OR9. Association between Echocardiographic Pulmonary to Left Atrial Ratio (ePLAR) and Pulmonary Vascular Resistance in Patients with Adult Congenital Heart Diseases

Abstract

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 <5 WU and PVR >5 WU. There were 15 patients (median age 37.00 (24.00 - 64.00) in PVR <5WU group and 10 patients (median age 29.00 (24.00 – 49.00) in PVR >5 WU group. Mean ePLAR in PVR <5 WU group was 0.28 ±0.13 and 0.52 ±0.23 in patients with PVR >5 WU group. Statistical analysis has shown significant difference of ePLAR between the PVR <5 WU group and the PVR >5 WU group, p < 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 < 0.007). Patients with ePLAR value of >0.341 will significantly show higher PVR by RHC of > 5 WU (OR 24.7, (95% CI 2.333-262.5), p < 0.004). Conclusion Our study shows the association between ePLAR and PVR in patients with ACHD. The ePLAR value of >0.341 can predict PVR >5 WU with good sensitivity and specificity.