dengan KIM karotis pada laki-laki hiperkolesterolemia usia 19 ??49 tahun. Dari 47 subjek yang merupakan karyawan RS Jantung dan Pembuluh Darah Harapan Kita Jakarta, didapatkan nilai tengah usia subjek 41 33 ??45 tahun. Sebanyak 57,4 subjek memiliki kadar low density lipoprotein LDL tinggi dan sangat tinggi, 29,8 kadar high density lipoprotein HDL rendah dan 27,6 kadar trigliserida tinggi dan sangat tinggi. Sebagian besar subjek memiliki tekanan darah sistolik dan diastolik normal. Sebanyak 72,3 subjek tergolong obesitas dan 66,0 tergolong obesitas sentral. Sebagian besar subjek merupakan perokok ringan dan sebanyak 48,9 subjek beraktivitas ringan. Pada pemeriksaan KIM karotis didapatkan nilai tengah 1 0,8 ??1,4 mm dengan 63,8 subjek terdapat penebalan. Nilai tengah asupan energi total 1209 1020 ??1645 kkal/hari, asupan karbohidrat, protein, lemak sebagian besar tergolong cukup, asupan serat 100 tergolong kurang dan rerata asupan fruktosa 31,97 ? 15,48 gram/hari. Hasil analisis bivariat tidak terdapat korelasi antara asupan fruktosa dengan KIM karotis namun terdapat korelasi positif bermakna antara lingkar pinggang dan asupan lemak dengan KIM karotis. Hasil analisis multivariat didapatkan bahwa asupan lemak mempunyai hubungan bermakna dengan KIM karotis.

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Cardiovascular disease is the number one cause of death worldwide with an increasing prevelance annually. Atherosclerosis is the main cause of cardiovascular disease that is detectable early by ultrasound examination of the intima media thickness IMT of the carotid artery. One of the modifiable risk factors for developing atherosclerosis is dyslipidemia, that can be affected by food intake among them is high fructose diet. Apart from naturally occurring, fructose is largely used commercially as food beverage sweetener. This cross sectional study was conducted to investigate the correlation between fructose intake and IMT in male subjects with hypercholesterolemia aged 19 49 years old. Of 47 subjects who are Harapan Kita National Cardiovascular Center Hospital s employee, median age was 41 33 45 years old. In 57.4 subjects, low density lipoprotein LDL was found high and very high, 29.8 subjects have low high density lipoprotein HDL levels, and 27.6 subjects have high and very high triglycerides levels. Most subjects have normal systolic and diastolic blood pressure. Around 72.3 subjects were classified as obesity and 66.0 were classified as having central obesity. Majority of subjects were light smoker and 49.8 of them performed light activity. In carotid IMT examination, median of 1 0.8 1.4 mm was found with 63.8 subjects developed thickness. Median total energy intake was 1209 1020 1645 Kcal day, mostly with adequate carbohydrate, protein, and fat, fiber intake was inadequate in 100 subjects, and mean fructose intake of 31,97 15,48 gram day. Bivariate analysis did not demonstrate any correlation between fructose intake and carotid IMT however there was positive correlation between waist circumference and fat intake with carotid IMT. Multivariate analysis showed that fat intake has a significant correlation with carotid IMT.

Abstrak :
ABSTRAK Aterosklerosis merupakan proses terjadinya penyempitan dan pengerasan pembuluh darah yang disebabkan oleh penimbunan lemak, terutama dalam pembuluh darah arteri. Pada tahun 2016, tercatat bahwa 35% kematian di Indonesia disebabkan oleh penyakit yang terjadi karena aterosklerosis. Beberapa alternatif penyembuhan aterosklerosis adalah dengan mengkonsumsi obat antiaterosklerosis. Namun, obat anti-aterosklerosis yang telah beredar di masyrakat luas saat ini memiliki efek samping yang cukup mengganggu saat dikonsumsi. Kombinasi herbal yang terdiri dari daun tanjung, daun belimbing manis dan temulawak dipercaya secara empirik berperan sebagai jamu antiaterosklerosis yang mengandung senyawa fenolik dan flavonoid yang berpotensi sebagai antioksidan, antihiperglikemik, dan antiinflamasi serta meningkatkan aktivitas imunomodulator dalam tubuh. Pengujian aktivitas antihiperglikemik, antiinflamasi dan aktivitas imunomodulator dilakukan masing-masing terhadap 5 kelompok perlakuan tikus putih jantan yaitu kelompok normal (tanpa perlakuan), kontrol positif (diberikan obat antihiperglikemik/antiinflamasi/imboost), dosis 1 ekstrak jamu (13,5 mg/g BB), dosis 2 ekstrak jamu (18 mg/g BB), dan dosis 3 esktrak jamu (22,5 mg/g BB). Melalui pengujian yang dilakukan, dosis jamu anti-aterosklerosis yang menghasilkan aktivitas imunomodulator yang optimum bervariasi antara dosis 2 dan 3. Dapat disimpulkan bahwa formulasi ekstrak jamu anti-aterosklerosis dapat digunakan sebagai imunomodulator yang mampu untuk meningkatkan dan meregulasi sistem kekebalan tubuh karena diketahui adanya aktivitas antihiperglikemik dan antiinflamasi dari jamu antiaterosklerosis.

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ABSTRACT Atherosclerosis is a process of narrowing and hardening of the arteries caused by accumulation of fat, especially in arteries. In 2016, it was recorded that 35% of deaths in Indonesia were caused by diseases that occur due to atherosclerosis. Some alternatives to cure atherosclerosis are by taking antiaterosclerosis drugs. However, anti-atherosclerosis drugs that have been circulating in the wider community now have side effects that are quite disturbing when consumed. The combination of herbs consisting of tanjung leaves, sweet starfruit leaves and ginger is empirically believed to act as an antiaterosclerosis herbal medicine containing phenolic and flavonoid compounds that have the potential to be antioxidants, antihyperglycemic, and anti-inflammatory and to increase immunomodulatory activity in the body. Testing of antihyperglycemic, anti-inflammatory and immunomodulatory activities was carried out on each of the 5 treatment groups of male white rats namely normal group (without treatment), positive control (given antihyperglycemic/anti-inflammatory / imboost drug), dose 1 of herbal extract (13.5 mg/g BW), dose 2 of herbal extract (18 mg/g BW), and dose 3 of herbal extracts (22.5 mg/g BW). Through testing, the dosage of anti-atherosclerosis herbs that produce optimum immunomodulatory activity varies between doses 2 and 3. It can be concluded that the formulation of anti-atherosclerosis herbal extract can be used as an immunomodulator that is able to enhance and regulate the immune system because of the known antihyperglycemic and anti-inflammatory activity of anti-atherosclerosis herbs.

Abstrak :
Latar Belakang: Obesitas merupakan suatu keadaan terdapatnya jaringan lemak dalam tubuh yang berlebihan. Kondisi ini berhubungan dengan penyakit kardiovaskular, salah satunya adalah aterosklerosis. Aterosklerosis pada sistem pembuluh darah karotis hingga saat ini merupakan penyebab terbesar stroke iskemik di dunia dengan jumlah kasus terbanyak pada rentang usia 45-64 tahun. Dengan menggunakan teknik single slice CT-scan dapat dihitung komposisi lemak viseral (VAT) maupun lemak subkutan (SAT) tubuh dengan baik. Sedangkan USG merupakan modalitas radiologi yang baik untuk skrining aterosklerosis pada arteri karotis komunis dengan mengukur ­Intima-Media Thickness (IMT). Tujuan: Tujuan penelitian ini adalah untuk menentukan komposisi lemak yang berhubungan terhadap aterosklerosis karotis komunis dan lingkar pinggang. Metode: Sebanyak 32 subjek penelitian yang melakukan pemeriksaan CT-scan regio abdomen, dilakukan penghitungan luas penampang VAT, SAT dan rasio VAT/SAT dengan menggunakan software volumetri SyngoTM, pengukuran IMT arteri karotis komunis kanan dan kiri menggunakan USG yang dilengkapi dengan software auto-IMT, dan pengukuran lingkar pinggang. Kemudian dilakukan analisa korelasi antara VAT, SAT, dan rasio VAT/SAT terhadap IMT karotis serta lingkar pinggang (WC). Hasil: Terdapat korelasi lemah antara luas penampang VAT terhadap IMT karotis komunis (ρ = 0,21 ; p = 0,248), antara luas penampang SAT terhadap IMT karotis komunis (ρ = 0,37 ; p = 0,036) dan korelasi negatif lemah antara rasio VAT/SAT terhadap IMT karotis komunis (ρ = -0,24 ; p = 0,193). Selain itu didapatkan korelasi kuat antara VAT terhadap lingkar pinggang (ρ = 0,73 ; p < 0,05), korelasi positif sangat kuat antara SAT terhadap lingkar pinggang (ρ = 0,87 ; p < 0,05), dan korelasi negatif lemah antara rasio VAT/SAT terhadap lingkar pinggang (ρ = -0,37 ; p = 0,038). Kesimpulan: Luas penampang VAT dan SAT berkorelasi lemah terhadap IMT karotis komunis. Luas penampang VAT berkorelasi kuat terhadap lingkar pinggang, luas penampang SAT berkorelasi sangat kuat terhadap lingkar pinggang. Rasio VAT/SAT memiliki korelasi negatif lemah terhadap IMT karotis komunis dan lingkar pinggang. Pengukuran lingkar pinggang dapat digunakan unuk memprediksi volume VAT dan SAT. ......Backgorund: Obesity is a condition with high level of fat deposition in the body. This condition is related to cardiovacular diseases including atherosclerosis. Carotid athersclerosis until now is known as the main cause of ischemic stroke in the world with the most cases ranged between 45-64 years old. With single slice CT-scan technique, we can estimate the composition of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) very well. USG is the best modality for carotid atherosclerosis screnning by measuring ­Intima-Media Thickness (IMT) of the common carotid artery. Purpose: of this study is to determine which one of these fat is correlated to carotid atherosclerosis and waist circumference (WC). Methods: Thirty two subjects that underwent an abdominal CT-scanning were calculated for their area of VAT, SAT, dan VAT/SAT ratio using SyngoTM volumetric software. Measurement of the IMT was done by using auto-IMT software in USG. Their waist circumference were also measured. Correlational analysis were done between VAT, SAT, VAT/SAT ratio with carotid IMT and waist circumference (WC). Result: There was a low correlation between VAT and common carotid IMT (ρ = 0,21 ; p = 0,248), SAT and common carotid IMT (ρ = 0,37 ; p = 0,036). Low negative correlation was shown between VAT/SAT ratio and carotid IMT (ρ = -0,24 ; p = 0,193). This study also showed a strong correlation between VAT and waist circumference (ρ = 0,73 ; p < 0,05), very strong correlation between SAT and waist circumference (ρ = 0,87 ; p < 0,05), also low negative correlation between VAT/SAT ratio and waist circumference (ρ = -0,37 ; p = 0,038). Conclusion: There are low correlation between VAT and SAT and common carotid IMT. There is strong correlation between VAT and waist circufmerence, very strong correlation between SAT and waist circumference. There is low inverse correlation between VAT/SAT ratio and waist circumference. Therefore the measurement of waist circumference can be used to predict VAT and SAT volume.

Abstrak :
In this volume, international experts in the field discuss the pathogenetic, diagnostic, preventive and possible therapeutic relevance of inflammation in atherogenesis. This book is intended for researchers and physicians in the fields of vascular biology, immunology and atherosclerosis.