ePLAR — The echocardiographic Pulmonary to Left Atrial Ratio — A novel non-invasive parameter to differentiate pre-capillary and post-capillary pulmonary hypertension
Pulmonary hypertension is an important condition with a heterogeneous range of aetiologies. Tailored treatment modalities for specific pre-capillary physiologies now offer hope to a subgroup of these patients. Transthoracic echocardiography is typically the initial investigation in patients with suspected pulmonary hypertension, but is often a poor discriminator in the key dichotomisation of pre-capillary versus postcapillary causes. This research applied a novel, non-invasive, easily obtained echocardiographic parameter, ePLAR, to a broad range of pulmonary hypertensive patients to discriminate between pre-capillary and post-capillary hypertension. ePLAR demonstrated a gradient from lowest values in isolated post-capillary PHT cases, through intermediate values in combined pre- and post-capillary PHT cases, to highest values in the post-capillary PHT cases. This ePLAR parameter may offer value as a broadly applicable non-invasive screening tool for consideration of specific pulmonary vasodilator therapies.
ePLAR is a simple echocardiographic parameter which can accurately differentiate the smaller subset of patients with pre-capillary pulmonary hypertension from the more common post-capillary aetiology. The use of this easily obtained echocardiographic parameter has the potential to enhance non-invasive triage of patients for specific pulmonary vasodilator therapy.
Thanks to the authors.
