Tesis

Rekayasa dinding jantung artifisial untuk terapi infark miokard: perbandingan suhu optimal transpor jaringan untuk isolasi kardiomiosit antara medium konvensional (4⁰C) dengan medium fisiologis (37⁰C) = Artificial cardiac tissue engineering for myocardial infarction therapy: comparison of optimal tissue transport temperature for isolation of cardiomyocytes between conventional medium (4⁰C) and physiological medium (37⁰C).

Latar belakang: Penyakit jantung koroner merupakan salah satu penyebab utama kematian di negara berkembang, termasuk Indonesia. Penyakit ini merupakan salah satu penyebab gagal jantung. Terapi yang selama ini dilakukan belum sepenuhnya mampu memperbaiki kerusakan otot jantung yang telah terjadi. Terapi sel punca baik injeksi maupun patch juga masih belum memperlihatkan hasil yang memuaskan. Penggunaan patch jantung dihadapkan pada masalah seperti rendahnya viabilitas sel yang dihasilkan. Hipotermia pada suhu 4°C yang digunakan untuk isolasi kardiomiosit selama ini dikaitkan dengan gangguan aktivitas sel yang menyebabkan penurunan jumlah sel viabel yang dihasilkan. Suhu 37°C yang merupakan suhu fisiologis tubuh dinilai mampu menghasilkan viabilitas sel lebih baik Metode: Studi ekperimental in vitro dilakukan di Pelayanan Jantung Terpadu Rumah Sakit Cipto Mangunkusumo (PJT-RSCM) dan Indonesian Medical Education and Research Institute (IMERI) Fakultas Kedokteran Universitas Indonesia dalam periode Desember 2019 hingga November 2020 dengan mengikutsertakan subjek pasien yang menjalani operasi total koreksi tetralogy of Fallot. Jaringan reseksi otot infundibulum jantung diambil kemudian dilakukan isolasi untuk menilai viabilitas sel dan ekspresi genetik. Hasil: Delapan subjek ((n = 4) ± 95% C.I) kelompok suhu 37°C secara signifikan menghasilkan jumlah sel viabel yang lebih banyak (mean: 2675sel/mg) dibandingkan suhu 4°C (mean: 970 sel/mg) dengan (p < 0,05). Ekspresi gen yang mengekspresikan sel kardiomiosit secara flowsitometer terlihat kelompok medium transpor 37°C secara bermakna lebih tinggi dibandingkan dengan suhu 4°C. Simpulan: Isolasi kardiomiosit menggunakan medium transpor suhu fisiologis (37⁰C) menghasilkan jumlah sel viable yang lebih banyak dibandingkan medium konvensional (4⁰C).
Kata kunci: Isolasi kardiomiosit, hipotermia, suhu fisiologis


Background: Coronary heart disease is one of the main causes of death in developing countries, including Indonesia. This disease is one of the causes of heart failure. The therapy that has been implemented has not able to repair the damage of the heart muscles that have occurred. Stem cell therapy, either injection or patch, has not succeeded satisfactorily. The use of the cardiac patch is exposed to many problems such as low viability of the cells produced. Hypothermia at 4°C, which is used for isolation of cardiomyocytes related with activity disturbance which causes a decrease in the number of viable cells produced. The temperature 37°C which is the body's physiological temperature considered can produce better cell viability Methods: An experimental invitro study was conducted in the Pelayanan Jantung Terpadu Cipto Mangunkusumo (PJT-RSCM) and the Indonesian Medical Education and Research Institute (IMERI) Faculty of Medicine, University of Indonesia from December 2019 to November 2020 by recruiting patient subjects who underwent total correction of tetralogy of Fallot. The resection of the cardiac infundibulum was taken and then isolated to assess cell viability and gene expression. Results: A total of eight subjects ((n = 4) ± 95% CI) the 37°C group produced significantly more viable cells (mean: 2675 cells/mg) than at 4°C (mean: 970 cells/mg).)) with (p < 0.05). The expression of genes expressing cardiomyocytes by flowcitometer showed that the physiological group (37°C) was significantly higher than the conventional group (4°C). Conclusion: Isolation of cardiomyocytes using a physiological temperature transport medium (37⁰C) resulted in a higher number of cells than conventional medium (4⁰C).
Key words: Isolation of cardiomyocytes, hypothermia, physiological temperature