ePLAR: Echocardiographic Pulmonary to Left Atrial Ratio

ePLAR: Echocardiographic Pulmonary to Left Atrial Ratio ePLAR is a simple echocardiographic estimation useful in differentiating pre-capillary from post capillary pulmonary hypertension [1]. ePLAR = TR Vmax/(Mitral E/e’) ePLAR: Echocardiographic pulmonary to left atrial ratio TR Vmax: Maximum velocity of tricuspid regurgitation jet by Doppler echocardiography in m/s E: E wave in the mitral flow Doppler e’: Septal mitral annular tissue Doppler velocity ePLAR values are lower in post-capillary pulmonary hypertension. E/e’ reflects left ventricular filling pressure which is left atrial pressure. TR Vmax reflects the pulmonary artery systolic pressure. That is how TR Vmax divided by E/e’ is a pulmonary to left atrial ratio. ePLAR can be used to triage patients for pulmonary vasodilator therapy non-invasively. It may be noted that right heart catheterization is the gold standard for differentiating pre-capillary from post capillary pulmonary hypertension. Pulmonary capillary wedge pressure is elevated in post-capillary pulmonary hypertension. In a study of 16,356 echocardiograms, normal reference value of ePLAR was 0.30±0.09m/s [1]. Elevated ePLAR in acute submassive pulmonary embolism suggests increased transpulmonary gradients even in the absence of acute elevation of pulmonary arterial pressure [2]. Estimation of ePLAR increases the sensitivity of echocardiography in submassive pulmonary embolism. An ePLAR of ≥ 0.3 m/s had a sensitivity of 70%. This ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Echocardiography Source Type: blogs