Case Report: The Role of Intravascular Ultrasonography in Patients Underwent Percutaneous Coronary Intervention

Intravascular ultrasonography (IVUS) has an important role as a complimentary diagnostic tool in percutaneous coronary intervention procedure. IVUS provides valuable information regarding coronary vessel lumen and dimension and also plaque burden and its characteristic. The main use of IVUS in PCI is to guide the choose of interventional strategies to optimize stent deployment. Since drug eluting stent (DES) has promised to decrease the incidence in stent restenosis and stent thrombosis than bare metal stent, but neither the suboptimal results nor the complication after stenting with DES is still high. Thus, optimization of stent deployment under IVUS guidance is important in cases to decrease stent failure after PCI procedure, as well as to decrease complication rate after stenting in order to decrease mortality rate caused by coronary artery disease. We present here the use of IVUS guidance in a 43 and 46 year-old man underwent PCI

Garlic Extract (Allicin) Improves the Proliferation of Endothelial Progenitor Cell (EPC) from Patients with Stable Coronary Artery Disease

BACKGROUND: The reduced number and function of endothelial progenitor cell (EPC) in stable coronary artery disease (SCAD) patients aggravate endothelial dysfunction and inhibit neovascularization, thus lead to atherosclerosis. Garlic is currently believed to increase the number and function of EPC. AIM: Therefore, this in vitro study was conducted to analyze the effect of garlic extract (allicin) on the proliferation of EPC in patients with SCAD. METHODS: Mononuclear cells were isolated from peripheral blood of eight SCAD patients and cultured on colony-forming unit (CFU)-Hill medium for 3 days. Samples were divided into two groups: Group treated with allicin and control group. The treatment group was then divided into three subgroups which received 10, 50, and 100 mg/ml of doses and incubated for 48 h. EPC proliferation was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) cell proliferation assay. Immunohistochemical method of CD34+ was performed for EPC identification. Data were analyzed using independent t-test and ANOVA. RESULTS: MTT assay showed a significant increase in EPC proliferation in the allicin group compared to the control group (0.2811 ± 0.008 vs. 0.194 ± 0.151, p < 0.05) and significant improvements were observed in each dose increment. CFU-Hill quantification shows the addition of EPC colony in high-dose allicin. Immunohistochemical method shows positive CD34+ expression. CONCLUSION: Allicin increases EPC proliferation dose-dependently from peripheral blood of SCAD patients

Extracellular-Signal Regulated Kinase Signalling Pathway Mediates the Increased Proliferation of EPCs Treated with Garlic (Allium sativum) Extract, Purple Sweet Potato (Ipomoea batatas) Extract and Vitamin C

The endothelial progenitor cell (EPCs) proliferation capability is reduced in the patient with stable coronary artery disease (SCAD). Garlic (Allium sativum), purple sweet potato (Ipomoea batatas), and vitamin C are proven antioxidant which potentially improve EPCs proliferation ability. Objective: To investigate the effect of garlic (Allium sativum), purple sweet potato (Ipomoea batatas), and vitamin C in EPCs proliferation from CAD patients and identify the involvement of Extracellular-Signal Regulated Kinase (ERK) Signalling Pathway. Material and Method: Mononuclear cells were isolated from SCAD patients and cultivated with colony-forming unit (CFU)-Hill medium and divided into untreated (control), garlic extract (10 mcg/ml and 100 mcg/ml), purple sweet potato extract (1 mcg/ml and 25 μg/ml), and vitamin C (10 μg/ml and 250 μg/ml). EPCs proliferation was measured using the MTT Assay. Results: This research shows that EPCs proliferation was increased in the treatment with garlic extract at 10 mcg/ml and 100 mcg/ml dose (0.267 ± 0,003 and 0.391 ± 0.008 ; p < 0.05), purple sweet potato extract at 1 mcg/ml and 25 μg/ml dose (0.250 ± 0.005 and 0.3562 ± 0.023 ; p < 0.001), and vitamin C at 10 μg/ml and 250 μg/ml dose (0.259 ± 0.016 and 0.306 ± 0.022 ; p < 0.001). Increased ERK expression was found in the treatment with garlic extract, purple sweet potato extract and vitamin C. Conclusion: Garlic extract, purple sweet potato extract, and vitamin C can increase EPC proliferation through the ERK signaling pathway

EFEK PEMBERIAN EKSTRAK BAWANG PUTIH (ALLICIN) TERHADAP PROLIFERASI ENDOTHELIAL PROGENITOR CELL PADA PENDERITA PENYAKIT JANTUNG KORONER STABIL

Endothelial Progenitor Cell (EPC) memiliki peran terhadap proses atherosklerotik yang merupakan patogenesis dari penyakit jantung koroner. Jumlah dan fungsi EPC yang berkurang pada penderita penyakit jantung koroner (PJK) akan semakin memperberat disfungsi endotel dan menghambat terjadinya neovaskularisasi. Bawang putih dengan segala manfaatnya di bidang kardiovaskuler pun saat ini dipercaya mampu meningkatkan jumlah dan fungsi EPC. Oleh karena itu, penelitian ini dilakukan untuk menilai efek pemberian ekstrak bawang putih (Allicin) terhadap proliferasi EPC secara in vitro Tujuan : Untuk menganalisis efek pemberian ekstrak bawang putih (Allicin) terhadap proliferasi EPC pada penderita PJK stabil Metode : Penelitian ini merupakan quasi experimental post-test control group study. Sel mononuklear diisolasi dari darah tepi penderita PJK stabil dan dikultur dengan medium CFU-Hill selama tiga hari. Sampel kemudian dibagi menjadi 2 kelompok yaitu kelompok yang mendapat perlakuan berupa pemberian ekstrak bawang putih (Allicin) dan kelompok kontrol. Kelompok perlakuan dibagi lagi menjadi 3 sub kelompok yaitu yang mendapat dosis 10 g/ml, 50 g/ml, dan 100 g/ml dan diinkubasi kembali selama 48 jam. Proliferasi EPC dinilai menggunakan MTT Cell Proliferation Assay. Metode imunohistokimia ekspresi CD34+ dilakukan untuk identifikasi EPC. Evaluasi pada CFU-Hill dilakukan untuk mengkonfirmasi karakteristik fungsional dari EPC. Analisis data dilakukan dengan menggunakan uji T 2 sampel bebas dan ANOVA Hasil : MTT Cell Proliferation Assay menunjukkan peningkatan bermakna terhadap proliferasi EPC dengan pemberian ekstrak bawang putih (Allicin) pada dibandingkan dengan kelompok kontrol (0.2811  0.008 vs 0.194  0.151 p<0.05) dan peningkatan bermakna juga didapatkan untuk setiap peningkatan dosis. Penghitungan CFU-Hill memperlihatkan penambahan koloni pada ekstrak bawang putih (Allicin) dosis tinggi. Pemeriksaan imunohistokimia menunjukkan ekspresi positif CD34+ Kesimpulan : Ekstrak bawang putih (Allicin) meningkatkan proliferasi EPC secara dose-dependent pada darah tepi penderita PJK stabi

Pengaruh Pemberian Bawang Putih Terhadap Jumlah Endothelial Progenitor Cell pada Kultur Darah Pasien Penyakit Jantung Koroner (PJK)

Penelitian Pendanaan FK Unair 201

Prolonged Resolution of Intrauterine Fetal Tachyarrhythmia Treatment

Abstract Fetal tachyarrhythmia is a rare condition associated with a high risk of fetoplacental circulatory failure, fetal hydrops, and intrauterine fetal death. This report, present a case of fetal tachyarrhythmia that was successfully managed with a multidisciplinary approach in a tertiary hospital, but with prolonged prenatal resolution. A 36-year-old multigravida was diagnosed with fetal tachyarrhythmia at 30 weeks of gestational age. No secondary cause of fetal tachyarrhythmia was identified. A basic ultrasound examination revealed a normal heart structure without hydrops or polyhydramnios. The fetal heart rate was consistently at 230 bpm during the examination. M-mode echocardiography presented the 1:1 atrioventricular contraction with short intervals, confirming the diagnosis of sustained supraventricular tachycardia. Transplacental treatment was initiated using digoxin at a dose of 0.5 mg, followed by 0.25 mg intravenously every 8 hours. On the fifth day, the arrhythmia was not improved, thus oral combination therapy commenced with digoxin at a dose of 0.25 mg every 12 hours, along with propranolol at a dose of 40-20-20 mg, and this treatment was continued for the subsequent 5 weeks. Fetal heart rate, movement, and treatment toxicity were monitored daily, while fetal well-being was assessed on a weekly basis. Prenatal resolution was achieved 6 weeks after the treatment initiation. Digoxin levels reached a therapeutic concentration (1.75 ng/mL) without any signs of intoxication. A cesarean section was performed at 38/39 weeks of gestational age. The postnatal evaluation did not reveal any recurrence of tachyarrhythmia or neurodevelopmental disorders. Evaluation of atrioventricular contractions using M-mode echocardiography proved to be a straightforward method. In this case of sustained supraventricular tachycardia, the absence of fetal hydrops was likely attributed to ventricular contractions remaining below 230 beats per minute. The use of combination therapy demonstrated superiority over monotherapy in achieving prenatal resolution. Transplacental anti-arrhythmic combination therapy can be considered for cases of refractory tachyarrhythmia. Further large-scale population studies are necessary to determine appropriate therapeutic doses and adjust available drug options to achieve faster prenatal resolution of fetal tachyarrhythmias