In this cross-sectionalstudy, 102 ASD patients admitted from December 2019 to November 2020were enrolled and divided into two cohorts: those with SPAH and those without.Blood tests were conducted to measure serum direct bilirubin (DBIL), totalbilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase(AST), uric acid (UA) and N-terminal pro B-type natriuretic peptide (NT-proBNP).Additionally, all participants underwent transthoracic echocardiography, andinvasive hemodynamic data were gathered through right heart catheterization. Here, NPPB is linked to atrial septal defect.