Nani Hersunarti
Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia National Cardiaovascular Center “Harapan Kita”, Jakarta, Indonesia

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Pengaruh Pemberian Pentoksifilin Terhadap Perubahan Kadar Platelets Activating Factor pada Cedera Reperfusi-Iskemik Tungkai Akut Daf Juzar; Manoefris Kasim; Nani Hersunarti; RWM Kaligis
Jurnal Kardiologi Indonesia Vol. 28, No. 2 Maret 2007
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v28i2.252

Abstract

Background. In Acute limb ischemia reperfusion causes further damage to the ischemic tissue through local compartment syndrome, and systemic syndrome: multiorgan dysfunction and failure. Several method and attempt had been studied and performed to prevent and attenuate reperfusion injury such as, ischemic preconditioning, antioxidant, and anti-cytokine therapy, but their clinical benefit were not satisfactory. Pentoxifylline (PTX) a nonspesifik phosphodiesterase derivate of xanthine has emerged as a promising agent that may attenuate inflammation response through several mechanism. However, studies on PTX and its function to prevent and attenuate inflammation response through attenuating Platelet-Activating Factor (PAF) in acute limb ischemic were not consistent. The aim of this study is to investigate the effect of PTX on PAF in rabbits with acute limb ischemic-reperfusion injury.Methods and results.Acute limb Ischemia were performed by direct occlusion of the left femoral artery of 10 New Zealand White male rabbit using non traumatic clamp, and followed by releasing the clamp after 3 hours of occlusion. The rabbits were randomly separated into 2 groups of five (PTX group and control group). The PTX group was given PTX 40 mg/kg bolus half an hour prior to reperfusion, followed by maintenance dose 1 mg/kg/hour until 2 hour post reperfusion, while the control group was given normal saline solution with comparable volume and rate administration. Level of PAF were measured after 2.5 hour of ischemic period and after 2 hours of reperfusion period. After 2.5 hours of ischemic period, the mean PAF levels did not show any significant difference (p=0.754), the mean PAF level of PTX group 13.09±0.41 pg/mL, while the control group 13.38±0.28 pg/mL. After 2 hours period of reperfusion, there were significant differences of mean PAF level between the two groups (p=0.009). The mean PAF level in the control group increase by 12.11±0.79 to became 25.5±0.78 pg/dL, while the mean PAF level of the PTX group decrease by 1.73±1.1 pg/mL and became 11.36±0.78 pg/mL.Conclusions. Pentoxifylline attenuate the production Platelet-Activating Factor level in rabbits with acute limb ischemic-reperfusion injury.
Natrium Urin Petanda Surrogate Brain Natriuretic Peptide Plasma Pasien Infark Miokard dengan Elevasi ST? Januar W Martha; Hariadi Hariawan; S Taofan; Nani Hersunarti; Bambang B Siswanto
Jurnal Kardiologi Indonesia Vol. 28, No. 1 Januari 2007
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v28i1.263

Abstract

Background. High level of Brain Natriuretic Peptide (BNP) was suspected as a predictor of adverse events in acute ST Elevation Myocardial Infarc-tion (STEMI). Unfortunately, the cost and availability of BNP assay had hampered its use. Natriuresis is one of the hallmark effect of raised BNP and measuring urinary sodium might offer insight to the plasma BNP. This study aims to search for any correlation between measured plasma BNP and urinary sodium in patients presenting with acute STEMI.Methods. In an observational descriptive analytic study, we selectively in-cluded patients presenting with acute STEMI and checked for plasma BNP and urinary sodium. All patients had no symptoms or therapy of heart failure prior to admission, had no prior MI, had no valvular abnormalities, and had normal renal function. Plasma BNP was tested using immunoassay method from Abbot Diagnostics, while urinary sodium with ionic specific electrode method. Specimen for plasma BNP were taken at the admission while urinary sodium in the next morning, taking account of urine volume. Results. There were 17 patients, 15 were (82.4%) men, with age 55.1+8.2 years old, onset of STEMI 18.6+2.3 hours, and left ventricular ejection fraction (LVEF) 47.6+11.6%. The urinary sodium was 85.1+34.3 mEq/L, and plasma BNP 449.7+48.8 pg/ml. Pearson’s correlation and linear re-gression analysis showed positive correlation between urinary sodium and plasma BNP (r = 0.71). In multivariate analysis, plasma BNP (p<0.01) and LVEF (p<0.05) were the major influencing factors for urinary sodium level.Conclusion.This study revealed a strong correlation between plasma BNP and urinary sodium in patients presenting with acute STEMI. While mea-surement of urinary sodium cannot replace plasma BNP, it might actually reflect plasma BNP level.