Budhi Setianto
Department of cardiology and vascular medicine of National Cardiovascular Center of Harapan Kita, Faculty of medicine of Universitas Indonesia

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Angiotensin converting enzyme 2 (ACE2), COVID-19 and cardiac injury: what cardiologist should know Sidhi Laksono; Budhi Setianto; Steven Philip Surya
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020): Special Issue: COVID-19
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (197.966 KB) | DOI: 10.19106/JMedSciSI005203202009

Abstract

Coronavirus disease 2019 (COVID-19) has already stated as a pandemic by the World Health Organization (WHO). Until now, Indonesia has also infected with this severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. All medical staffs join hand by hand to overcome this pandemic, not only pulmonologist but also cardiologist. Early reports from China showed that cardiovascular comorbidities add more mortality than without comorbid. Cardiac implication of this infection is cardiac injury. Viral pathology and pathophysiology that induced cardiac injury is still debatable and not well understood. Angiotensin-converting enzyme 2 (ACE2) has emerged as a key regulator of renin-angiotensin system in cardiovascular disease. ACE2 has been postulated as one of the pathophysiology of COVID-19 and cardiac injury.
Role of Matrix Metalloproteinase in the Progression of Heart Failure: A Narrative Review Sidhi Laksono; Budhi Setianto; Reynaldo Halomoan
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol 10, No 1 (2021): MARET 2021
Publisher : Universitas Wijaya Kusuma Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30742/jikw.v10i1.987

Abstract

Heart failure (HF) is a cardiovascular disease with a complex pathological pathway and influenced by many factors. Such a complex pathological mechanism would impair cardiac function and structural stability. One that plays a role in maintaining the function and structure of the heart is the extracellular matrix (ECM), and disruption in the extracellular matrix has a role in causing cardiac dysfunction. ECM regulation is associated with matrix metalloproteinase (MMP). Overexpression of matrix metalloproteinases can lead to ECM degradation process which leads to cardiac remodelling. The role of MMP in heart failure is also related to the increased inflammatory response, which is one of the pathways for progression of heart failure. The close association of MMP with the development of heart failure makes MMP a potential biological marker. This article aims was to understand the role of MMP and its mechanisms in cardiac remodelling pathways leading to heart failure. This narrative review suggests that overexpression of MMP can lead to heart failure. Inflammation is one of the factors triggering the expression of MMP. Inflammation will increase the release of pro-inflammatory cytokines, thereby triggering MMP expression. MMP expression imbalance can damage collagen tissue through ECM degradation and damage the structure and function of the heart. MMP can also be used as a biological marker in heart failure cases. The application of MMP as a biological marker can be used to assess the degree of disease severity as well as a predictor of heart failure. In conclusion, MMP has an important role in the development process of heart failure and can be a biological marker in cases of heart failure.