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Association between frontal QRS-T angle and thrombus burden in patients with ST-elevation myocardial infarction: A single-center cross-sectional study Azmi, Muhammad; Nasution, Ali Nafiah; Lubis, Hilfan Ade Putra; Siregar, Abdullah Afif; Habib, Faisal; Sitepu, Andika
Heart Science Journal Vol. 6 No. 4 (2025): The Pursuit of Precision: Navigating Risks, Refining Diagnosis, and Securing Lo
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.04.13

Abstract

BACKGROUND: ST-Elevation Myocardial Infarction (STEMI) is one of the leading causes of global morbidity and mortality, with burden of thrombus as an influential factor of clinical outcomes. OBJECTIVES: The purpose of this study was to evaluate the relationship between frontal QRS-T (fQRST) angle and thrombus burden in STEMI patients. METHODS: A cross-sectional study was carried out at Haji Adam Malik General Hospital, Medan, between January 2024 and July 2024. STEMI patients who underwent coronary angiography were included. The fQRST angle was measured using a 12-lead electrocardiogram (ECG), the thrombus burden was graded according to the Thrombolysis in Myocardial Infarction (TIMI) grading system. Statistical analysis included Spearman's correlation and Receiver Operating Characteristic (ROC) curve analysis. RESULTS: 108 STEMI patients were included in the study. The fQRST angle was strongly positively correlated with thrombus burden (r = 0.61–0.80, p < 0.05). Patients with more thrombus burden had larger fQRST angles compared to patients with less thrombus burden. Additionally, diabetes mellitus and symptom delay exceeding 12 hours were highly correlated with higher thrombus burden (p < 0.05), whereas infarct-related artery (IRA) location was not significantly associated (p > 0.05). ROC curve demonstrated that the fQRST angle had an AUC of 0.88 (p = 0.001) At the optimal cut-off value of 61°, the sensitivity and specificity were 88.3% and 87.5% (95% CI of 88.5%–98.2).
Management of Decongestion in Acute Heart Failure: Time for a New Approach? Pramudyo, Miftah; Putra, Iwan Cahyo Santosa; Zulkarnain, Edrian; Danny, Siska Suridanda; Bagaswoto, Hendry Purnasidha; Anjarwani, Setyasih; Mazwar, Irmaliyas; Juzar, Dafsah Arifa; Pratama, Vireza; Habib, Faisal; Ispar, Akhtar Fajar Muzakkir Ali; Widyantoro, Bambang
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1381

Abstract

As the primary cause of hospitalization in acute heart failure (AHF) patients, congestion was responsible for a higher risk of mortality, rehospitalization, and renal dysfunction in AHF patients. Although loop diuretic was routinely used as the mainstay of AHF therapy, it is still ineffective to obtain the euvolemic state in most hospitalized AHF patients. Therefore, a higher loop diuretic dose was often required to increase the decongestion effect. However, consequently, it can cause several detrimental complications, including renal dysfunction, neurohormonal activation, hyponatremia, hypokalaemia, and reduced blood pressure, which eventually result in poor prognosis. Hence, the new approach may be proposed to optimize decongestion in acute phase, including the use of arginine vasopressin V2 receptor antagonist – Tolvaptan. As an additive therapy to loop diuretic in AHF patients, it can be considered due to its several beneficial effects, including greater decongestion effect, lowered worsening renal function incidence, counteract neurohormonal activation, neutralized hyponatraemic state, no alteration of potassium metabolism, stabilize the blood pressure, and reduced requirement of a higher dose of loop diuretic to achieve an equal or even greater decongestion effect compared to a high dose of loop diuretic alone. Tolvaptan provided favourable outcomes in several specific populations and was considered safe with several mild adverse effects. Several guidelines across countries have approved the use of Tolvaptan in AHF patients with or without hyponatremia. The initial dose of Tolvaptan was 7.5 to 15 mg and can be titrated up to 30 mg. However, further studies were still required to determine the timing dose and optimal dose of Tolvaptan in general and elderly populations with AHF, respectively.This article has a related Erratum.
Management of Decongestion in Acute Heart Failure: Time for a New Approach? Pramudyo, Miftah; Putra, Iwan Cahyo Santosa; Zulkarnain, Edrian; Danny, Siska Suridanda; Danny, Hendry Purnasidha; Anjarwani, Setyasih; Mazwar, Irmaliyas; Juzar, Dafsah Arifa; Pratama, Vireza; Habib, Faisal; Ispar, Akhtar Fajar Muzakkir Ali; Widyantoro, Bambang
Jurnal Kardiologi Indonesia Vol 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2036

Abstract

In “Management of Decongestion in Acute Heart Failure: Time for a New Approach?” (Indonesian Journal of Cardiology, 43(2), 77-89. https://doi.org/10.30701/ijc.1381), there is an error noted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1381. The error occurs only in the PDF; the DOI listed in the article metadata is already correct. The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.1381
Operating-Point Optimization of an Organic Rankine Cycle Under Variable Waste Heat Conditions: An Energy Exergy Mahmuddin, Mahmuddin; Habib, Faisal; Pakka, Hariani
Jurnal Rekayasa Mesin Vol. 17 No. 2 (2026)
Publisher : Jurusan Teknik Mesin, Fakultas Teknik, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Low-grade waste heat varies in thermal quality and can shift an Organic Rankine Cycle (ORC) away from favorable operating conditions. This study evaluates operating-point optimization of a single-pressure subcritical ORC using integrated energy and component-level exergy analyses. R245fa was used as the reference fluid, while R245fa/R1233zd(E) mixtures were examined for composition and temperature-matching effects. At a heat-source temperature of 150 °C, increasing evaporation pressure from 1.5 to 3.0 MPa raised thermal efficiency from 11.912% to 14.311%. A pressure of 2.8 MPa was retained as the reference near-optimal point, yielding 33.976 kW net power on a 1.0 kg/s working-fluid basis, 14.164% thermal efficiency, and 48.739% exergy efficiency. Increasing pressure to 3.0 MPa improved net power by only 0.57% while reducing the evaporator hot-end temperature difference from 10.7 to 7.0 K. At 2.8 MPa, total exergy destruction was 35.734 kW, distributed among the evaporator (54.16%), expander (23.49%), condenser (20.58%), and pump (1.77%). The 0.3/0.7 R245fa/R1233zd(E) mixture was the first feasible composition under the 5 K minimum temperature-difference constraint and gave the highest feasible thermal efficiency, 14.636%, or 0.472 percentage points above pure R245fa, with a temperature glide of 0.528 K. This modest gain is associated with composition-dependent source–fluid temperature matching under the imposed feasibility constraint rather than an unconstrained interior optimum. Under a 140-160 °C heat-source variation, operating-point adjustment limited the maximum relative net-power deviation to approximately ±1.8%. Raising condensation temperature from 30 to 40 °C reduced both thermal and exergy efficiencies by about 8.96%, while increasing expander isentropic efficiency from 0.80 to 0.88 raised exergy efficiency from 48.739% to 53.990%. The study integrates operating-point adaptation, mixture assessment, and component-level thermodynamic diagnosis within a simple ORC framework for variable waste-heat recovery.