Rheumatic heart disease (RHD), a sequela of acute rheumatic fever (ARF), is a preventable disease but remains a significant health problem, especially in developing countries. It causes disability, poor quality of life, early mortality, and national economic burden. The World Heart Federation (WHF) aimed to achieve a 25% reduction in premature deaths from ARF and RHD among individuals aged <25 years by 2025. Primordial and primary prophylaxis of RHD is aimed to prevent the occurrence of ARF, while the goal of secondary and tertiary prophylaxis is to limit the progression and reduce the consequences of RHD. Early recognition of RHD is important for early prophylaxis strategies to inhibit any progression to advanced stages. In 2012, WHF introduced the latest echocardiographic criteria to recognize the early stage of RHD. This includes the evaluation of pathological regurgitation jet and morphological features of RHD based on 2D, color, and spectral Doppler criteria. In remote areas, portable echocardiography is preferable for RHD screening. Previous portable devices were only capable of producing 2D and color images. Hence, a simplified echocardiographic criterion without spectral Doppler evaluation is needed in selected areas. Indonesia is a developing country, an archipelago with a population of over 250 million. Currently, there are no data on ARF incidence and RHD prevalence nationwide. The only data available are the number of patients in advanced stages who came to referral centers for further management. The screening program has to be introduced in Indonesia as part of national RHD prophylaxis.

Impairment of the endothelial progenitor cells (EPCs) ability to proliferate and migrate in the patients with coronary heart disease (CHD) is partly caused by oxidative stress. This research evaluates the effect of treatment with Ipomoea batatas L./purple sweet potato (PSP) extract and l-ascorbic acid on the proliferation and migration of impaired EPCs. EPCs were isolated from CHD patient’s peripheral blood. EPCs culture were cultivated and divided into control (untreated), PSP extract treatment (dose 1 and 25 μg/mL), and l-ascorbic acid treatment (dose 10 and 250 μg/mL) groups for 48 h. EPCs proliferation was analyzed with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) cell proliferation assay, and migration was evaluated with the cell migration assay kit. Statistical tests were evaluated using SPSS 25.0. This research showed that EPCs proliferation and migration was significantly higher in all PSP extract and l-ascorbic acid treatment compared to the control (p < 0.001). EPCs migration on treatment with a PSP extract dose of 25 μg/mL was significantly higher compared to the treatment with l-ascorbic acid dose of 250 μg/mL (303,000 ± 1000 compared to 215,000 ± 3000 cells, p< 0.001). In conclusion, both treatments with PSP extract and l-ascorbic acid can improve the proliferation and migration of impaired EPCs. At the dose of 25 μg/mL, PSP extract seems to be superior to the l-ascorbic acid dose of 250 μg/mL to improve EPCs migration.

Introduction: Endothelial progenitor cell (EPC) numbers are reduced in stable coronary artery disease (CAD), partly due to oxidative stress. This study aimed to evaluate the effect of different antioxidants, purple sweet potato (PSP) extract and vitamin C, on EPC proliferation in stable CAD patients.Methods: Peripheral blood mononuclear cells were isolated and cultivated on fibronectin-coated plates with the colony-forming unit (CFU)-Hill medium for three days. Non-adherent cells were divided into control, PSP extract (1, 5, 25 μg/ml), and vitamin C (10, 50, 250 μg/ml) groups; then cultured for two days. EPC proliferation was assessed with MTT Cell Proliferation Assay Kit. EPCs were identified by detecting the expression of CD34. Resulted CFU-Hill colonies were counted under an inverted light microscope.Results: EPC proliferation was increased in low, moderate, and high doses of PSP extract and vitamin C compared to control (all groups vs. control, p<0.001). The high dose of PSP extract increased EPC proliferation non significantly compared to the moderate dose (p=0.289). Vitamin C increased EPC proliferation better than PSP extract in moderate and high dose groups (p=0.042 and p<0.01, respectively). Meanwhile, the low dose of both treatments increased the EPC proliferation equally (p=0.353). CFU numbers, representing EPC differentiation capability, were highest in the groups given PSP extract compared to control and vitamin C groups.Conclusions: PSP extract and vitamin C increased EPC proliferation dose-dependently. Vitamin C induced EPC proliferation better than PSP extract. Furthermore, PSP extract was presumably a better EPC differentiation inducer.

Coronary air embolism remains a serious complication of cardiac catheterization despite careful prevention. The complications of coronary air embolism range from clinically insignificant events to acute coronary syndrome, cardiogenic shock, and death. We report here a case of multiple air emboli in both left coronary arteries, complicated by cardiogenic shock and ventricular fibrillation in a 49-year-old male patient undergoing elective percutaneous coronary intervention. The patient recovered after supportive measures, including oxygen, intravenous dopamine infusion, and cardiac compression, and repeated forceful injection of heparinized saline successfully resolved the air emboli. He then eventually underwent successful percutaneous coronary intervention in the left anterior descending artery without any residual stenosis.

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