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All Journal Indonesian Journal of Cardiology
Surya Sinaga Immanuel
Advanced Cardiac Care Clinic, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia
Health Professions Medicine & Pharmacology

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The Forgotten Spongy Myocardium: Clinical Trajectory of Left Ventricular Noncompaction Cardiomyopathy in an Asymptomatic Adult Leonardo Paskah Suciadi; Dony Yugo Hermanto; Surya Sinaga Immanuel; Jason Wirandy Haryanto; Harvian Satya Dharma
Jurnal Kardiologi Indonesia Vol 47 No 2 (2026): April - June, 2026
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2180

Abstract

Background: Left Ventricular Noncompaction (LVNC) is a rare cardiomyopathy characterized by a thin compacted epicardial layer and an extensive noncompacted endocardial layer with prominent trabeculations and deep intertrabecular recesses that communicate with the Left Ventricular (LV) cavity. The classic triad of complications includes chronic heart failure, ventricular arrhythmias, and systemic embolic events. At present, evidence-based management guidelines remain limited. Case Illustration: We report a 42-year-old man with LVNC, initially detected as an incidental Left Bundle Branch Block (LBBB) on Electrocardiogram (ECG) during a routine medical checkup. Although he remained asymptomatic, LV Ejection Fraction (LVEF) progressively declined, accompanied by rising N-Terminal pro-B-type Natriuretic Peptide (NT-proBNP) levels. Coronary artery disease was excluded by coronary computed tomography angiography. Given worsening LV systolic function over 2 years, Cardiac Magnetic Resonance (CMR) demonstrated an LVNC phenotype consistent with cardiomyopathy. Guideline-Directed Medical Therapy (GDMT) for heart failure was initiated, along with oral anticoagulation for primary prevention of LV thrombus. After medication optimization, LVEF improved markedly, and NT-proBNP normalized. Conclusions: This case illustrates the value of comprehensive evaluation and multimodality imaging in patients with unexplained LBBB, even when asymptomatic. Early diagnosis, phenotype-guided treatment, and longitudinal surveillance may help prevent clinical progression and future heart-failure, arrhythmic, or thromboembolic complications.
Prevalence and Lipid Profile Associations of Elevated Lipoprotein(a) Among Indonesian Adults: A Cross-Sectional Study Jason Wirandy Haryanto; Kevin Jonatan Sandi; Surya Sinaga Immanuel; Angely Christie Rumayar; Leonardo Paskah Suciadi
Jurnal Kardiologi Indonesia Online First
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1846

Abstract

Background: Lipoprotein(a) [Lp(a)] is a genetically determined lipoprotein and an independent risk factor for Atherosclerotic Cardiovascular Disease (ASCVD). While 20–30% of adults worldwide have elevated Lp(a), data from Indonesia remain scarce. Given reported differences by sex and metabolic profile, this cross-sectional study aimed to determine the prevalence of elevated Lp(a) and its associations with lipid parameters and Hemoglobin A1c (HbA1c) among adults undergoing routine health screening at a tertiary hospital in Indonesia. Methods: This cross-sectional study analyzed data from 904 adults who underwent routine health screening at Siloam Hospitals Kebon Jeruk, Jakarta (2021–2024). Data on Lp(a), lipid profile, and HbA1c were extracted from the medical records. The normality of data was assessed using the Shapiro–Wilk test. Group comparisons were performed using the Mann–Whitney U test, and correlations between log-transformed Lp(a) and metabolic parameters were evaluated using Spearman correlation and simple linear regression. Results: Among 904 participants, 18.8 % had elevated Lp(a) levels (> 30 mg/dL). Females showed significantly higher Lp(a) concentrations than males (p = 0.008). Low-Density Lipoprotein Cholesterol (LDL-C) levels were slightly higher in participants with elevated Lp(a) but did not differ significantly (p = 0.19). On linear regression, LDL-C was positively associated with log-transformed Lp(a) (B = 0.002, p < 0.001), whereas triglycerides were inversely associated (B = −0.001, p = 0.029); no significant relationships were observed for High-Density Lipoprotein Cholesterol (HDL-C) or HbA1c. Conclusion: Nearly one in five adults undergoing routine health screening in this Indonesian cohort had elevated Lp(a) levels. Females exhibited significantly higher Lp(a) concentrations than males, and LDL-C showed a modest positive association with Lp(a). These findings reinforce the relevance of Lp(a) as an important, genetically influenced cardiovascular risk marker and support routine Lp(a) screening for improved risk stratification in clinical practice.
Co-Authors Angely Christie Rumayar Dony Yugo Hermanto Harvian Satya Dharma Jason Wirandy Haryanto Kevin Jonatan Sandi Leonardo Paskah Suciadi