Background: High neutrophil to lymphocyte ratio (NLR) is independently associated with lower EF, in hospital complications, and higher mortality rates in acute myocardial infarction (AMI). Global longitudinal strain (GLS) measurement after AMI demonstrated specific benefit compared with LVEF in evaluation of the extent of post MI left ventricular myocardial injury. The aim of this study was to determine the association between NLR and left ventricular GLS in AMI patients.Methods: An analytic observational study was conducted on August-December 2017 to patients who admited to Dr. Moewardi General Hospital which diagnosed STEMI or NSTEMI. Blood examination and transthoracic echocardiography were performed. They were divided into two groups according to GLS measurement result, GLS>-13.8% and GLS≤-13.8%. The cut-off value of NLR to predict GLS>-13.8%was determined by ROC curve analysis. Bivariate and multivariate analysis to assess whether high NLR was associated with GLS>-13.8% were performed.Results: As many as 57 patients were included in this study, 24 patients (mean age 56,21±9,43) in GLS ≤-13.8% group and 33 patients (mean age 56.67±8.24) in GLS >-13.8%. NLR was significantly higher in GLS>-13.8% group 6.06 (5.36-6.86) compare 4.20 (3.49-5.04),in GLS≤-13.8%, p=0.001. The cut-off value of NLR was 4.69. The bivariate analysis showed that NLR>4.69 associated with GLS>-13.8%, OR 2.70 (CI 95% 1.41-5.17, p=0.001). Multivariate analysis shown that higher NLR have more probability to develop GLS>-13.8%, OR 8.53 (CI 95% 2.38-30.60, p<0.001).Conclusion: There is an association between NLR and left ventricular GLS in AMI patients. AMI patients with high NLR are more likely to have worse GLS.

Background and Aims Echocardiographic pulmonary to left atrial ratio (ePLAR) is a new echocardiographic valuable parameter for distinguishing precapillary and postcapillary PH. This study aims to determine the association between ePLAR and PVR in patients with ACHD. Methods and Results A total of 42 patients with ACHD who underwent RHC at Dr Moewardi General Hospital between May 2019 to February 2021 were included in this retrospective observational study. Transthoracic echocardiography and RHC were performed in all patients. The ePLAR then compared between the patient with PVR &lt;5 WU and PVR &gt;5 WU. There were 15 patients (median age 37.00 (24.00 - 64.00) in PVR &lt;5WU group and 10 patients (median age 29.00 (24.00 – 49.00) in PVR &gt;5 WU group. Mean ePLAR in PVR &lt;5 WU group was 0.28 ±0.13 and 0.52 ±0.23 in patients with PVR &gt;5 WU group. Statistical analysis has shown significant difference of ePLAR between the PVR &lt;5 WU group and the PVR &gt;5 WU group, p &lt; 0.003. The ePLAR cut off value for PVR was 0.341 with sensitivity of 90.0% and specificity of 73.3% (AUC 0.827; p &lt; 0.007). Patients with ePLAR value of &gt;0.341 will significantly show higher PVR by RHC of &gt; 5 WU (OR 24.7, (95% CI 2.333-262.5), p &lt; 0.004). Conclusion Our study shows the association between ePLAR and PVR in patients with ACHD. The ePLAR value of &gt;0.341 can predict PVR &gt;5 WU with good sensitivity and specificity.