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Reginald L. Lefrandt
Universitas Sam Ratulangi Manado
Biochemistry, Genetics & Molecular Biology Health Professions

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MENGATASI FIBRILASI ATRIUM RAPID RESPONSE DENGAN BISOPROLOL Tumiwa, Franky A.; Lefrandt, Reginald L.
Jurnal Biomedik : JBM Vol 1, No 3 (2009): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.1.3.2009.835

Abstract

Abstract: We reported a 77-year old female, admitted to the Prof dr RD Kandou General Hospital due to dyspnea. Physical examination revealed hypertension, rales and wheezing in both lungs, heart enlargement, and an auscultation heart rate of 140 beats per minute. ECG showed a rapid response atrial fibrillation. Besides that, chest X ray examination showed cardiomegaly with CTR>50%. A working diagnosis revealed lung edema (pneumonia as a differential diagnosis),  and functional heart failure class II-III due to hypertensive heart disease, associated with a rapid response atrial fibrillation. Bisoprolol 5 mg once daily was given immediately along with oxygen, a NaCL 0.9% infusion, and furosemide 40 mg intravenously. In addition to this, was added ceftriaxon 1g twice daily, captopril 6.25 mg three times daily, furosemide 40mg, thiazide 25 mg, and aspirin 80 mg once daily, coenzyme Q10 100 mg twice daily, and trimetazidine 35 mg two tablets daily. The ECG result after approximately 10 hours  was a normal respone atrial fibrillation. The patient left the hospital at the fifth day with the same ECG result. Key words: atrial fibrillation, bisoprolol, congestive heart failure. Abstrak: Telah dilaporkan seorang perempuan berusia 77 tahun, dirawat di RSU Prof dr RD Kandou dengan keluhan sesak napas. Pada pemeriksaan fisik ditemukan hipertensi, adanya ronki dan wheezing, pada perkusi pembesaran jantung, auskultasi frekuensi denyut jantung 140 kali per menit. EKG memperlihatkan fibrilasi atrium rapid response. Selain itu pada foto dada tampak kardiomegali dengan CTR>50%. Diagnosis kerja adalah suspek pneumonia, gagal jantung kongestif fungsional kelas I-III karena penyakit jantung hipertensi, disertai fibrilasi atrium rapid response. Pemberian bisoprolol 5 mg sekali sehari telah dimulai sejak saat masuk, disertai pemberian oksigen, infus cairan Nacl 0,9%, dan furosemid 40 mg intra venous. Kemudian ditambahkan ceftriaxon 1g dua kali sehari, captopril 6,25 mg tiga kali sehari, tiazid 25 mg sekali sehari, furosemid 40 mg sekali sehari, coenzim Q10 100 mg dua kali sehari, trimetazidine 35 mg dua tablet sehari, dan aspirin 80 mg sekali per hari. Pada hari kedua EKG telah memperlihatkan gambaran fibrilasi atrium normal response. Pasien dipulangkan pada hari ke lima dengan diagnosis gagal jantung kongestif fungsional I-II karena penyakit jantung hipertensi, hipertensi terkontrol, dan fibrilasi atrium normal response. Kata kunci: fibrilasi atrium, bisoprolol, gagal jantung kongestif.
THE IMPACT OF METABOLIC SYNDROME ON RADIAL ARTERY DIAMETERS Luntungan, Marshell; Purabaya, Andhi; Budiono, Bambang; Pangemanan, Janry A.; Lefrandt, Reginald L.
Jurnal Biomedik : JBM Vol 5, No 2 (2013): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.5.2.2013.2593

Abstract

Abstrak: Dewasa ini akses arteri radialis telah digunakan secara luas pada intervensi koroner transkateter. Pada pasien sindroma metabolik (MetS) yang berisiko tinggi diabetes melitus tipe 2 (DMT2), proses aterosklerosis sistemik telah memengaruhi struktur arteri radialis. Penelitian ini bertujuan untuk menentukan faktor-faktor yang berpengaruh terhadap diameter arteri radialis pada pasien MetS. Penelitian ini bersifat prospektif dan dilaksanakan di Laboratorium Kateterisasi Rumah Sakit Awal Bros Makassar sejak 1 Januari sampai dengan 15 Ferbuari 2013 (45 hari). Hasil penelitian memperlihatkan bahwa dari 40 pasien yang menjalani prosedur angiografi koroner melalui akses transradial, 22 di antaranya (55%) menyandang MetS. Rerata diameter arteri radialis pada kelompok pasien MetS dan non-MetS ialah 2,13 mm dan 2 mm. Lingkar pinggang, lingkar pergelangan, kolesterol total, HDL-C, dan trigliserida berbeda secara bermakna antara kedua kelompok. Analisis statistik dengan regresi linear menunjukkan korelasi bermakna antara diameter arteri radialis terhadap usia saja (r = 0,185;  P < 0,05). Simpulan: Terdapat korelasi bermakna antara diameter arteri radialis dengan usia, dan tidak dengan faktor lainnya. Kata kunci: diameter arteri radialis, sindroma metabolik.     Abstract: Nowadays, radial artery access is widely used as a route for transcatheter coronary interventions. Albeit, in metabolic syndrome (MetS) patients who are at high risks of developing type 2 diabetes mellitus, the systemic atheroslerosis process may have influenced the radial artery structures. This study aimed to determine factors that might influence the radial artery diameters in MetS patients. This was a prospective study conducted in the Catheterization Laboratory Awal Bros Hospital Makassar from 1st January until 15th Febuary 2013 (45 days). The results showed that in this study there were 40 consecutive patients who underwent coronary angiography procedures using the transradial apporach, of these 22 patients (55%) were with MetS. The mean radial artery diameters in MetS and non-MetS patients were 2.13 mm and 2 mm, respectively. The waist circumference, wrist circumference, total cholesterol, HDL-C, and triglyceride were significantly different between the two groups. The data were analyzed by using a  linear regression resulting in radial artery diameters (RAD) which were significantly and positively correlated only with age among  the MetS subjects (r = 0.185, P < 0.05). Conclusion: Among the metabolic syndrome patients radial artery diameters were only significantly correlated to ages, and not other factors. Keywords: radial artery diameter, metabolic syndrome.
THE COMPARISON OF ANKLE BRACHIAL INDEX IN PATIENTS WITH AND WITHOUT ACS IN PROF. DR. R. D. KANDOU HOSPITAL, MANADO Moeljono, Elfan; Suhartono, Iman Y.; Ransun, Terrance; Tedjo, Fonny M.; Panda, Agnes L.; Lefrandt, Reginald L.
JURNAL BIOMEDIK : JBM Vol 5, No 2 (2013): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.5.2.2013.2594

Abstract

Abstrak: Walaupun merupakan pengukuran sederhana dan non-invasif, ankle brachial index (ABI) menunjukkan sensitifitas dan spesifisitas yang tinggi dalam mendiagnosis penyakit arteri perifer pada nilai ABI ?0,9. ABI juga merupakan indikator yang kuat untuk mengetahui penyakit aterosklerosis pada area vaskular lainnya. Penelitian ini bertujuan untuk menentukan perbandingan antara ABI pada pasien dengan atau tanpa sindroma koroner akut (SKA). Penelitian ini menggunakan analisis analitik observasional dengan desain potong lintang. Subyek penelitian ialah pasien dengan SKA dan pasien tanpa SKA yang datang ke Departemen Kardiologi dan Pembuluh Darah RSU Prof. Dr. R.D Kandou, Manado bulan September-Desember 2012. Nilai normal ABI yaitu >0,9 dan <1,4, sedangkan ABI <0,9 perlu dipertimbangkan abnormal. Nilai ABI >1,4 dipertimbangkan tidak valid dan diekslusi. Hubungan antara variabel dievaluasi menggunakan SPSS. Hasil penelitian memperlihatkan 33 pasien SKA (72,8% laki-laki) dan 33 pasien tanpa SKA (81,8% laki-laki) sebagai subyek penelitian. Rerata usia pasien SKA 57 tahun dan tanpa SKA 52,3 tahun. Angka kejadian pasien SKA dengan ABI abnormal lebih tinggi, yaitu 82,1% vs 17,9% (P < 0,001). Uji chi-square menunjukkan terdapatnya hubungan antara SKA dan peningkatan risiko ABI abnormal (OR 12, P < 0,05). Simpulan: Sindroma koroner akut berhubungan dengan peningkatan risiko dari ABI abnormal. Kata kunci: Ankle brachial index, sindroma koroner akut.   Abstract: Although the ankle-brachial index (ABI) is a simple and non-invasive measurement, it shows a high sensitivity and specificity in the diagnosis of peripheral arterial disease (PAD) when its value is ?0.9. Moreover, ABI is a powerful indicator of atherosclerotic diseases in other vascular areas. This study aimed to determine the comparison between ankle brachial indices (ABI) in patients with or  without acute coronary syndrome (ACS). This was an analytical observational study with a cross sectional design. We measured ABI indices in 33 patients with ACS and 33 patients without ACS admitted to the Department of Cardiology and Vascular Medicine, Prof. Dr. R.D. Kandou Hospital, Manado. The normal ABI is >0.9 and <1.4. However, ABI <0.9 was considered as abnormal. On the other hand, ABI >1.4 was considered invalid and then excluded. The association of variables was evaluated by SPSS software. The results showed that there were 33 ACS patients (72.8% male) and 33 patient without ACS (81.8% male). ACS patients were older (57 vs 52.3 years). ACS patients had more prevalent abnormal ABI (82.1% vs 17.9%; P < 0.001). Chi square test showed that ACS was associated with an increased risk of abnormal ABI (OR 12, P < 0.05). Conclusion: ACS was associated with an increased risk of abnormal ABI. Keywords: ankle brachial index, acute coronary syndrome.
ANEMIA PADA GAGAL JANTUNG Hendrata, Cecilia; Lefrandt, Reginald L.
JURNAL BIOMEDIK : JBM Vol 2, No 3 (2010): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.2.3.2010.1191

Abstract

Abstract: Anemia, a frequently occuring comorbid in patients with heart failure, is increasingly recognized as an independent predictor of morbidity and mortality. The etiology of anemia associated with heart failure is not entirely understood. It is assumed as a multifactorial anemia, most likely caused by chronic kidney diseases and other chronic diseases. Besides that, iron deficiency due to lack of iron intake and absorption, and chronic blood loss due to anti-platelet agents play some important roles, too. Other factors related to risks of anemia in heart failure are old age, female gender, decrease of body mass index, usage of angiotensin converting enzyme inhibitors (ACE-inhibitors) and angiotensin receptor blockers (ARBs), and advanced heart failure.  Based on its documented impact on clinical outcomes, anemia has emerged as a possible target for treatment in patients with heart failure. Further studies are needed to determine the optimal threshold for initiation of treatment, target hemoglobin, optimum dosing regimen, choices of erythropoietic agents, roles of iron suplementation, and long-term safety of erythropoietic agents in anemic patients with heart failures. Key words: anemia, heart failure, management, therapy.     Abstrak: Anemia merupakan komorbid yang sering ditemukan pada penderita gagal jantung dan telah dikenal sebagai prediktor independen dari morbiditas dan mortalitas. Penyebab anemia yang menyertai gagal jantung tidak sepenuhnya diketahui, diduga sebagai anemia multifaktor yang umumnya diakibatkan oleh gagal ginjal kronis dan penyakit kronis lainnya. Selain itu defisiensi besi akibat kurangnya asupan maupun absorbsi besi, serta kehilangan darah kronik akibat konsumsi obat-obatan anti platelet turut berperan. Faktor lainnya yang berhubungan dengan resiko terjadinya anemia pada gagal jantung adalah: usia tua, jenis kelamin perempuan, adanya  penurunan indeks massa tubuh, penggunaan obat-obat angiotensin converting enzyme inhibitors (ACE-inhibitors) dan angiotensin receptor blockers (ARBs), serta gagal jantung tingkat lanjut. Berdasarkan dampaknya terhadap hasil klinis, anemia perlu dipikirkan sebagai target pengobatan pada penderita gagal jantung. Studi lanjut diperlukan untuk menentukan ambang optimal untuk memulai pengobatan anemia, hemoglobin target, regimen dosis yang optimum, pemilihan preparat eritropoietik, peran suplementasi besi, dan keamanan pemberian jangka panjang preparat eritropoietik pada penderita anemia dengan gagal jantung. Kata kunci: anemia, gagal jantung, penanganan, pengobatan.
HIPERURISEMIA DAN SINDROMA KORONER AKUT Wantania, Frans; Lefrandt, Reginald L.
JURNAL BIOMEDIK : JBM Vol 8, No 3 (2016): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.3.2016.14149

Abstract

Abstract: Recent studies show that hyperuricaemia plays an important role in endothelial dysfunction results in atherosclerotic plaque and myocardial infarction. Hyperuricemia can induce platelet aggregation in the vessel results in cardiovascular events. Meanwhile, inflammation plays a pivotal role in the development of atherosclerotic procces. Moreover, hyperuricemia produces reactive oxygen species that stimulate lipid peroxidation which could disrupt the biological membrane structure, therefore, triggers atherosclerotic plaque rupture and the occurence of acute coronary syndrome.Keywords: hyperuricemia, acute coronary syndromeAbstrak: Beberapa penelitian telah menunjukkan adanya peran signifikan hiperurisemia terhadap terjadinya disfungsi endotel vaskuler yang akan menyebabkan pembentukan plak ateroslerosis. Hubungan antara peningkatan kadar asam urat dengan aterosklerosis adalah disfungsi endotel dan proses inflamasi. Hiperurisemia menyebabkan terbentuknya agregasi platelet pada pembuluh darah, yang akhirnya mencetus penyakit kardiovaskuler. Bahkan, hiperurisemia menyediakan terbentuknya radikal bebas, reactive oxygen species (ROS) yang menginduksi peroksidasi lipid yang dapat menganggu struktur dan kekentalan membran biologik, sehingga memicu rupturnya plak dan terjadi sindroma koroner akut.Kata kunci: hiperurisemia, sindroma koroner akut
ADIPONECTIN AND TUMOR NECROSIS FACTOR ALPHA LEVELS, AND THEIR CORRELATIONS WITH ENDOTHELIAL DYSFUNCTION IN CENTRAL OBESITY Wantania, Frans; Lefrandt, Reginald L.; Pandelaki, Karel
Jurnal Biomedik : JBM Vol 3, No 3 (2011): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.3.3.2011.876

Abstract

Abstract: Background: In obesity, macrophages that infiltrate into adipose tissues create an inflammatory condition.  Besides that, adipose tissues release proinflammatory cytokines such as TNF alpha. These cytokines promote LDL oxydation by ROS, and accelerate NO degradation resulting in endothelial dysfunction. Adiponectin which could prevent endothelial dysfunction is decreased secondarily to TNF alpha’s action. Objectives: To determine the serum levels of TNF alpha and adiponectin, and their correlations with the endothelial dysfunction. Methods: This was an observational, descriptive, and analytic study with cross sectional. Samples were students of senior high schools in Manado.  Sampling method was carried out consecutively until the required number was enough. Data consisted of age, blood pressure, waist circumference, body weight, lipid profile, creatinin, TNF alpha, adiponectin, and albumin creatinine ratio. We used the Spearman Correlation to analyze the data. Result: Over a 4-month period, there were 35 obese male subjects with ages of 16-18 years old. The average of body weights was 83.23 kg, and of waist circumferences was 103.94 cm.  Endothelial dysfunction was found in 5.72% of samples, high levels of TNF alpha in 68.57% of samples, and low levels of adiponectin in 62.8% of samples.  We found a significant positive correlation between TNF alpha and endothelial dysfunction (r=0.554, p<0.000), and an inverse correlation between adiponectin level and endothelial dysfunction (r = -0.349, p=0.020). Conclusion: There were high levels of TNF alpha in 68.57% of samples and low levels of adiponectin in 62.86% of samples. There was a significant correlation between TNF alpha level and endothelial dysfunction. There was an inverse correlation between adiponectin level and endothelial dysfunction. Key words: obesity, adiponectin TNF alpha, endothelial dysfunction.
KORELASI ANTARA INTERVAL S2-OPENING SNAP DAN MITRAL VALVE AREA YANG DIIDENTIFIKASI DENGAN COLOR SPECTROGRAPH PHONOCARDIOGRAPHY PADA PASIEN MITRAL STENOSIS Suhartono, Iman Y.; Ransun, Terrance; Kawilarang, Michael S.; Moeljono, Elfan; Tedjo, Fonny M.; Panda, Agnes L.; Awaloei, Jan H.; Lefrandt, Reginald L.
Jurnal Biomedik : JBM Vol 5, No 2 (2013): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.5.2.2013.2596

Abstract

Abstract: Color spectrograph phonocardiography (CSP) is a method for recording heart sounds by using a digital stethoscope. The recorded result can be analyzed by using a soft ware. CSP can identify the opening snap (OS) and measure the S2-OS interval. This study aimed to determine the correlation between adjusted S2-OS to the mitral valve area (MVA) in mitral stenosis (MS) patients. The samples were MS patients admitted to the ICCU and the ward of Prof. Dr. R.D. Kandou Hospital, Manado. Patients with atrial fibrillation were excluded. Every patient underwent echocardiography and CSP to obtain the MVA and S2-OS interval. The adjusted S2-OS interval is the S2-OS interval divided by the number of heart beats (milisecond/beat per minute). Variables were analyzed by using the Pearson correlation test. The results showed that there were 14 MS patients involved in this study. There was a strong correlation between adjusted S2-OS interval and MVA. Estimated MVA was obtained by using the formula MVA = -1.358 + 2.07. Conclusion: The adjusted S2-OS interval was strongly correlated to the MVA of MS Patients and could predict the MVA value. Keywords: color spectrograph phonocardiography, S2-OS interval, mitral valve area, mitral stenosis, echocardiography.   Abstrak: Color spectrograph phonocardiography (CSP) merupakan metode merekam bunyi jantung dengan menggunakan stetoskop digital. Hasil rekaman ini dapat dianalisis dengan piranti lunak. CSP dapat mengidentifikasi opening snap (OS) dan mengukur interval S2 – OS. Penelitian ini bertujuan untuk mendeteksi korelasi antara interval S2-OS yang sudah disesuaikan dengan mitral valve area (MVA) pada pasien mitral stenosis (MS). Sampel penelitian ialah pasien mitral stenosis yang dirawat di ICCU dan bangsal BLU RSUP Prof. Dr. R.D. Kandou Manado. Pasien dengan atrial fibrilasi dieksklusi. Masing-masing pasien menjalani pemeriksaan echocardiography dan CSP untuk memperoleh MVA dan interval S2-OS. Interval S2-OS yang telah disesuaikan adalah interval S2-OS yang dibagi dengan denyut jantung (milidetik/denyut jantung per menit). Variabel-variabel tersebut dianalisis dengan menggunakan analisis korelasi Pearson. Hasil penelitian memperlihatkan  sebanyak 14 pasien mitral stenosis diikutsertakan dalam penelitian. Terdapat korelasi sangat kuat antara interval S2-OS yang telah disesuaikan dengan MVA. Estimasi MVA dapat diperoleh dari persamaan MVA = -1,358 + 2,07.(Interval S2-OS yang telah disesuaikan). Simpulan: Interval S2-OS yang telah disesuaikan memiliki korelasi yang sangat kuat dengan MVA pada pasien-pasien mitral stenosis. Interval S2-OS yang telah disesuaikan dapat memperkirakan nilai MVA. Kata kunci: color spectrograph phonocardiography, interval S2-OS, mitral valve area, mitral stenosis, echocardiography.
SINDROM KARDIORENAL Paliliewu, Novita; Lefrandt, Reginald L.
Jurnal Biomedik : JBM Vol 2, No 2 (2010): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.2.2.2010.848

Abstract

Abstract: Cardiorenal syndrome can be generally defined as a pathophysiological disorder of the heart and kidneys, whereby acute or chronic dysfunction of one organ may induce acute or chronic dysfunction of the other ones. In the end stage renal disease, the prevalences of left ventricular hypertrophy and coronary heart diseases are high enough. On the other hand, patients with moderate congestive heart failure show low glomerular filtration rates. There is no consistent and effective strategy for the management of cardiorenal patients. Most approaches are empirical and include: recognizing the cardiorenal syndrome and anticipating the development of worsening renal function and/or diuretic resistance, optimizing heart failure therapy, evaluating renal structure and function, and optimizing diuretic dosaging and renal specific therapy. Investigational therapies such as vasopressin antagonist and adenosine antagonist are still being developed. Keywords: cardiorenal syndrome, organ dysfunction, therapy.   ABSTRAK: Sindrom kardiorenal secara umum dapat didefinisikan sebagai keadaan gangguan patofisiologi jantung dan ginjal, dimana terjadi disfungsi akut atau kronis salah satu organ yang mengakibatkan disfungsi akut atau kronis organ lainnya. Pada penyakit ginjal tahap akhir prevalensi hipertrofi ventrikel kiri dan penyakit jantung koroner cukup tinggi. Demikian pula halnya dengan pasien-pasien gagal jantung sedang memiliki gangguan laju filtrasi glomerulus (LFG). Sampai saat ini belum terdapat strategi yang konsisten dan efektif  dalam penanganan pasien sindrom kardiorenal. Umumnya dilakukan pendekatan secara empirik yaitu: deteksi sindrom kardiorenal dan mengantisipasi timbulnya perburukan fungsi ginjal dan atau resistensi diuretik, optimalisasi pengobatan gagal jantung, mengevaluasi struktur dan fungsi ginjal, optimalisasi dosis diuretik serta terapi khusus untuk ginjal. Penggunaan antagonis vasopresin dan antagonis adenosin untuk sindrom kardiorenal masih sedang dalam tahap penelitian. Kata kunci: sindrom kardiorenal, disfungsi organ, pengobatan.
THE IMPACT OF CORONARY ARTERY DISEASE RISK FACTORS ON INNER DIAMETERS OF RIGHT RADIAL ARTERIES Wangko, Loretta C.; Budiono, Bambang; Lefrandt, Reginald L.
Jurnal Biomedik : JBM Vol 5, No 2 (2013): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.5.2.2013.2592

Abstract

Abstrak: Dewasa ini, akses transradial  lebih banyak digunakan oleh para ahli kardiologi intervensi, baik untuk prosedur diagnosis maupun intervensi koroner. Diameter dalam arteri radialis kanan berperan penting dalam keberhasilan prosedur transradial ini. Faktor risiko penyakit arteri koroner (CAD) dapat memengaruhi diameter dalam arteri radialis kanan, antara lain melalui vasokonstriksi, pembentukan plak ateroma, dan arteriosklerosis. Penelitian ini bertujuan untuk mendapatkan korelasi diameter dalam arteri radialis kanan dengan faktor risiko CAD tertentu (hipertensi, diabetes melitus, dislipidemia, dan merokok). Sebagai subyek penelitian, digunakan pasien yang menjalani angiografi koroner di Rumah Sakit Awal Bros Makassar sejak Juli sampai dengan Desember 2012 secara retrospektif. Jumlah sampel sebesar 110 pasien; 43 pasien dengan fakor risiko 0 (skor 0); 32 dengan satu faktor risiko (skor 1); 23 dengan dua faktor risiko (skor 2); dan 12 dengan tiga atau lebih faktor risiko (skor 3). Korelasi diameter dalam arteri radialis kanan dengan jumlah faktor risiko dihitung dengan uji korelasi Spearman. Hasil penelitian memperlihatkan terdapat korelasi negatif yang kuat antara diameter dalam arteri radialis kanan dan peningkatan faktor risiko (korelasi Spearman -0,001). Uji Spearman menunjukkan bahwa hipertensi dan diabetes melitus berkorelasi negatif dengan diameter dalam arteri radialis kanan (koefisien korelasi -0,067 dan -0,176), sedangkan dislipidemia dan merokok tidak. Simpulan: Pada pasien yang menjalani angiografi koroner di Rumah Sakit Awal Bros Makassar sejak Juli sampai dengan Desember 2012 terdapat faktor risiko CAD yang berpengaruh negatif terhadap diameter dalam arteri radialis kanan. Hipertensi dan diabetes melitus memperkecil diameter dalam arteri radialis kanan secara bermakna, sedangkan dislipidemia dan merokok tidak memengaruhinya. Kata kunci: diameter dalam, arteri radialis kanan, faktor risiko, penyakit arteri koroner.     Abstract: Nowadays, the transradial access has become the preference of most intervention cardiologists, either for diagnostic or intervention coronary procedures. The inner diameter of the right radial artery plays a very important role in the success of this transradial procedure. Risk factors of coronary artery diseases (CAD) can influence the diameter of the right radial arteries (RRAs), e.g. by vasocontriction, atheroma plaque forming, and arteriosclerosis. This study aimed to find out the correlation of inner diameters of the RRAs to certain risk factors of CAD (hypertension, diabetes mellitus, dyslipidemia, and smoking). We retrospectively reviewed all patients that underwent coronary angiography in Awal Bros Hospital Makassar from July until December 2012. The total number of patients was 110: 43 patients with zero risk factor (scored 0); 32 with one risk factor (scored 1); 23 with two risk factors (scored 2); and 12 with three or more risk factors (scored 3). The correlation of inner diameters of the right radial arteries with the number of risk factors was calculated by using the correlative test of Spearman. The results showed that there was a strong negative correlation between the inner diameters of RRAs and the increase of risk factors (Spearman correlation - 0.001). The Spearman test showed that hypertension and diabetes melllitus was negatively correlated to the inner diameters of RRAs (correlation coefficient - 0.067 and – 0.176, respectively), while dyslipidemia and smoking showed no correlation with the decrease of the inner diameters of RRAs. Conclusion: Among patients that underwent coronary angiography in Awal Bros Hospital Makassar from July until December 2012, there were certain risk factors that negatively affected the inner diameters of RRAs. Hypertension and diabetes mellitus significantly decreased the inner diameters of RRAs, while dyslipidemia and smoking did not affect the radial arteries. Keywords: inner diameter, right radial artery, risk factors, coronary artery disease.
PEMANFAATAN SEL PUNCA PADA GAGAL JANTUNG KRONIK Lasut, Pearla; Lefrandt, Reginald L.
Jurnal Biomedik : JBM Vol 3, No 2 (2011): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.3.2.2011.862

Abstract

Abstract: A therapeutic approach of chronic heart failure by using pharmacotherapy and heart devices still can not decrease morbidity and mortality satisfactorily. More promising therapies are needed to overcome this problem. One of them is the stem cell therapy. There are several kinds of selected stem cells: myoblasts, bone marrow and blood cells, and umbilical cord blood cells. All of these have their own benefits and limitations. The effective and safe procedure mostly chosen for transplantation is intracoronary infusion, using a standard balloon catether. In this case, stem cells are directly transplanted to the myocardium where the blood and oxygen supply can be maintained. Although stem cell therapy has brought a highlight in the therapeutic approach, there are still many things to be concerned about, e.g. the most suitable kind of cell for myocardium repairment, the suitable procedure, the right time to do the transplant, the given dose, and the morbidity and survival rates. Key words: stem cells, heart failure, cardiomyocytes.   Abstrak: Pendekatan terapi untuk gagal jantung kronik dengan menggunakan obat-obatan dan alat bantu belum dapat menekan morbiditas dan mortalitas secara memuaskan. Untuk mengatasi hal ini diperlukan terapi yang lebih menjanjikan; salah satunya yang paling diminati dewasa ini adalah terapi sel punca. Terdapat beberapa jenis sel punca pilihan, yaitu mioblas, derivat sumsum tulang dan darah, serta derivat sel darah umbilikus. Kesemuanya ini mempunyai kelebihan dan keterbatasan masing-masing. Cara pemberian yang efektif dan aman yang paling diminati adalah secara infus intrakoroner dengan kateter balon standar. Dengan cara ini sel-sel punca dapat ditransplantasi secara langsung hanya ke dalam daerah miokardium dimana aliran darah dan suplai oksigen dapat dipertahankan. Walaupun terapi sel punca telah memberi titik terang dalam pendekatan terapi untuk gagal jantung kronik, masih banyak hal yang perlu diteliti lanjut, antara lain  jenis sel yang paling tepat untuk perbaikan miokardium, cara dan waktu pemberian, dosis yang paling aman, serta angka harapan hidup dan perbaikan morbiditas. Kata kunci: sel punca, gagal jantung, kardiomiosit.
Co-Authors Agnes L. Panda Alice I. Supit Andhi Purabaya Bambang Budiono Cecilia Hendrata Elfan Moeljono Fonny M. Tedjo Franky A. Tumiwa Frans Wantania Ike Adriana, Ike Iman Y. Suhartono Jan H. Awaloei Janry A. Pangemanan Karel Pandelaki Loretta C. Wangko Marshell Luntungan Michael S. Kawilarang Monique Rotty, Monique Novita Paliliewu Pearla Lasut Ronaldi ., Ronaldi Terrance Ransun