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"ABSTRACTAtrial septal defect is one of the most common forms of congenital heart disease. Although various M-mode and two-dimensional echocardiographic characteristics of atrial septal defect have been described, these criteria lack sensitivity and specificity. By allowing visualization of blood flow, the demonstration of right-toleft or left-to-right shunting is possible with contrast echocardiography(11-16). The purpose of the first part of this study was to verify the utility of this technique for evaluating patients with atrial septal defect.We observed that contrast echocardiographic shunts may persist long after closure of an atrial septal defect. The aim of the second part of' this study was to determine whether this indicates unsuccessful repair or a hemodynamically important residual shunt.Peripheral venous injection of echocardiographic contrast allows the visualization of blood flow through the right sided cardiac cavities. The purpose of the third part of the study was to determine whether the technique may aid to the diagnosis of some right heart abnormalities by the demonstration of specific blood flow patterns.The patterns of echo contrast appearance in the inferior vena cava after upper extremity injection may be related to right heart hemodynamics(17,18). The purpose of the fourth part of the study was to determine the utility of contrast echocardiography of the inferior vena cava for the assessment of right heart hemodynamics. Since the technique can be used to detect tricuspid regurgitation( 9-21), we also studied whether estimation of its severity is possible,. because this would have important therapeutic and prognostic implications.An intriguing potential .future application of contrast echocardiography is the study of myocardial perfusion. The technique would offer many advantages over the other imaging modalities such as radionuclide techniques, contrast-enhanced computerized transmission tomography, positron emission tomography and nuclear magnetic resonance. Contrast echocardiographic. myocardial perfusion imaging would have a good spatial and temporal resolution and allows direct and simultaneous assessment of both the perfusion and function of the myocardium. It is also much less expensive. However, a good and safe echocardiographic contrast agent for such application in humans is not yet available. "

"ABSTRACTCoronary Heart Disease (CHD) morbidity and mortality rate is increasing dramatically in the last 15 years in Indonesia. Available data show that among the contribution factor changes in life style and demographic transition are prominent.A hypothetical risk factor for CHD is lipid peroxidation, a reaction between oxygen free radical and lipid parts of cell membranes and low density lipoprotein (LDL). Food habit is following a pattern of nutrient and non-nutrient intakes, including fatty acids and antioxidants. Fatty acid intakes determine the susceptibility of the lipid parts of eell membranes and LDL to peroxidation by free radicals. Theoretically, antioxidants will protect against oxidative damage caused by oxygen free radicals. Commercially available and advertised antioxidants such as vitamin E are widely used inspite of limited information on the interrelation between lipid peroxide levels in the Indonesian elderly with CHD risk factors such as food habits, dyslipidemia and obesity.A two-phase study on the elderly (55-85 years.) guided by the health centers was undertaken in Jakarta. Data for both phases were collected through interviews, anthropometric measurements, blood analysis and blood pressure measurements. Univariate, bivariate and multivariate analysis were done using SPSS and WorldFood 2 programs.The first phase was a cross-sectional study to see the association between lipid peroxides and fatty acids, vegetables, fruits, tempe intakes, obesity, smoking, dyslipidemia and hypertension. The samples were 394 elderly. The variables found correlated with lipid peroxides were LDL, intake of mono and poly-unsaturated fatty acids, tempe, and vitamin E. The study showed an increase level of lipid peroxides with age and ethnic differences with the highest level of lipid peroxides among the Minangkabau.The second phase is a randomized double-blind trial giving 600 mg/day vitamin E supplementation or placebo for 12 weeks to 152 elderly with the high level of lipid peroxides found in the cross-sectional study. The objective was to see if there was a change of lipid peroxide levels after the intervention. The results showed a significant decrease of lipid peroxides level in the vitamin E group compared to placebo after being adjusted with age, waist-hip ratio (WHR), plasma cholesterol, and saturated fatty acids (SAFA) intake. The high density lipoprotein (HDL) was also increased significantly in the vitamin E group compared to placebo group.Randomized controlled trial taking into account the confounding variables such as age, sex, ethnic, waist-hip ratio, saturated fat intake, carbohydrate intake and plasma cholesterol might be able to elucidate the specific beneficial effect of vitamin E supplementation. Health education and information concerning foods that have effect on lipid peroxidation, such as tempe should be endorsed. More studies should be undertaken to find other food or beverage that have protecting effects against lipid peroxides."

""Specifically designed to prepare medical students for their initial encounters with patients with heart disease, this award-winning text bridges basic cardiac physiology with clinical care. Written by internationally recognized Harvard Medical School faculty and select medical students, this text provides a solid foundation of knowledge regarding diseases of the heart and circulation.Designed to prepare medical students for their initial encounters with patients with heart disease, this book bridges basic cardiac physiology with clinical care, offering a foundation of knowledge regarding diseases of the heart and circulation."