Usefulness of ePLAR as a non-invasive predictor of adverse clinical events following transcatheter aortic valve implantation

Abstract Background The echocardiographic pulmonary to left atrial ratio (ePLAR) is a simple Doppler-derived parameter, calculated as the ratio between the maximum tricuspid regurgitation velocity (TRVmax) and the medial E/e’ ratio, that has proved to be helpful for differentiating precapillary from postcapillary pulmonary hypertension (PH). Our objective was to evaluate its prognostic value in patients with elevated pulmonary pressures undergoing transcatheter aortic valve implantation (TAVI). Methods A total of 1,456 patients who underwent TAVI at a single center between 2009-2023 were prospectively recruited. Of those, 277 patients with TRVmax > 2.8 m/s were analyzed and stratified based on ePLAR values, following published thresholds: ePLAR < 0.45 (representing postcapillary PH [