Citations 1
Evaluation of ePLAR, the echocardiographic pulmonary to left atrial ratio, in a large cohort with pulmonary hypertension
Scalia, Isabel G. , Ali, Nima Baba , Bismee, Nadera N. , Mahmoud, Ahmed K, Esfahani, Sogol Attaripour , Sheashaa, Hesham, Ibrahim, Oman H, Abdelfattah, Fatmaelzahraa , Barry, Timothy, Tamarappoo, Balaji , Scott, Robert L, Rosenthal, Julie , Lester, Steven J, Ayoub, Chadi, Arsanjani, Reza, Mahmoud, Ahmed , Scalia, Isabel G , Pietri, Milagros Pereyra, Awad, Kamal , Javadi, Niloofar , Mahmoud, Ahmed K , Tamarappoo, Balaji K, Alsidawi, Said , Ayoub, Chadi , Farina, Juan M. , Pereyra, Milagros , Abbas, Mohammed Tiseer , Awad, Kamal , Barry, Timothy , Alsidawi, Said , Scott, Robert L. , Lester, Steven J., Arsanjani, Reza
European Heart Journal Open | December 18, 2025 | Volume: 6 | Issue: 3 | Pages: No page available
Abstract Aims Pre-capillary pulmonary hypertension (PHTN), typically due to intrinsic pulmonary pathology, requires right heart catheterization (RHC) for diagnosis. ePLAR, the echocardiographic pulmonary to left atrial ratio [calculated: tricuspid regurgitation maximum velocity (TRVmax) divided by mitral valve E to e′ wave ratio (E/e′)], has been demonstrated as a promising non-invasive surrogate for characterization of pre-capillary PHTN. As such, this study aimed to further evaluate the diagnostic utility of ePLAR in a large cohort of patients with PHTN. Methods and results All RHCs between 2018 and 2023 across three tertiary centres were retrospectively reviewed. Patients with PHTN were characterized as pre-capillary or post-capillary (isolated or combined). Concurrent ePLAR was calculated. ROC analysis evaluated the accuracy of ePLAR in detecting pre-capillary PHTN. Overall, 2235 patients had PHTN by RHC, mean age 63.5 ± 14.7 years, 53.5% male. Of these, 43.3% had pre-capillary PHTN. ROC analysis demonstrated ePLAR to have good accuracy in detection of pre-capillary PHTN (AUC 0.760), with a cutoff of 0.20 m/s demonstrating a sensitivity and specificity of 77% and 60% respectively. This persisted on sensitivity analysis for contemporaneous investigations and for right ventricular function. Conclusion In this large cohort, ePLAR was validated as an accurate tool for identifying patients with pre-capillary PHTN. This widely available, non-invasive, and reproducible parameter can have an important role in the work up of PHTN and may guide the need for invasive testing.