Background: Congenital Heart Disease which if not corrected on time can result in increased pulmonary artery pressure or what is referred to as Pulmonary Artery Hypertension (HAP). The pathogenesis of HAP involves remodeling of the pulmonary artery Pomegranate extract (EBD) can be developed as a therapy in cardiovascular disease as anti-proliferation and anti-inflammatory.
Purpose: Analyzing the effect of pomegranate extract administration on the expression of Endothelin-1 (ET-1), Inducible Nitric Oxide Synthase (iNOS), and thickness of the tunica smooth muscle media of pulmonary arteries in rats modeled by pulmonary arterial hypertension.
Method: This study was an observational analytic retrospective cohort study design. Analysis of the data used is a descriptive analysis of the number of cells expressing ET-1 and iNOS as well as the thickness of the tunica smooth muscle media of the pulmonary arteries for each group.
Result: In the HAP model mouse group that was given EBD, the average number of cells expressing ET-1 decreased sharply from observation after 2 weeks to observation after 4 weeks. The mean number of cells expressing iNOS and the mean thickness of smooth muscle of the pulmonary artery also experienced a sharp decline from observation after 2 weeks to observation after 4 weeks.
Conclusion: The administration of EBD can reduce the expression of ET-1, iNOS, and smooth muscle thickness in tunica pulmonary artery media in hypertensive mice.

• Anggraini, D., & Hendarto, H. (2018). Pomegranate Fruit extract Administration in mice induced by Formaldehyde to Folliculogenesis Observation and Caspase-3 Expression. Reaserch Journal of Pharmacy and Technology, 11(2), 773-776.
• Barst, R. J., Ertel, S. I., Beghetti, M., & Ivy, D. D. (2011). Pulmonary arterial hypertension: a comparison between children and adults. European Respiratory Journal, 37(3), 665-677.
• Chang, Y., & Kim, G. (2018). Forecasting Waste Agricultural Plastics Generation in the Republic of Korea and its Policy Implications. Agriculture and Food Sciences Research, 5(2), 68-72.
• Dewachter, L., Dewachter, C., & Naeije, R. (2010). New therapies for pulmonary arterial hypertension: an update on current bench to bedside translation. Expert opinion on investigational drugs, 19(4), 469-488.
• Geiger, R., Sharma, H. S., Mooi, W. J., & Berger, R. M. (2009). Pulmonary vascular remodeling in congenital heart disease: Enhanced expression of heat shock proteins. Indian Journal of Biochemistry and Biophysics, 46(6), 482-490.
• Haarman, M. G., Kerstjens-Frederikse, W. S., Vissia-Kazemier, T. R., Breeman, K. T., Timens, W., Vos, Y. J., ... & Berger, R. M. (2020). The Genetic Epidemiology of Pediatric Pulmonary Arterial Hypertension. The Journal of Pediatrics.
• Humbert, M., Morrell, N. W., Archer, S. L., Stenmark, K. R., MacLean, M. R., Lang, I. M., ... & Rabinovitch, M. (2004). Cellular and molecular pathobiology of pulmonary arterial hypertension. Journal of the American College of Cardiology, 43(12 Supplement), S13-S24.
• Jurenka, J. (2008). Therapeutic applications of pomegranate (Punica granatum L.): a review. Alternative medicine review, 13(2).
• Maharani, A., Praveen, D., Oceandy, D., Tampubolon, G., & Patel, A. (2019). Cardiovascular disease risk factor prevalence and estimated 10-year cardiovascular risk scores in Indonesia: The SMARThealth Extend study. PloS one, 14(4), e0215219.
• Putri, C. G. (2019). Pengaruh Ekstrak Buah Delima Terhadap Ekspresi Endothelin-1, Inducible Nitric Oxide Synthase Dan Ketebalan Otot Polos Pada Tunika Media Arteri Pulmonalis (Studi Pada Blok Parafin Tikus Model Hipertensi Arteri Pulmonalis) (Doctoral dissertation, Universitas Airlangga).
• Seeram, N. P., Adams, L. S., Henning, S. M., Niu, Y., Zhang, Y., Nair, M. G., & Heber, D. (2005). In vitro antiproliferative, apoptotic and antioxidant activities of punicalagin, ellagic acid and a total pomegranate tannin extract are enhanced in combination with other polyphenols as found in pomegranate juice. The Journal of nutritional biochemistry, 16(6), 360-367.
• Wardle, A. T.R. (2012). Update on pulmonary arterial hypertension in children: management strategies and clinical utility of sildenafil. Pediatr Heal Med Ther.;3:59–67.
• Widiyanti, P., Paramadini, A. W., Jabbar, H., Fatimah, I., Nisak, F. N., & Puspitasari, R. A. (2016, March). Morphology characterization and biocompatibility study of PLLA (Poly-L-Llactid-Acid) coating chitosan as stent for coronary heart disease. In AIP Conference Proceedings (Vol. 1718, No. 1, p. 060008). AIP Publishing LLC.
• Wilkins, M. R. (2012). Pulmonary hypertension: the science behind the disease spectrum. European Respiratory Review, 21(123), 19-26.
• Yu, X., Zhang, F., & Shi, J. (2019). Effect of sevoflurane treatment on microglia activation, NF-kB and MAPK activities. Immunobiology, 224(5), 638-644.

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