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Background: Meniscus injuries often accompany anterior cruciate ligament (ACL) tears. However, little is known about how different surgical approaches to treat concomitant meniscus injuries impact hop performance after ACL reconstruction. Purpose: The purpose of this study was to compare hop test inter-limb symmetry for patients who had undergone ACL reconstruction without an associated meniscal surgery, patients who had undergone ACL reconstruction with a meniscus repair, and patients who had undergone ACL reconstruction with a partial meniscectomy. Study Design: Cross-sectional study Methods: Hop test data collected at the time of return-to-sport testing (average of 6.4 ± 1.4 months after surgery) was extracted from electronic medical records for 192 patients who had undergone ACL reconstruction. Of these patients, 102 had undergone an isolated ACL reconstruction, 60 had undergone an ACL reconstruction along with a meniscus repair, and 30 had undergone an ACL reconstruction along with a partial meniscectomy. Analysis of variance was used to compare limb symmetry indices for the single- and triple-hop tests. These limb symmetry indices reflected the ratio of the hop distance for the involved limb relative to the uninvolved limb, expressed as a percentage. Results: The sample was comprised of 100 males and 92 females. Their average age was 20.6 ± 8.2 years. There were significant differences among the groups for the single-hop test (p = 0.031) and triple-hop test (p = 0.024) limb symmetry indices. For both tests, the patients who had undergone ACL reconstruction with a partial meniscectomy tended to exhibit greater deficits in hop performance for their involved limb (relative to their uninvolved limb), compared to those without a meniscal injury and those who had undergone meniscus repair. Conclusions: The results of this study suggest that patients who undergo ACL reconstruction along with a partial meniscectomy tend to experience less complete and/or delayed recovery of involved-limb hop performance, which could reflect more persistent deficits in lower body power. Level of Evidence: 3 [ABSTRACT FROM AUTHOR]

There has been a recent push to transition procedures previously performed at hospital-based outpatient surgical departments (HOPDs) to ambulatory surgery centers (ASCs). However, limited data regarding differences in early postoperative complications and care utilization (eg, emergency department visits and unplanned admissions) may drive increased overall costs or worse outcomes. The purpose of this study was to examine differences in early 90-day adverse outcomes and postoperative emergency department visits associated with shoulder surgeries excluding arthroplasties that were performed in HOPDs and ASCs in a closed military health care system. We hypothesized that there would be no difference in outcomes between treatment settings. We retrospectively evaluated the records for 1748 elective shoulder surgeries from 2015 to 2020. Patients were considered as 1 of 2 cohorts depending on whether they underwent surgery in an ASC or HOPD setting. We evaluated groups for differences incomplexity, surgical time, and medical risk. Outcome measures were emergency department visits, unplanned hospital admissions, and complications within the first 90 days after surgery. There was no difference in 90-day postoperative emergency department visits between procedures performed at HOPDs (n = 606) and ASCs (n = 1142). There was a slight increase in rate of unplanned hospital admission within 90 days after surgery in the HOPD cohort, most commonly for pain or overnight observation. The surgical time was significantly shorter (105 vs. 119 minutes, P <.01) at the ASC, but there was no difference in case complexity between the cohorts (P =.28). Our results suggest that in appropriate patients, surgery in ASCs can be safely leveraged for its costs savings, efficiency, patient satisfaction, decreases in operative time, and potentially decreased resource utilization both during surgery and in the early postoperative period. [ABSTRACT FROM AUTHOR]

Microbiota composition regulates colitis severity, yet the innate immune mechanisms that control commensal communities and prevent disease remain unclear. We show that the innate immune receptor, Clec12a, impacts colitis severity by regulating microbiota composition. Transplantation of microbiota from a Clec12a−/− animal is sufficient to worsen colitis in wild-type mice. Clec12a−/− mice have expanded Faecalibaculum rodentium , and treatment with F. rodentium similarly exacerbates disease. However, Clec12a−/− animals are resistant to colitis development when rederived into an 11-member community, underscoring the role of specific species. Colitis in Clec12a−/− mice is dependent on monocytes, and cytokine and sequencing analysis in Clec12a−/− macrophages and serum shows enhanced inflammation with a reduction in phagocytic genes. F. rodentium specifically binds to Clec12a, and Clec12a−/−-deficient macrophages are impaired in their ability to phagocytose F. rodentium. Thus, Clec12a contributes to an innate-immune-surveillance mechanism that controls the expansion of potentially harmful commensals while limiting inflammation. [Display omitted] • The innate immune receptor, Clec12a, regulates colitis severity • Clec12a dictates microbiota composition • In the absence of Clec12a, F. rodentium expands • Clec12a binds F. rodentium and regulates colonization via phagocytosis Chiaro and Greenewood et al. demonstrate that the innate immune receptor, Clec12a, impacts colitis severity by regulating intestinal immune responses to the microbiota. Clec12a controls microbiota composition by binding specific microbiota members, leading to phagocytosis. Clec12a-deficient mice show a heightened inflammatory response, exacerbating colitis that can be transferred via microbiota. [ABSTRACT FROM AUTHOR]

The university Virtual Library Space (VLS) is increasingly becoming a strategic source for information access. The digital libraries are opening up avenue to information for the virtual library users whose number is increasing exponentially. This current study assessed the use of VLS at the university library in Nigeria. A descriptive survey design was used with a population of 233 academic librarians at the federal, state and private universities in South-South zone of Nigeria. With a sample size of 213 (91.4 %) of the population who responded to the online questionnaire that were analysed, the findings shows that university libraries are at the threshold of increasing access to digital information with advancement in VLS. The finding showed that most university libraries in Nigeria have developed one form of virtual/digital space such as ILS, ERM, social media sites, library website, web catalog, institutional repository and library Blog. The findings revealed that more than 50 % of the respondents attested that they have used VLS frequently on daily, weekly, monthly and bi-monthly to disseminate digital information such as e-books, e-journals, dataset, lecture notes, students projects, e-thesis and dissertations, inaugural lectures, laboratory results and conference proceedings. The findings further showed that the major challenges facing the use of VLS at the university library were inadequate funding, lack of training, poor technical support, irregular power supply, poor internet connectivity, lower bandwidth and inadequate ICT infrastructure. The study concluded with specific recommendations to enhance the use of VLS at the university library for the benefit of library patrons. [ABSTRACT FROM AUTHOR]

Although previous studies deal with tourism experience, destination image and related outcomes, this study innovates by elaborating on a more comprehensive view of the tourism experience and destination image. Guided by suggestions for more research in the relevant literature, this study examines the correlation between tourism experience, experiential destination image, tourism memory, satisfaction and loyalty and explores domestic and international tourists. The data were collected from tourists visiting the Algarve, Portugal, in 2021. A multi-group analysis determined the main differences between domestic and international tourists. The results show that the tourist experience has five dimensions: active learning, emotional engagement, passive entertainment, immersive escape, and aesthetic appeal. Furthermore, tourism experiences of both domestic and international tourists positively affect the cognitive image of the Algarve. There is a significant difference among domestic and international tourists regarding the impact of tourism memory on tourists' loyalty. Theoretical and managerial implications, limitations, and potential directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Sustained asymptomatic hypertension in ED patients is a powerful predictor of chronic uncontrolled hypertension. In this study, we assess the feasibility of using a storyboard video and communicating real-time cardiovascular imaging results on blood pressure control and primary care engagement. This was a prospective observational exploratory sub-study. Following Institutional Review Board approval (#18-00197), 20 English-speaking adults in an urban emergency department with an initial blood pressure ≥160/100 mm Hg and a second blood pressure ≥140/90 mm Hg were enrolled. Patients watched a 60-second storyboard video about uncontrolled hypertension in the ED setting, featuring racially and ethnically diverse avatars. They then received a real-time bedside echocardiogram. Emergency nurses communicated the echocardiogram results using a standard script and advised follow-up within 2 weeks after discharge. Patient characteristics, blood pressure control, primary care engagement, and acceptability of the intervention were assessed at baseline, 12 weeks, and 24 weeks post-discharge. All 20 enrolled patients (mean age 55, 70% female, and 95% from underrepresented groups [30% Black, 50% Hispanic, and 15% Black and Hispanic]) exhibited subclinical heart disease on echocardiograms. Blood pressure control improved from baseline (systolic 166 mm Hg, diastolic 97 mm Hg) to 24 weeks (systolic 137 mm Hg, diastolic 78 mm Hg). Seventy percent of patients engaged with primary care post-discharge, and the intervention had high acceptability (94.8% approval). The Brief Risk Communication for ED patients with sustained asymptomatic hypertension study demonstrates the feasibility and acceptability of using a brief video and real-time cardiovascular imaging for risk communication in the emergency department. Future research will build on these findings with a larger, more comprehensive study. [ABSTRACT FROM AUTHOR]

In this invited expert review, we focus on evolving lifetime management strategies for adolescents and young adults with congenital aortic valve disease, acknowledging that these patients often require multiple interventions during their lifetime. Our goal is to preserve the native aortic valve when feasible. Leveraging advanced multimodality imaging, a detailed assessment of the aortic valve and root complex can be obtained, and a surgically approach tailored to an individual patient's anatomy and pathology can be used. In turn, aortic valve repair and reconstruction can be offered to a greater number of patients, either as a definitive strategy or as a component of a staged strategy to delay the need for aortic valve replacement until later in life when more options are available. [Display omitted] [ABSTRACT FROM AUTHOR]

Purpose: The aim of this project was to characterize the incidence of men's health disorders, specifically focusing on the incidence of erectile dysfunction (ED) and testosterone deficiency (TD) in a large, nationwide study of testicular cancer (TC) survivors treated in a centralized health care system. Materials and Methods: We conducted a retrospective cohort study of US veterans diagnosed with TC from 1990 to 2021. These veterans were compared with an age-matched and race-matched control group of US veterans without a diagnosis of TC. ED and TD were defined by the presence of diagnosis codes or at least a 6-month prescription for medications treating these conditions or both. Time was measured from the date of TC diagnosis (for patients with TC and matched TC patient date for the corresponding noncancer controls). Impact of chemotherapy among TC survivors on ED and TD was evaluated using multivariable Cox regression models. Results: The cohort included 1754 patients with TC compared with 7117 noncancer controls, with a mean age at diagnosis of 42 years. Patients with TC were significantly more likely than controls to experience ED (hazard ratio, 2.97; 95% CI, 2.68-3.28; P <.001) and TD (hazard ratio, 6.71; 95% CI, 5.78-7.81; P <.001). However, within the TC group, there was no significant difference in the incidence of ED and TD when stratified by receipt of chemotherapy (P =.9 and P =.066, respectively). Conclusions: Men's health disorders arise commonly in the lives of TC survivors. It is important for treating physicians to identify these and conduct sexual health assessments as part of survivorship care. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Although the rate of Alzheimer's disease (AD) in African‐ancestry (AA) Americans is higher than that of persons from European‐ancestry (EA) populations, AA participants have been underrepresented in AD neuropathological studies. Method: Utilizing the AD Research Centers (ADRC) infrastructure, we obtained AA donor pre‐frontal cortex (PFC) tissue from brain repositories of 12 ADRC and generated bulk RNA sequencing (RNA‐seq) data for 179 samples that met QC and inclusion criteria. Previously generated PFC RNAseq data were obtained for 28 additional AA donors from the Columbia University ADRC. Differential gene expression was evaluated among 125 donors with a neuropathological diagnosis of AD (NIA‐Reagan intermediate or high likelihood) and 82 neuropathologically confirmed controls using regression models including covariates for age at death, sex, cell‐type frequencies, and RNA integrity number (RIN) calculated with Limma. FDR‐corrected p‐values (padj) were calculated to control for the 33,611 genes examined. Result: A total of 482 genes surpassed the multiple‐testing threshold. The most significant, ADAMTS2 (p = 2.96 × 10‐8, padj = 0.001), showed increased expression in AD cases (see Table/Figure). We note that ADAMTS2 was differentially expressed in a prior EA study of neuropathologically confirmed AD cases and controls (Panitch et al. Molecular Psychiatry 2021). Additionally, a recent analysis of cognitive resilience in EA neuropathological AD cases identified a strong association with ADAMTS2 (See Li et al. AAIC2024 abstract). Of the differentially expressed genes observed in the Panitch et al. EA study, 385 (35%) were nominally significant,65 (5.8%) were corrected significant, and most (89%) of these genes had the same effect direction in the AA cohort. Some of the observed associations appear to be AA specific (e.g., EFR3B, IRS4, and CA12; see Table). Additionally, we found nominally significant (p<0.05) associations with expression of APOE (Log2 fold change [L2FC = ‐0.20, p = 0.012) and several other established AD genes including SORL1 (L2FC = ‐0.10, p = 0.014) and IGF1R(L2FC = 0.11, p = 0.0013). Conclusion: This largest‐ever (to our knowledge) gene expression study of AD in postmortem brain tissue from AA donors implicates many more genes as having a role in AD in this population than previously identified in genome‐wide association studies and provides insight into trans‐ancestry differences risk for AD. [ABSTRACT FROM AUTHOR]

Background: Limbic‐predominant age‐related TDP‐43 encephalopathy neuropathologic change (LATE‐NC) is a common cause of dementia in older age. LATE‐NC was first coined in 2019 with proposed staging criteria of TDP‐43 progressing from amygdala (stage 1), to hippocampus (stage 2), to middle frontal gyrus (stage 3). Criteria were updated in 2023 to further categorize stage 1 to either TDP‐43 inclusions in amygdala alone (stage 1a) or hippocampus alone (stage 1b). We applied this updated LATE‐NC staging criteria to data from participants in the National Alzheimer's Coordinating Center (NACC) and examined associations with clinical diagnosis and other neuropathologic changes (NCs). Method: We selected participants in NACC with regional TDP‐43 assessments, excluding those with frontotemporal dementia‐related and rare NCs, or with a non‐Alzheimer's disease (AD) etiologic clinical diagnosis. LATE‐NC stages were assigned according to updated criteria. We performed logistic regressions with LATE‐NC stages as predictors and clinical diagnosis (dementia, cognitive impairment, memory impairment), other neuropathologic changes (ADNC, Lewy bodies, hippocampal sclerosis of aging (HS‐A), and vascular NCs), or gross atrophy at autopsy (cortical, hippocampal, frontal/temporal lobar) as outcomes. We also examined the association of LATE‐NC stages with dementia and memory impairment while accounting for other NCs. Result: Of N = 1365 participants, LATE‐NC was present in 519 (37%): 31% stage 1 (78% 1a, 22% 1b), 56% stage 2, 13% stage 3 (Table‐1). Participants with stage 1a were younger at death compared to higher stages. Stage 1a and 1b had similar associations with cognitive problems (Figure‐1). However, while other stages were associated with ADNC and Lewy bodies, stage 1b was not. Meanwhile stage 1b was associated with HS‐A more strongly than stage 1a and to a similar degree as stage 2. We observed expected associations of higher LATE‐NC stages with dementia and other NCs (Figure‐1). Lastly, LATE‐NC stage 1b was significant (and stage 1a trended) for associations with dementia and memory impairment, while higher LATE‐NC stages had associations eclipsed in strength only by highest level ADNC (Figure‐2). Conclusion: These findings highlight the utility of the updated LATE‐NC staging criteria in general, and stage 1 subtypes in particular, in capturing broad associations with cognitive impairment and specific associations with other neuropathologic changes. [ABSTRACT FROM AUTHOR]

Background: Propofol is commonly used for pediatric MRIs to minimize patient movement. At our institution, intensivists typically administer a prophylactic 20 ml/kg saline bolus to maintain blood pressure (BP) during propofol sedation. This quality improvement project assessed whether a 10 ml/kg and a completely eliminated saline bolus are as effective as the standard 20 ml/kg bolus in completing pediatric propofol sedation and maintaining Mean Arterial Pressure (MAP). Methods: We reviewed pediatric propofol sedations over an 18 month period in which pediatric intensivists administered the standard 20 ml/kg saline bolus, a reduced 10 ml/kg bolus, and no saline bolus. Successful sedation meant completing the MRI without complications. Results: 172 patients aged 19 months to 16 years were assessed. The percentage of successful sedations with a 20 ml/kg bolus, 10 ml/kg bolus, and no saline bolus was 92%, 100%, and 91%, respectively. There was a statistically significant higher average MAP in the 0 ml/kg group than in the 10 and 20 ml/kg cohorts (p = 0.002). No patients required an additional bolus to maintain blood pressure. Conclusions: The preservation of hemodynamic stability without a saline bolus supports the literature that the saline bolus can be safely reduced during pediatric propofol sedation for MRI. [ABSTRACT FROM AUTHOR]

Background: The risk of spinal epidural hematoma (SEH) has been described in the literature but the impact in various patient populations has not been assessed in the same study. We identified the risk factors for SEH and calculated the OR for recovery in the pediatric, adult and obstetric (OB) patients based on the degree of neurological deficit before surgery. Methods: Adult non-OB cases were categorized whether they were on anticoagulants or not; SEH was related to neuraxial or pain procedure; or whether there was adherence to the American Society of Regional Anesthesia (ASRA) guidelines. Eligible cases were identified through PubMed and Embase searches in the English literature from 1954 to July 2022. Results: A total of 940 cases were evaluated. In the pediatric cases, SEH was typically spontaneous, related to coagulopathy or athletic trauma. OB cases were spontaneous or related to neuraxial injections. Among adults on anticoagulant(s), SEH was mostly spontaneous with no related etiology or related to neuraxial procedure. SEH occurred despite adherence to the ASRA guidelines. Among non-OB adults not on anticoagulants, SEH was due to trauma, neuraxial injections, surgery or other causes. Neurological recovery was related to the degree of neurological deficit before surgery. Conclusions: Our data show a preponderance of spontaneous SEH in all patient populations. SEH developed even though the ASRA guidelines were followed, especially in patients on multiple anticoagulants. Patients with less impairment prior to surgery had a higher likelihood of complete recovery, regardless of the interval between surgery and onset of symptoms. [ABSTRACT FROM AUTHOR]

Copyright of Ius et Praxis (07172877) is the property of Universidad de Talca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Development Studies is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: High mammographic density is one of the strongest breast cancer risk factors; however, determinants of high mammographic density are understudied in Black women. We assessed growth and development factors across the lifecourse in relation to mammographic density. Methods: Within the Black Women's Health Study, we used Cumulus software to assess percent mammographic density from digital screening mammograms for 5,905 women ages 40 to 74 years. We fit linear regression models to quantify the association of lifecourse characteristics including birthweight, childhood somatotype, age at menarche, body mass index (BMI) at age 18 years, height, BMI at mammography, and adulthood waist-to-hip ratio with density overall and by age. We also performed a path analysis to assess the total and mediating effects of the growth and development factors on density. Results: BMI at age 18 years, height, BMI at mammography, and waist-to-hip ratio were significantly and inversely associated with density. On path analysis, total effects of childhood somatotype (standardized ß = -0.05, P < 0.001), BMI at age 18 years (standardized ß = -0.13, P < 0.001), BMI at mammography (standardized ß = -0.22, P < 0.001), and waist-to-hip ratio (standardized ß = -0.04, P < 0.001) were associated with density. Conclusions: Several factors across the lifecourse--greater childhood somatotype, BMI at age 18 years, height, BMI at mammography, and waist-to-hip ratio--were associated with lower mammographic density in this cohort of Black women. [ABSTRACT FROM AUTHOR]

Serial health assessment of a managed population of American horseshoe crabs (HSC; Limulus polyphemus) was performed. Twenty HSC were examined once a month for 7 mon; this included a physical exam with a standardized scoring sheet, HR, morphometrics, and hemolymph evaluation with hemocyte count, copper concentration, and biochemistry panel. The HSC in this population had varying levels of external lesions at enrollment. All HSC were clinically and behaviorally stable over the study period, with no apparent differences in evaluated parameters in relation to degree of external lesions. Although the standardized scoring sheet was found to be helpful to complete the evaluation, the qualitative criteria potentially masks clinically important gradations in some parameters. HR ranged from 4 to 60 bpm, with high intra- and interindividual variability. Increased prosomal widths (PW) were found to be correlated with lower HR. Plots of weight (W) in grams divided by PW in centimeters are roughly linear, and W:PW shows promise as a method of body condition evaluation in a hard-shelled animal. Serial collection of ∼2 ml of hemolymph led to no appreciable clinical decline in any animal. Total protein levels were stable and higher than previously reported for HSC in managed care. Glucose values were stable throughout the study period, which is interpreted as reflecting adequate nutritional intake in the study animals. Further studies are needed to determine the clinical utility of standardized vertebrate biochemistry panels in invertebrate species. [ABSTRACT FROM AUTHOR]

We investigated the feasibility of estimating high-frequency empirical Green's tensor spatial derivatives (EGTDs) using aftershocks of the 2016 Kumamoto earthquake, Japan. Before the EGTD estimation, we accurately determined two source parameters (seismic moment and duration of the source time function [STF]) and three fault parameters (strike, dip angle, and rake angle), which are necessary for the EGTD estimation. Further, we investigated the extent to which high-frequency EGTDs can be estimated using five groups consisting of aftershocks in the Japan Meteorological Agency magnitude scale range over 1.5 < Mj < 3.5, within zones of 1 and 2 km diameter. We found that high-frequency EGTDs with cutoff frequencies between 8 and 16 Hz could be estimated from the aftershocks within the zone of 1 km diameter using optimum values of the source and fault parameters. In contrast, it is difficult to stably estimate the high-frequency EGTDs from the aftershocks within the zone of 2 km diameter, even for the cutoff frequency of 4 Hz. Furthermore, we found that the accuracy of the EGTDs is evaluated by the reproducibility of earthquake motion records as well as the STF. We examined whether there is a difference in the reproducibility of recorded earthquake motions by earthquake motions synthesized using EGTDs with two different STFs. The two types of EGTDs, which were estimated by adopting the two STFs, reproduced the earthquake motion records with equal accuracy but were quite different in waveform and amplitude from each other, indicating that we should adopt the STF that is based on or consistent with the physics of fault fracture when estimating the high-frequency EGTDs. Thus, it is certainly feasible to estimate the high-frequency EGTDs from earthquake motion records radiated from a 1 km diameter zone using an appropriate STF. [ABSTRACT FROM AUTHOR]

Obesity has been correlated with heightened risk of complications after orthopedic surgeries. Bariatric surgery (BS) is an effective tool commonly utilized for the reduction of body mass index. However, the impact of BS on complications in total shoulder arthroplasty (TSA) remains inadequately investigated. This study examines the 5-year risk of revision following TSA in patients with a history of BS compared to matched cohorts without history of BS. Utilizing the PearlDiver Mariner database, a retrospective cohort analysis was conducted on over 157 million U.S. patients from January 2010 to October 2021. Inclusion criteria identified patients undergoing primary TSA with a minimum 2-year follow-up. Propensity-score matching was employed to control for covariates, comparing BS patients with a matched control and a matched class III obesity control without history of BS. Demographics, comorbidities, and outcomes, including 5-year cumulative incidence of revision were analyzed. The 5-year cumulative incidence of all-cause revision within the BS group was found to be 4.6%. While this represented a higher risk than that of the general population (hazard ratio 1.70; 95% confidence interval 1.21-2.39), there was no significant difference when compared to controls with class III obesity. The BS cohort had higher risk of revision secondary to dislocation/subluxation and rotator cuff tear than in the general population. When compared to the class III obesity cohort, only the risk of revision due to rotator cuff tear was found to be higher. Individuals with a history of BS showed a higher risk of revision than a cohort without history of BS and an equivalent risk of revision compared to a cohort of class III obesity controls after undergoing TSA. Though obesity is an important risk factor for complications after TSA, BS might not be an effective tool for preoperative risk optimization. [ABSTRACT FROM AUTHOR]

There are sex differences in left ventricular ejection fraction (LVEF) relevant to prognosis where women experience greater mortality at relatively higher LVEF compared to men, yet mechanistic understanding of this adverse prognosis is limited. Women with suspected ischemia with no obstructive coronary disease (INOCA) develop heart failure with preserved ejection fraction (HFpEF), yet contributors to LVEF remain largely unknown. In 370 women with suspected ischemia with no obstructive coronary disease (INOCA) who prospectively underwent cardiac magnetic resonance imaging (CMRI), we investigated the contributions of LV morphology, function, and myocardial perfusion reserve on LVEF using univariate and multiple linear regression. A majority 71% of participants had high LVEF (>65%), followed by 24% having normal LVEF (55%-65%), and only 5% having low EF (<55%). Baseline characteristics were comparable among the 3 groups, with the exception of age which was 6 years higher in the high LVEF group (P <.01). Women in the high LVEF group also had the lowest LV cavity volume, greatest LV mass-volume ratio, and highest LV end-systolic elastance (all P <.05, adjusted for age, BMI, diabetes, and blood pressure). Myocardial perfusion reserve index was low in all groups (mean MPRI < 2.1) but was not significantly different across the spectrum of LVEF (P =.458). Taken together, these data demonstrate that the majority of women with suspected INOCA have elevated LVEF related to smaller, thicker ventricles with greater contractility. Future work is needed to better understand the specific mechanisms driving morphologic and functional changes in women with INOCA, and relations to longer-term HFpEF and mortality. NCT02582021. [ABSTRACT FROM AUTHOR]