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"Latar Belakang. Proses aterosklerosis menjadi penyebab kematian dan morbiditas utama dan berkaitan dengan penyakit jantung koroner (PJK) yang merupakan implikasi klinis proses aterosklerosis. Hipertensi dan dislipidemia menjadi salah satu faktor risiko proses aterosklerosis. Pemeriksaan ketebalan intima-media karotis (KIMK) dapat menjadi prediktor gangguan kardiovaskuler di kemudian hari. Studi Framingham merupakan penelitian yang memprediksi PJK dengan menggunakan kategori faktor risiko dan telah digunakan secara luas pada populasi yang berbeda. Populasi yang berbeda belum tentu memberikan perbedaan hasil analisis terhadap faktor risiko aterosklerosis.Tujuan. Penelitian ini bertujuan melihat hubungan rasio LDL-HDL dengan plak karotis pada populasi hipertensi di Mlati, Sleman, Daerah Istimewa Yogyakarta.Metode. Ini adalah penelitian potong lintang. Data dianalisis menggunakan regresi logistik dengan melihat besar dari nilai rasio odds (odds ratio, OR) 95% interval kepercayaan (confidence interval, CI), dan nilai p.Hasil. Subyek penelitian sebanyak 115 orang terdiri atas 56 (48,7%) laki-laki dan 59 (51,3%) perempuan dengan rerata usia 47,61±7,92 tahun. Jenis kelamin laki-laki yang memiliki KIMK ≥ 1,5 mm lebih banyak dengan proporsi 0,72±0,46 (95% CI 0,57-0,87 ; p=0,0003). Kemungkinan kejadian plak meningkat pada quartile rasio LDL-HDL kolesterol yang lebih besar. Analisis quartile >75% terhadap kejadian plak dibandingkan quartile lebih rendah memberikan OR 4,15 (95% CI 1,74-9,89; p=0,001) dan setelah disesuaikan tetap menunjukkan kemungkinan kejadian plak lebih besar (OR 3,95; 95% CI 1,39-11,22; p=0,01). Didapatkan area under curve 0,8262.

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Background. Atherosclerosis had become main problem in mortality and morbidity and related with coronary heart disease as a clinical implication of atherosclerosis process. Hypertension and dyslipidemia had become risk factors for atherosclerosis process. Carotid intima-media thickness (CIMT) measurement could be a predictor for future cardiovascular disease. Framingham study was an experiment that predicted coronary heart disease using risk factor categories and had been used widely in many regions in the world with various population. A different population might not always give different result related with atherosclerosis process.

Aim of study. To see the relaionship of LDL-HDL ratio with carotid plaque among hypertensive population in Mlati, Sleman, DIY.

Method. This is a cross-sectional syudy. Data were analyzed with logistic regression by seeing odds ratio (OR), 95% confidence interval (CI), and p value.

Result. There were 115 subjects in this experiment with 56 (48,7%) male and 50 (51,3%) female with age rate was 47,61±7,92 years old. Male subjects with CIMT value ≥1,5 mm were higher than female with proportion of 0,72±0,46 (95% CI 0,57- 0,87; p=0,0003). The possibility of plaque increased in subjects with higher LDL- HDL ratio. Analyzis of >75% quartile compared with lower quartile gave OR 4,15 (95% CI 1,74-9,89; p=0,001) and after being adjusted still gave higher possibility of plaque (OR 3,95; 95% CI 1,39-11,22; p=0,01). Area under curve was 0,8262."

"ABSTRAK Latar belakang. Pada pasien SA fraksi ejeksi ventrikel kiri dapat normal bahkan supra normal untukjangka waktu yang lama walaupun proses remodeling ventrikel kiri sudah mulai terjadi..Ekokardiografi speckle tracking dua dimensi (EST) mempunyai kelebihan untukdigunakan dalam menilai penurunan fungsi kontraktilitas miokard subklinis, dimanakeadaan tersebut dapat mempengaruhi prognosis pasien SA. sST2 merupakan biomarkeryang relatif baru, dapat meningkat pada regangan otot jantung (myocardial stretch),fibrosis, inflamasi, dan injuri miokard, apakah berhubungan dengan disfungsi diniventrikel kiri masih belum diketahui.Tujuan. Mengetahui korelasi sST2 terhadap nilai GLS EST pada pasien SA berat denganFEVK normalMetode. Merupakan studi potong lintang. Evaluasi dilakukan pada 29 pasien stenosisaorta berat dengan fraksi ejeksi normal yang datang ke poliklinik RS Jantung HarapanKita periode Februari 2015 sampai November 2015. Dilakukan pengambilan figurekokardiografi untuk menilai severitas SA dan untuk perhitungan nilai global longitudinalstrain speckle tracking kemudian dilakukan pengambilan sampel darah di laboratoriumRS Jantung Harapan Kita untuk menilai sST2.Hasil Penelitian. Dua puluh sembilan subjek ikut dalam penelitian ini dengan rerata usiaadalah 59.7±12.1 tahun. Fungsi intrinsik ventrikel kiri pasien SA berat pada penelitian inimengalami penurunan dengan nilai rerata GLS -11±4.5%. Hasil uji korelasi menunjukanterdapat korelasi positif dengan kekuatan korelasi sedang yang bermakna (r=0.429,p=0.02). Analisis multivariat tetap menunjukkan adanya hubungan antara kadar sST2dengan nilai GLS EST (r=0,282 p=0.036). Kesimpulan. Terdapat korelasi sST2 dengan global longitudinal strain speckle trackingpada pasien SA berat dengan fraksi ejeksi normal.ABSTRACT Background. In severe aortic stenosis (AS), cardiac performance measured at theventricular chamber is typically normal or supranormal, whereas Global LongitudinalStrain providing comprehensive information on LV myocardial contractility and issuperior in detecting subtle deteriorations. Impaired LV GLS is associated mortality riskand reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,and myocardial injury. Whether sST2 is increased in relation to the subclinical LVdysfunction assessed by GLS in AS is unknown.Objectives. To study correlation beetwen sST2 and GLS in patients with AS severeMethods. This is a correlation study with cross sectional design. The subject was aorticstenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at ouroutpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. Acomprehensive transthoracic echocardiography was performed to evaluate severity ofaortic stenosis. and echocardiographic figure recordings were stored in digital for off-linesubsequent GLS analysis. sST2 measurements were drawn after echocardiography.Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.APearsoncorrelaterevealedsignificantpositivecorrelationbetweensST2andGLS(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor stillshowed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation betweensST2 with left ventricle global longitudinal strain speckle tracking in patients with severeaortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at theventricular chamber is typically normal or supranormal, whereas Global LongitudinalStrain providing comprehensive information on LV myocardial contractility and issuperior in detecting subtle deteriorations. Impaired LV GLS is associated mortality riskand reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,and myocardial injury. Whether sST2 is increased in relation to the subclinical LVdysfunction assessed by GLS in AS is unknown.Objectives. To study correlation beetwen sST2 and GLS in patients with AS severeMethods. This is a correlation study with cross sectional design. The subject was aorticstenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at ouroutpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. Acomprehensive transthoracic echocardiography was performed to evaluate severity ofaortic stenosis. and echocardiographic figure recordings were stored in digital for off-linesubsequent GLS analysis. sST2 measurements were drawn after echocardiography.Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.APearsoncorrelaterevealedsignificantpositivecorrelationbetweensST2andGLS(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor stillshowed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation betweensST2 with left ventricle global longitudinal strain speckle tracking in patients with severeaortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at theventricular chamber is typically normal or supranormal, whereas Global LongitudinalStrain providing comprehensive information on LV myocardial contractility and issuperior in detecting subtle deteriorations. Impaired LV GLS is associated mortality riskand reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,and myocardial injury. Whether sST2 is increased in relation to the subclinical LVdysfunction assessed by GLS in AS is unknown.Objectives. To study correlation beetwen sST2 and GLS in patients with AS severeMethods. This is a correlation study with cross sectional design. The subject was aorticstenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at ouroutpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. Acomprehensive transthoracic echocardiography was performed to evaluate severity ofaortic stenosis. and echocardiographic figure recordings were stored in digital for off-linesubsequent GLS analysis. sST2 measurements were drawn after echocardiography.Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.APearsoncorrelaterevealedsignificantpositivecorrelationbetweensST2andGLS(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor stillshowed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation betweensST2 with left ventricle global longitudinal strain speckle tracking in patients with severeaortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at theventricular chamber is typically normal or supranormal, whereas Global LongitudinalStrain providing comprehensive information on LV myocardial contractility and issuperior in detecting subtle deteriorations. Impaired LV GLS is associated mortality riskand reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,and myocardial injury. Whether sST2 is increased in relation to the subclinical LVdysfunction assessed by GLS in AS is unknown.Objectives. To study correlation beetwen sST2 and GLS in patients with AS severeMethods. This is a correlation study with cross sectional design. The subject was aorticstenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at ouroutpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. Acomprehensive transthoracic echocardiography was performed to evaluate severity ofaortic stenosis. and echocardiographic figure recordings were stored in digital for off-linesubsequent GLS analysis. sST2 measurements were drawn after echocardiography.Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.APearsoncorrelaterevealedsignificantpositivecorrelationbetweensST2andGLS(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor stillshowed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation betweensST2 with left ventricle global longitudinal strain speckle tracking in patients with severeaortic stenosis with preserved EF. ;Background. In severe aortic stenosis (AS), cardiac performance measured at theventricular chamber is typically normal or supranormal, whereas Global LongitudinalStrain providing comprehensive information on LV myocardial contractility and issuperior in detecting subtle deteriorations. Impaired LV GLS is associated mortality riskand reflect fibrosis. sST2 is a novel biomarker of mechanical stress, fibrosis, inflamation,and myocardial injury. Whether sST2 is increased in relation to the subclinical LVdysfunction assessed by GLS in AS is unknown.Objectives. To study correlation beetwen sST2 and GLS in patients with AS severeMethods. This is a correlation study with cross sectional design. The subject was aorticstenosis severe patient (aortic valve area <1.0 cm2) with preserved EF (>50%) at ouroutpatient clinic in Harapan Kita Hospital from February 2015 until Novenber 2015. Acomprehensive transthoracic echocardiography was performed to evaluate severity ofaortic stenosis. and echocardiographic figure recordings were stored in digital for off-linesubsequent GLS analysis. sST2 measurements were drawn after echocardiography.Results. Twenty nine patient were enrolled in this study. The mean ages was 59.7±12.1years. left ventricle intrinsic function in aortic stenosis patient was decreased with GLS 11±4.5%.APearsoncorrelaterevealedsignificantpositivecorrelationbetweensST2andGLS(r=0.429, p=0.02). Multivariate analysis with introduced confounding factor stillshowed a positive correlation between sST2 and GLS (r=0,282 p=0.036). Conclusion. This cross sectional study demonstrated a moderate correlation betweensST2 with left ventricle global longitudinal strain speckle tracking in patients with severeaortic stenosis with preserved EF. "

"ABSTRAK Latar Belakang : Hipertensi merupakan faktor resiko utama penyakit kardiovaskular, terutama sindrom koroner akut dan stroke. Peningkatan konsumsi garam berhubungandengan kenaikan tekanan darah. Beberapa studi randomized-controlled trial (RCT)menyatakan bahwa konsumsi rendah garam dapat menurunkan tekanan darah padapopulasi dewasa dengan atau tanpa hipertensi. Variabilitas tekanan darah selama 24 jambersifat dinamis. Peningkatan darah nokturnal memiliki makna klinis yang cukup besar,merupakan salah satu prediktor dari penyebab kerusakan target organ, terutama kejadiankardiovaskular dan stroke. Asupan garam dapat mempengaruhi variasi tekanan darah 24jam, yang dalam hal ini dapat juga berpengaruh pada hipertensi nokturnal. Obat penyekatEKA merupakan obat hipertensi lini pertama yang sering digunakan, terutama pada usiamuda dan hipertensi yang disertai sindrom metabolik, mengingat peranan Sistem ReninAngiotensin memiliki peranan yang sangat penting dalam patofisiologi hipertensi. Asupangaram juga memiliki peranan pada patofisiologi terjadinya hipertensi dalam sistem ReninAngiotensin. Sedikit studi yang meneliti perpaduan obat penyekat EKA dengan asupanrendah garam dalam menrunkan kejadian hipertensi. Oleh karena itu, Menarik untuk ditelitipengaruh asupan garam dengan tekanan darah nokturnal pada pasien yang mengkonsumsiobat penyekat EKA.Tujuan : Menilai pengaruh asupan garam dengan tekanan darah nokturnal pada pasienhipertensi yang mendapatkan terapi penyekat EKA. Metode : Pasien poliklinik berusia 30 ? 50 tahun yang terdiagnosis hipertensi dan belumpernah mendapatkan anti-hipertensi sebelumnya, dibagi menjadi 2 kelompok (asupanrendah garam (Na <15 g/hari) dan asupan tinggi garam ≥15 g/hari). Kedua kelompok akandiberikan lisinopril dan dilakukan pemeriksaan natrium urin 24 jam dan home bloodpressure monitoring..Hasil Penelitian : Sebanyak 80 pasien hipertensi pasien hipertensi yang belummendapatkan terapi diikutsetakan dalam penelitian ini, yang terdiri dari 37 pasienkelompok rendah garam dan 43 pasien kelompok tinggi garam. Kelompok pasien denganasupan rendah garam memliki delta penurunan darah nokturnal sistolik (p<0,001),diastolic (p<0,001), dan rerata arteri (p<0,001) yang lebih besar dibandingkan padakelompok asupan tinggi garam. Rerata asupan garam pada penelitian ini sebesar 16,77gram/hari. Pada analisa multivariat didapatkan delta penurunan tekanan darah tidakdipengaruhi oleh usia, jenis kelamin, dislipidemia, IMT, dan durasi tidur.Kesimpulan : Penelitian ini membuktikan asupan rendah garam dapat mempengaruhi efektivitas terapi penyekat EKA dalam menurunkan tekanan darah nokturnal. ABSTRACT Background : Hypertension is one of important risk factor of cardiovascular disease, especially acute coronary syndrome and stroke. High salt intake correlatesto high blood pressure. Some Randomized-Controlled-Trials stated that low saltintake may decrease blood pressure in adult population with or withouthypertension. Blood pressure variation in 24 hours is not static but dynamicallychanges. Increasing nocturnal blood pressure has significantly impacts, and becomeone of predictor of target organ damage, especially cardiovascular events andstroke. Salt intake may interferes both 24 hours blood pressure variation and nocturnal blood pressure. Angiotensin Converting Enzyme(ACE) Inhibitors is first drug of choice anti-hypertensive therapy, especially in young age and associatedwith metabolic syndrome, due to important role of Renin Angiotensin AldosteroneSystem in pathophysiology of hypertension, whereas salt intake also has role in thatsystem. Only few of studies that had proved combination of ACE Inhibitors andlow salt intake in decreasing blood pressure in hypertension population. Therefore,it is so important to know the impact of low salt intake to nocturnal blood pressurein hypertension patient treated with ACE Inhibitors.Objectives : To know impact of low salt intake to nocturnal blood pressure inhypertension patient treated with ACE Inhibitors.Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreatedhypertension, divided into two groups (low salt intake (Na <15 grams/day) and highsalt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg andunderwent 24-hours sodium urine collection and home blood pressure monitoringperiodically.Results : There are 80 ambulatory patients diagnosed as untreated hypertension,consist of 37 patients in low salt intake group and 43 patients in high salt intakegroup. Low salt intake group has lower nocturnal systolic (p<0.001), diastolic(p<0.001), and mean arterial (p<0.001) blood pressure compared with high saltintake group. Mean salt intake in this study was 16.77 grams/day. Multivariateanalyzes showed that the difference of decreasing nocturnal blood pressure was notinterfered by age, sex, dyslipidemia, BMI, and sleep duration.Conclusion : This study has proved that low salt intake may interfere ACE Inhibitors therapy effectiveness in decreasing nocturnal blood pressure.;Background : Hypertension is one of important risk factor of cardiovascular disease, especially acute coronary syndrome and stroke. High salt intake correlatesto high blood pressure. Some Randomized-Controlled-Trials stated that low saltintake may decrease blood pressure in adult population with or withouthypertension. Blood pressure variation in 24 hours is not static but dynamicallychanges. Increasing nocturnal blood pressure has significantly impacts, and becomeone of predictor of target organ damage, especially cardiovascular events andstroke. Salt intake may interferes both 24 hours blood pressure variation and nocturnal blood pressure. Angiotensin Converting Enzyme(ACE) Inhibitors is first drug of choice anti-hypertensive therapy, especially in young age and associatedwith metabolic syndrome, due to important role of Renin Angiotensin AldosteroneSystem in pathophysiology of hypertension, whereas salt intake also has role in thatsystem. Only few of studies that had proved combination of ACE Inhibitors andlow salt intake in decreasing blood pressure in hypertension population. Therefore,it is so important to know the impact of low salt intake to nocturnal blood pressurein hypertension patient treated with ACE Inhibitors.Objectives : To know impact of low salt intake to nocturnal blood pressure inhypertension patient treated with ACE Inhibitors.Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreatedhypertension, divided into two groups (low salt intake (Na <15 grams/day) and highsalt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg andunderwent 24-hours sodium urine collection and home blood pressure monitoringperiodically.Results : There are 80 ambulatory patients diagnosed as untreated hypertension,consist of 37 patients in low salt intake group and 43 patients in high salt intakegroup. Low salt intake group has lower nocturnal systolic (p<0.001), diastolic(p<0.001), and mean arterial (p<0.001) blood pressure compared with high saltintake group. Mean salt intake in this study was 16.77 grams/day. Multivariateanalyzes showed that the difference of decreasing nocturnal blood pressure was notinterfered by age, sex, dyslipidemia, BMI, and sleep duration.Conclusion : This study has proved that low salt intake may interfere ACE Inhibitors therapy effectiveness in decreasing nocturnal blood pressure.;Background : Hypertension is one of important risk factor of cardiovascular disease, especially acute coronary syndrome and stroke. High salt intake correlatesto high blood pressure. Some Randomized-Controlled-Trials stated that low saltintake may decrease blood pressure in adult population with or withouthypertension. Blood pressure variation in 24 hours is not static but dynamicallychanges. Increasing nocturnal blood pressure has significantly impacts, and becomeone of predictor of target organ damage, especially cardiovascular events andstroke. Salt intake may interferes both 24 hours blood pressure variation and nocturnal blood pressure. Angiotensin Converting Enzyme(ACE) Inhibitors is first drug of choice anti-hypertensive therapy, especially in young age and associatedwith metabolic syndrome, due to important role of Renin Angiotensin AldosteroneSystem in pathophysiology of hypertension, whereas salt intake also has role in thatsystem. Only few of studies that had proved combination of ACE Inhibitors andlow salt intake in decreasing blood pressure in hypertension population. Therefore,it is so important to know the impact of low salt intake to nocturnal blood pressurein hypertension patient treated with ACE Inhibitors.Objectives : To know impact of low salt intake to nocturnal blood pressure inhypertension patient treated with ACE Inhibitors.Methods : There are 30 ? 50 years old ambulatory patients diagnosed as untreatedhypertension, divided into two groups (low salt intake (Na <15 grams/day) and highsalt intake (≥15 grams/day). Both of groups were administered Lisinopril 10mg andunderwent 24-hours sodium urine collection and home blood pressure monitoringperiodically.Results : There are 80 ambulatory patients diagnosed as untreated hypertension,consist of 37 patients in low salt intake group and 43 patients in high salt intakegroup. Low salt intake group has lower nocturnal systolic (p<0.001), diastolic(p<0.001), and mean arterial (p<0.001) blood pressure compared with high saltintake group. Mean salt intake in this study was 16.77 grams/day. Multivariateanalyzes showed that the difference of decreasing nocturnal blood pressure was notinterfered by age, sex, dyslipidemia, BMI, and sleep duration.Conclusion : This study has proved that low salt intake may interfere ACE Inhibitors therapy effectiveness in decreasing nocturnal blood pressure."

"Latar belakang masalah : pada bedah pintos koroner (BPK) yang bertujuan memperbaiki miokard, dapat terjadi suatu keadaan yang tidak sesuai dengan yang diharapkan, fenomena ini dikenal sebagai injuri reperfusi. Salah satu hipotesis patofisiologi injuri reperfusi adalah pembentukan radikal bebas oksigen (RBO), dimana RBO yang sangat reaktif dan sitotoksik akan merusak membran fosfolipolipid sel sehingga terbentuk peroksida lipid. Salah satu sumber RBO yang penting berasal dari metabolisme arakidonat. Kadar asam arakidonat (AA) yang tinggi pada membran sel akan meningkatkan produksi RBO. Sebaliknya, diit suplementasi asam ekosapentanoat (AEP) terbukti menurunkan produksi RBO meskipun mekanismenya belum diketahui. TuJuan penelltlan : untuk membuktikan bahwa terjadi peningkatan peroksida lipid pascapintas jantung-paru (PJP), rasio AEP/AA dalam plasma berhubungan dengan peningkatan produksi peroksida lipid dan terdapat hubungan rasio AEP/AA dengan parameter klinis injuri reperfusi pada penderita PJK yang dilakukan BPK. Bahan dan Cara kerJa : penelitian ini bersifat observasional dengan jumlah sampel 20 penderita, semuanya laki-laki, belum pemah dilakukan angioplasti atau BPK sebelumnya, fraksi ejeksi ~ 50% berdasarkan kateterisasi koroner dan tidak minum obatobat yang mempengaruhi aktivitas radikal bebas. Kriteria eksklusi : kadar kreatinin serum > 2 mg/dl, terdapat gangguan fungsi hepar dan sedang dalam pengobatan kortikosteroid. Sampel darah diambil dari sinus koronarius sebelum PJP untuk pemeriksaan kadar AEP, AA dan peroksida lipid, kemudian 5-10 menit sesudah PJP darah diambil lagi untuk pemeriksaan peroksida lipid, semua pemeriksaan dilakukan dengan alat HPLC (high performance liquid chromatography). Parameter klinis injuri reperfusi yang dinilai adalah kejadian arimia reperfusi dan cardiac index. Hasll penelltlan : didapatkan kadar AEP rataan 1,971 I 1,716 j.lgT, kadar AA rataan 25,386 I 12,657 pgr dan rasio AEP/AA rataan 0,08 I 0,05. Kadar peroksida lipid sesudah PJP meningkat sangat bermakna dibanding sebelum PJP (0,802 I 0,281 vs 0,532 I 0,13 J.ITT1ol/L, p = 0,0003) dengan peningkatan peroksida lipid (8 PL) rataan sebesar 0,27 ::t 0,336 f.lTT1ol/L. Analisis regresi linier menunjukkan hubungan yang bermakna antara AEP us 8 PL (/3 = 0,798, p = 0,000), AA us 8 PL (/3 = 0,451, p = 0,046) dan rasio AEP/AA us 8 PL (/3 = 0,509, p = 0,022) sedangkan uariabellain seperti lama klem aorta, lama mesin PJP dan jumlah tandur tidak menunjukkan hubungan yang bermakna. Pada analisis regresi multipel, hanya kadar AEP yang menunjukkan hubungan bermakna dengan peningkatan peroksida lipid (/3 = 1,084, p = 0,03). Terhadap parameter klinis injuri reperfusi, hanya rasio AEP/AA yang menunjukkan hubungan bermakna dengan aritmia reperfusi (p = 0,044), sedangkan terhadap cardiac index tidak menunjukkan hubungan bermakna. Demikian pula, kadar peroksida lipid sesudah PJP tidak menunjukkan hubungan bermakna dengan parameter klinis injuri reperfusi. Keslmpulan : teTjadi peningkatan peroksida lipid pasca PJP, terdapat hubungan antara rasio AEP/AA dalam plasma dengan produksi peroksida lipid dan terdapat hubungan antara rasio AEP/AA dalam plasma dengan kejadian aritmia reperfusi pada penderita PJK yang dilakukan BPK. Saran : agar dilakukan penelitian lanjutan berupa pene/itian kasus-kontrol yang bertujuan untuk memperbaiki rasio AEP/AA sebagai upaya pencegahan terhadap injuri reperfusi yang akan teTjadi pada penderita PJK yang dilakukan BPK."

"Beberapa penelitian sebelumnya telah menunjukkan adanya hubungan antara stenosis arteri koroner dan ketebalan intima media arteri karotis pada populasi umum. Ketebalan intima media arteri karotis ini pada penderita DMTTI lebih tebal dibandingkan pada penderita yang tanpa diabetes. Oleh karena itu penelitian ini bertujuan untuk melihat apakah berat dan luasnya stenosis arteri koroner secara angiografi pada penderita PJK dengan DMTTI mempunyai korelasi dengan makin tebalnya intima media arteri karotis. Telah dilakukan pemeriksaan ketebalan intima media arteri karotis komunis, bifurkasio-bulbus, arteri karotis interna dan eksterna kanan dan kiri pada 30 orang penderita PJK dengan DMTTI yang terdiri dari 25 laki-laki dan 5 perempuan, berumur rata-rata 58 ± 8,5 tahun (44 - 74 tahun). Dari hasil angiografi koroner terdapat 2 orang dengan 1 VD, 11 orang dengan 2VD dan 17 orang dengan 3VD. Terdapat penebalan intima media arteri karotis pada semua penderita dengan rata-rata ketebalan intima media arteri karotis yaitu 2,6 ± 1,1 mm (1 - 6 mm), ini menunjukkan adanya korelasi antara ketebalan intima media arteri karotis dan stenosis arteri koroner, namun tidak didapatkan korelasi yang bermakna secara statistik antara 1 VD, 2 VD dan 3 VD dengan ketebalan intima media arteri karotis yang lebih tebal meskipun ada kecenderungan bahwa makin banyak pembuluh darah koroner yang mengalami stenosis makin tebal intima media arteri karotis."

"Percutaneous transluminal coronary angioplasty ( PTCA) isknown as the mechanical alternative intervention forrevascularization of coronary artcry stenosis.Unfortunately reocclusion and coronary spasm is seen on quite anumber of patients. This process is said due to an imbalance ofvasoactive substances at the cellular endothelial level which cause vasoconstriction of the smooth muscle cells. It's believed that endothelin and lipid peroxidc ( oxigen frec radicals) has a significant role in this process. This study is designed to prove the hypothesis that there is anincrease of endothclin and lipid peroxide concomitantlyimmediately after PTCA proseduce. On 37 patients with stenosis at left coronary artery, local plasma endothelin and lipid peroxide were measured before and after PTCA. Blood was obtained at side of coronary sinus. Endothelin was measured by specific competitive protein binding radioimmunoassay ( RIA Technique ), while lipid peroxide was measured by using Malonaldehyde (MDA) concentration. Local plasma MDA was measured by fuorosense spectrofotometri.The results showed a significant increase of local plasma endothelin after PTCA (5,28+1-3,33 to 8,53 +1- 4,5 . Pglml, p = 0,0001) and a significant increase of local plasma MDA concentration after PTCA ( 0,540+1-0,279 to 0,868+1-0,438. Umol/L, p = 0,0001). There was no correlation found between the increase of local plasma endothelin with the duration of balloon inflation, peak pressure of balloon inflation, diameter of the balloon, length of the balloon, the number of balloon inflation. This finding suggest that beside endothelial injury during PTe" other unknown factor contribute to the increasing level of endothelin. However correlation was found between the increase of local plasma MDA and the number of the balloon inflation.Conclusions: Local plasma endothelin and lipid peroxide were significantely increased immediately after PTCA, and there was correlation between the increase of local plasma lipid peroxide with the number of the balloon inflation."

"Tekanan darah bervariasi secara diurnal. Studi terdahulu telah menunjukkan, bahwa ada hubungan antara tekanan darah khususnya tekanan darah sistolik dengan hipertrofi ventrikel kiri pada penderita hipertensi dengan koefisien korelasi yang bervariasi. Studi ini bertujuan untuk mengetahui apakah pada subyek normotensi, tekanan darah diukur secara ambutatorik 24 jam sudah mempengaruhi indeks massa ventrikel kiri. Untuk mengetahui koretasi antara tekanan darah baik secara kasual maupun ambulatorik 24 jam dengan indeks massa ventrikel kiri pada subyek normotensi, telah dilakukan penelitian di RSJHK terhadap 42 karyawan bidang administrasi RSJHK. Semua subyek termasuk normotensi pada pengukuran kasual. Tiga di antaranya dieksklusi karena kelainan katup, dan gangguan pada pemeriksaan ambulatorik 24 jam sehinggga tidak memenuhi syarat untuk dianalisis. Subyek penelitian semuanya laki-Iaki, berumur 37,81 ± 4,65 tahun. Penelitian dilakukan dalam periode Nopember 1997 sampai dengan Juli 1998. Pengumpulan data dilakukan secara prospektif.

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Blood pressure varies diurnally. Previous studies have shown that there is a relationship between blood pressure, especially systolic blood pressure, and left ventricular hypertrophy in hypertensive patients with varying correlation coefficients. This study aims to find out whether in normotensis subjects, blood pressure measured ambutatorically at 24 hours has affected the left ventricular mass index. To determine the correlation between blood pressure both casually and ambulatory 24 hours with the left ventricular mass index in normotensis subjects, a study has been conducted at RSJHK on 42 employees in the field of administration of RSJHK. All subjects included normotensis to casual measurements. Three of them were excluded due to valve abnormalities, and interference with the 24-hour ambulatory examination so they were not eligible for analysis. The research subjects were all male, aged 37.81 ± 4.65 years. The research was conducted in the period from November 1997 to July 1998. Data collection is carried out prospectively "

"Latar Belakang: Reperfusi koroner sangat penting untuk menyelamatkan miokardium yang mengalami iskemia namun tindakan ini ternyata juga dapat mengakibatkan cedera miokardium yang dikenal sebagai jejas reperfusi Manifestasi klinisnya berupa komplikasi pasca BPAK diantaranya aritmia penurunan curah jantung dan perioperatif infark miokard Stres oksidatif merupakan salah satu inisiator utama kejadian jejas reperfusi Allopurinol sebagai inhibitor efektif enzim xantin oksidase dapat menurunkan stres oksidatif dengan menghambat pembentukan reactive oxygen species Sehingga diharapkan pemberian allopurinol pada pasien PJK dengan disfungsi ventrikel kiri yang akan menjalani BPAK dapat menurunkan kejadian komplikasi pasca operasiTujuan: Mengetahui efek allopurinol terhadap komplikasi pasca operasi BPAK low cardiac output syndrome yang dinilai dengan penggunaan inotropik dan IABP pasca operasi kematian dalam masa rawat perioperatif infark miokard dan aritmia pada pasien PJK dengan disfungsi ventrikel kiriMetode: Penelitian ini adalah uji klinis tersamar ganda 34 subjek dipilih secara konsekutif pada September November 2015 Subjek dibagi menjadi dua kelompok yaitu 16 orang mendapat allopurinol 600mg dan 18 orang mendapat plasebo Obat per oral diberikan 1 hari sebelum dan 6 jam sebelum operasi Pengamatan kejadian komplikasi pasca operasi dimulai sejak pelepasan klem silang aorta hingga pasien selesai perawatanHasil: Penggunaan inotropik dan IABP pasca operasi menunjukkan perbedaan yang bermakna pada kedua kelompok p 0 047 Ini berarti penggunaan allopurinol berpotensi mengurangi penggunaan inotropik dan IABP pasca operasi BPAK Proporsi kematian dalam masa rawat pasca operasi BPAK pada kedua kelompok tidak berbeda bermakna yaitu 6 25 vs 5 6 p 1 000 Sedangkan untuk kejadian aritmia pada kedua kelompok terdapat perbedaan bermakna dengan total proporsi 31 vs 66 p 0 039 dengan jumlah aritmia terbanyak pada kedua kelompok adalah fibrilasi atrium Kejadian perioperatif infark miokard tidak didapatkan pada penelitian ini sehingga efek pemberian allopurinol terhadap kejadian tersebut tidak dapat dinilaiKesimpulan: Pemberian allopurinol sebelum operasi pada pasien PJK dengan disfungsi ventrikel kiri berpotensi menurunkan kejadian low cardiac output syndrome LCOS yang terlihat dari rendahnya penggunaan obat inotropik dan IABP pasca operasi dan menurunkan kejadian aritmia pasca operasi BPAK

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Background: Reperfusion of coronary blood flow is important to resuscitate the ischemic or hypoxic myocardium However the return of blood flow to the ischemic area can result paradoxical cardiomyocyte dysfunction this is referred to as ldquo reperfusion injury rdquo Clinical manifestations of reperfusion injury post CABG surgery are arrhythmias decrease cardiac output and perioperative myocardial infarct Oxidative stress has been confirmed as one of the main initiator in myocardial injury at ischemic and reperfusion state Allopurinol as an effective inhibitor of xanthine oxidase XO can reduce the oxidative stress by blocking the formation of reactive oxygen species ROS Pre operative allopurinol on CAD's patient with LV dysfunction is expected reduce the complications of post CABG surgery

Objective: To analyze effects of pre operative administration of allopurinol on complications of post CABG surgery low cardiac output syndrome which is measured by the use of post surgery inotropic and IABP hospital mortality perioperative myocardial infarction and arrhythmias in CAD's patient with LV dysfunction

Methods: This study is a double randomized clinical trial 34 CAD's patients with LV dysfunction were randomly selected by consecutive sampling methods from September November 2015 They were divided into two groups Sixteen patients were given 600 mg dose of allopurinol per oral one day before and 6 hours before surgery and the rest received placebo Complications of post CABG surgery were observed since the aortic cross clamp off until discharged

Results: The use of post surgery inotropic and IABP found significantly lower in allopurinol group p 0 047 There was no significant difference in proportion of death in post operative hospitalization period in both groups 6 25 vs 5 6 p 1 000 While for the incidence of arrhythmias was found significantly different in the two groups 31 vs 66 p 0 039 with atrial fibrillation as the most common arrhythmia No perioperative myocardial infarction was found in this study therefore effects of allopurinol to the event is unknown

Conclusions: Pre operative administration of allopurinol may reduce the complications of post CABG especially the use of inotropic and IABP and occurrence of arrhythmias"