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Background: Hypertension (HTN) is highly prevalent in non‐ischemic dilated cardiomyopathy (NIDCM) patients, but little is known about its impact on left ventricular (LV) function and remodeling. Purpose: To evaluate the effect of hypertension on LV function and remodeling in NIDCM patients. Study Type: Retrospective. Population: Two‐hundred and twelve NIDCM (HTN−) patients, 91 NIDCM (HTN+) patients, and 74 normal controls. Field Strength/Sequence: 3.0 T/bSSFP and phase‐sensitive inversion recovery sequence. Assessment: The LV geometry, myocardial strain, remodeling index (calculated as LVM/LVEDV), and LGE were measured and compared between groups. Determinants of LV strain and remodeling in NIDCM were investigated. Statistical Tests: Student's t‐test, Mann–Whitney U test, one‐way analysis of variance, Kruskal–Wallis test, univariable and multivariable linear regression. A P value <0.05 was considered statistically significant. Results: Compared with normal controls, NIDCM patients had significantly higher LVEDV and significantly impaired LV strains, including LV global peak strain (PS) and peak systolic and diastolic strain rates in the radial, circumferential, and longitudinal directions. The NIDCM (HTN+) group had significantly decreased LV global longitudinal PS and peak diastolic strain rate (PDSR), and significantly increased LV mass index and remodeling index compared to the NIDCM (HTN−) group, despite there being no significant difference in ejection fraction (P = 0.241). The prevalence of LV LGE was significantly higher in the NIDCM (HTN+) group than in the NIDCM (HTN−) group. In multivariable regression models adjusted for potential confounders, hypertension was independently associated with LV global longitudinal PS and PDSR. Male sex, resting heart rate, and log(NT‐proBNP) level were independent determinants of LV strains. Moreover, male sex, systolic and diastolic blood pressure, and presence of LGE were independent determinants of LV remodeling index. Data Conclusion: These findings suggest that coexistence of hypertension may further exacerbate the reduction in LV global strain and the aggravation of LV remodeling in NIDCM patients. Level of Evidence: 3 Technical Efficacy: Stage 3 [ABSTRACT FROM AUTHOR]

Background: The relationship of left atrial (LA) strain to high‐risk heart failure (HF) events in patients with left ventricular myocardial noncompaction (LVNC) remains to be thoroughly investigated. Purpose: To evaluate the LA performance in patients with LVNC, and to investigate the prognostic value of LA phasic strain on high‐risk HF events, and its influencing factors. Study Type: Retrospective. Population: A total of 95 LVNC patients (74 with LA enlargement [LAE] and 21 without LAE) and 50 healthy controls. Field Strength/sequence: A 3.0 T, balanced steady‐state free‐precession cine imaging. Assessment: LA longitudinal strains were measured by cardiac MRI feature tracking technique. LA volume index (LAVI) and LA ejection fraction (LAEF) were calculated. Their intraobserver and interobserver reproducibility were evaluated. The primary outcome was high‐risk HF events, a composite of first HF hospitalization, hospitalization for worsening HF and death from HF. Statistical Tests: Student's t/Mann–Whitney U, one‐way analysis of variance/Kruskal–Wallis, Chi‐squared, receiver operating characteristic, Kaplan–Meier, log‐rank, Cox regression, Pearson and Spearman correlation and linear regression analyses were performed. The significance threshold was set at P < 0.05. Results: LAEF and LA longitudinal strains decreased in LVNC patients irrespective of the presence of LAE. During a median follow‐up of 32.17 months, high‐risk HF occurred in 13 (13.68%) patients. Patients with increased LAVI, decreased LAEF and decreased LA longitudinal strain had significantly higher risks of high‐risk HF events. In patients with LVNC, LA reservoir strain (εs) was independently associated with high‐risk HF (hazard ratio = 23.208 [95% CI: 2.993–179.967]). LV global longitudinal strain (LV GLS) (β = −1.783 [95% CI: −2.493 to −1.073]) was significantly and independently associated with εs. Intraobserver and interobserver reproducibility was excellent for LAVI, LAEF, and LA strain. Conclusion: In patients with LVNC, εs was an independent predictor for high‐risk HF events. LV GLS was an independent determinant of εs in LVNC. Evidence Level: 4 Technical Efficacy: Stage 4 [ABSTRACT FROM AUTHOR]

Objective: The pharmacokinetics and relative bioavailability of Jiaotai pill self-microemulsion were evaluated by investigating the blood concentration of Berberine, Coptisine, Palmatine and Jatrorrhizine in insomnia rats. Methods: Insomnia rat model was established by intraperitoneal injection of p-chlorophenylalanine (PCPA). The model rats were given Jiaotai pill selfmicroemulsion and Jiaotai pill suspension. The contents of Berberine, Coptisine, Palmatine and Jatrorrhizine in plasma at different times after administration were determined by UPLCMS/MS, and calculate pharmacokinetic parameters. Results: Under the set chromatographic conditions, the linear relationship of the four components was good, and the precision, accuracy and stability meet the requirements of biological samples. After intragastric administration of Jiaotai pill self-microemulsion, The Cmax of Berberine, Coptisine, Palmatine and Jatrorrhizine were (412.68±28.45), (68.65±3.92), (34.06±3.13), (40.60±1.22) ng/mL, and AUC0.4 were (672.70±72.55), (146.04±25.01), (71.49±18.67), (72.25±9.54) ng-mL-1, respectively. Compared with Jiaotai pill suspension, the Cmax, AUC0-4 and AUC0-/of the four components in insomnia rats were significantly increased (P<0.01). Conclusion: Jiaotai pill self-microemulsionl can promote the absorption of effective components in insomnia rats and improve its bioavailability. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) and obesity often coexist and together contribute to left atrial (LA) functional abnormalities. However, little is known about the impact of body mass index (BMI) on LA strains measured using cardiac magnetic resonance feature tracking (MR‐FT). Purpose: To investigate the additive effect of BMI on LA functional remodeling using MR‐FT as well as to explore abnormal atrioventricular interaction in T2DM patients. Study Type: Retrospective. Population: One hundred and fifty‐nine T2DM patients (53, 34, and 72 normal‐weight, overweight, and obese individuals) and 105 non‐diabetic controls (46, 32, and 27 normal‐weight, overweight, and obese individuals). Field Strength/Sequence: 3.0 T/balanced steady‐state free precession. Assessment: LA reservoir strain (εs), conduit strain (εe), and active strain (εa) and their corresponding strain rates (SRs, SRe, SRa) were measured together with left ventricular (LV) radial, circumferential, and longitudinal peak strain, peak systolic strain rate, and peak diastolic strain rate. Statistical Tests: Student's t‐test or Mann–Whitney U test, one‐way ANOVA, univariate and multivariate linear regression. A P value <0.05 was considered statistically significant. Results: Compared to controls in the same BMI category, T2DM patients had significantly decreased reservoir and conduit function, while pump function was not significantly different (εa and SRa: P = 0.757 and 0.583 for normal‐weight, P = 0.171 and 0.426 for overweight, P = 0.067 and 0.330 for obese). LA strains were significantly correlated with BMI (r = −0.346 for εs, −0.345 for εe) in T2DM patients. Multivariable linear regression analysis indicated that BMI was independently associated with LA εs and εe, LV global longitudinal strain was independently associated with LA εs and εa, and LV circumferential peak diastolic strain rate was independently associated with LA εe. Data Conclusion: These findings suggest that the coexistence of increased body weight and T2DM patients can exacerbate the impairment of LA strains and indicate abnormal atrioventricular interactions. Level of Evidence: 3 Technical Efficacy: Stage 3 [ABSTRACT FROM AUTHOR]

Background: The alteration of left atrial (LA) phasic function in subacute and chronic pulmonary embolism (PE) patients is unclear., Purpose: To investigate LA phasic strain and LA-right ventricular (RV) interaction in subacute and chronic PE patients with different degrees of obstruction by MRI-feature tracking (MRI-FT)., Study Type: Retrospective., Population: One hundred three PE patients (54 subacute [2 weeks to 3 months after initial symptoms], 49 chronic [>3 months after initial symptoms]) and 80 controls., Field Strength/sequence: 3.0 T/balanced steady state free precession sequence., Assessment: Patients were divided into mild (pulmonary artery obstruction index [PAOI] < 30%, N = 57), moderate (30% ≤ PAOI < 50%, N = 27), and severe (50% ≥ PAOI, N = 19) PE subgroups. LA reservoir, conduit, and active pump longitudinal strains (εs, εe, and εa) and strain rates (SRs, SRe, and SRa) and biventricular global strains were measured. Determinants of LA strains were investigated., Statistical Tests: ANOVA, t-tests, Mann-Whitney U tests, linear regression. P < 0.05 was considered statistically significant., Results: For both subacute and chronic PE patients, LA reservoir, conduit, and active pump strains and strain rates were significantly lower than in controls. However, there were no significant differences in LA strains between patients with subacute and chronic PE (P = 0.933, 0.625, and 0.630 for εs, εe, and εa). The severe PE subgroup had significantly higher εa and SRa than the mild and moderate PE subgroups. LA strains were significantly correlated with RV diameter and biventricular strains, and RV diameter (β = -6.836, -4.084, and -1.899 for εs, εe, and εa) was independently associated with LA strains after adjustment for other factors (R 2  = 0.627, 0.536, and 0.437 for εs, εe, and εa)., Data Conclusion: LA phasic function evaluated by MRI-FT was significantly impaired in subacute and chronic PE patients, and LA active pump function in the severe PE subgroup was higher than that in the mild and moderate PE subgroups. The independent association between RV diameter and LA strains demonstrates that RV diameter may be an important indicator for monitoring LA dysfunction in PE patients., Evidence Level: 3 TECHNICAL EFFICACY: Stage 3., (© 2024 International Society for Magnetic Resonance in Medicine.)

Background: Hypertension (HTN) and type 2 diabetes mellitus (T2DM) are both associated with left ventricular (LV) and left atrial (LA) structural and functional abnormalities; however, the relationship between the left atrium and ventricle in this population is unclear., Purpose: To identify differences between hypertensive patients with and without T2DM as the basis for further investigation the atrioventricular coupling relationship., Study Type: Cross-sectional, retrospective study., Population: 89 hypertensive patients without T2DM [HTN (T2DM-)] (age: 58.4 +/- 11.9 years, 48 male), 62 hypertensive patients with T2DM [HTN (T2DM+)] (age: 58.5 +/- 9.1 years, 32 male) and 70 matched controls (age: 55.0 +/- 9.6 years, 37 male)., Field Strength/sequence: 2D balanced steady-state free precession cine sequence at 3.0 T., Assessment: LA reservoir, conduit, and booster strain (ε s , ε e , and ε a ) and strain rate (SRs, SRe, and SRa), LV radial, circumferential and longitudinal peak strain (PS) and peak systolic strain rate and peak diastolic strain rate (PSSR and PDSR) were derived from LA and LV cine images and compared between groups., Statistical Tests: Chi-square or Fisher's exact test, one-way analysis of variance, analysis of covariance, Pearson's correlation, multivariable linear regression analysis, and intraclass correlation coefficient. A P value <0.05 was considered significant., Results: Compared with controls, ε s , ε e , SRe and PS-longitudinal, PDSR-radial, and PDSR-longitudinal were significantly lower in HTN (T2DM-) group, and they were even lower in HTN (T2DM+) group than in both controls and HTN (T2DM-) group. SRs, ε a , SRa, as well as PS-radial, PS-circumferential, PSSR-radial, and PSSR-circumferential were significantly lower in HTN (T2DM+) compared with controls. Multivariable regression analyses demonstrated that: T2DM and PS-circumferential and PS-longitudinal (β = -4.026, -0.486, and -0.670, respectively) were significantly associated with ε s ; T2DM and PDSR-radial and PDSR-circumferential were significantly associated with ε e (β = -3.406, -3.352, and -6.290, respectively); T2DM and PDSR-radial were significantly associated with SRe (β = 0.371 and 0.270, respectively); T2DM and PDSR-longitudinal were significantly associated with ε a (β = -1.831 and 5.215, respectively); and PDSR-longitudinal was significantly associated with SR a (β = 1.07)., Data Conclusion: In hypertensive patients, there was severer LA dysfunction in those with coexisting T2DM, which may be associated with more severe LV dysfunction and suggests adverse atrioventricular coupling., Evidence Level: 3., Technical Efficacy: Stage 3., (© 2024 International Society for Magnetic Resonance in Medicine.)

Background: Alcoholic cardiomyopathy (ACM) can lead to progressive cardiac dysfunction and heart failure, but little is known about biventricular impairment and ventricular interdependence (VI) in ACM patients., Purpose: To use cardiac MRI to investigate biventricular impairment and VI in ACM patients., Study Type: Retrospective., Population: Forty-one male patients with ACM and 45 sex- and age-matched controls., Field Strength/sequence: 3.0 T/balanced steady-state free precession sequence, inversion recovery prepared echo-planar imaging sequence and phase-sensitive inversion recovery sequence., Assessment: Biventricular structure, function, and global strain (encompassing peak strain [PS], peak systolic, and diastolic strain rate), PS of interventricular septal (IVS), microvascular perfusion (including upslope and time to maximum signal intensity [TTM]), late gadolinium enhancement (LGE), and baseline characteristics were compared between the controls and ACM patients., Statistical Tests: Student's t-test, Mann-Whitney U test, Pearson's correlation, and multivariable linear regression models with a stepwise selection procedure. A two-tailed P value <0.05 was deemed as statistically significant., Results: Compared to control subjects, ACM patients showed significantly biventricular adverse remodeling, reduced left ventricle (LV) global upslope and prolonged global TTM, and the presence of LGE. ACM patients were characterized by a significant decline in all global strain within the LV, right ventricle (RV), and IVS compared with the controls. RV global PS was significantly associated with LV global PS and IVS PS in radial, circumferential, and longitudinal directions. Multivariable analyses demonstrated the longitudinal PS of IVS was significantly correlated with RV global radial PS (β = 0.614) and circumferential PS (β = 0.545). Additionally, RV global longitudinal PS (GLPS) was significantly associated with radial PS of IVS (β = -0.631) and LV GLPS (β = 1.096)., Data Conclusion: ACM patients exhibited biventricular adverse structural alterations and impaired systolic and diastolic function. This cohort also showed reduced LV microvascular perfusion, the presence of LGE, and unfavorable VI., Evidence Level: 3 TECHNICAL EFFICACY: Stage 3., (© 2024 International Society for Magnetic Resonance in Medicine.)