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Background: First‐pass perfusion cardiac MR imaging could reflect pulmonary hemodynamics. However, the clinical value of pulmonary transit time (PTT) derived from first‐pass perfusion MRI in light‐chain (AL) amyloidosis requires further evaluation. Purpose: To assess the clinical and prognostic value of PTT in patients with AL amyloidosis. Study Type: Prospective observational study. Population: 226 biopsy‐proven systemic AL amyloidosis patients (age 58.62 ± 10.10 years, 135 males) and 43 healthy controls (age 42 ± 16.2 years, 20 males). Field Strength/Sequence: SSFP cine and phase sensitive inversion recovery late gadolinium enhancement (LGE) sequences, and multislice first‐pass myocardial perfusion imaging with a saturation recovery turbo fast low‐angle shot (SR‐TurboFLASH) pulse sequence at 3.0T. Assessment: PTT was measured as the time interval between the peaks of right and left ventricular cavity arterial input function curves on first‐pass perfusion MR images. Statistical Tests: Independent‐sample t test, Mann–Whitney U test, Chi‐square test, Fisher's exact test, analysis of variance, or Kruskal–Wallis test, as appropriate; univariable and multivariable Cox proportional hazards models and Kaplan–Meier curves, area under receiver operating characteristic curve were used to determine statistical significance. Results: PTT could differentiate AL amyloidosis patients with (N = 188) and without (N = 38) cardiac involvement (area under the curve [AUC] = 0.839). During a median follow‐up of 35 months, 160 patients (70.8%) demonstrated all‐cause mortality. After adjustments for clinical (Hazard ratio [HR] 1.061, confidence interval [CI]: 1.021–1.102), biochemical (HR 1.055, CI: 1.014–1.097), cardiac MRI‐derived (HR 1.077, CI: 1.034–1.123), and therapeutic (HR 1.063, CI: 1.024–1.103) factors, PTT predicted mortality independently in patients with AL amyloidosis. Finally, PTT could identify worse outcomes in patients demonstrating New York Heart Association class III, Mayo 2004 stage III, and transmural LGE pattern. Data Conclusion: PTT may serve as a new imaging predictor of cardiac involvement and prognosis in AL amyloidosis. Level of Evidence: 2 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Background: Hepatic alterations are common aftereffects of heart failure (HF) and ventricular dysfunction. The prognostic value of liver injury markers derived from cardiac MRI studies in nonischemic dilated cardiomyopathy (DCM) patients is unclear. Purpose: Evaluate the prognostic performance of liver injury markers derived from cardiac MRI studies in DCM patients. Study Type: Prospective. Population: Three hundred fifty‐six consecutive DCM patients diagnosed according to ESC guidelines (age 48.7 ± 14.2 years, males 72.6%). Field Strength/Sequence: Steady‐state free precession, modified Look‐Locker inversion recovery T1 mapping and phase sensitive inversion recovery late gadolinium enhancement (LGE) sequences at 3 T. Assessment: Clinical characteristics, conventional MRI parameters (ventricular volumes, function, mass), native myocardial and liver T1, liver extracellular volume (ECV), and myocardial LGE presence were assessed. Patients were followed up for a median duration of 48.3 months (interquartile range 42.0–69.9 months). Primary endpoints included HF death, sudden cardiac death, heart transplantation, and HF readmission; secondary endpoints included HF death, sudden cardiac death, and heart transplantation. Models were developed to predict endpoints and the incremental value of including liver parameters assessed. Statistical Tests: Optimal cut‐off value was determined using receiver operating characteristic curve and Youden method. Survival analysis was performed using Kaplan–Meier and Cox proportional hazard. Discriminative power of models was compared using net reclassification improvement and integrated discriminatory index. P value <0.05 was considered statistically significant. Results: 47.2% patients reached primary endpoints; 25.8% patients reached secondary endpoints. Patients with elevated liver ECV (cut‐off 34.4%) had significantly higher risk reaching primary and secondary endpoints. Cox regression showed liver ECV was an independent prognostic predictor, and showed independent prognostic value for primary endpoints and long‐term HF readmission compared to conventional clinical and cardiac MRI parameters. Data Conclusions: Liver ECV is an independent prognostic predictor and may serve as an innovative approach for risk stratification for DCM. Evidence Level: 1 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Objective: Closure surgery of patent foramen ovale (PFO) has been found to effectively control cryptogenic stroke and migraine, but it is uncertain whether PFO closure could also alleviate epileptic seizures. This study aims to observe the therapeutic effect of PFO closure on epileptic seizures. Methods: Since July 11th, 2017, in the neurology department of West China Hospital, Sichuan University, Chengdu, we have been regularly monitoring patients with epilepsy who have undergone PFO closure. The patient's clinical information, such as frequency, duration, and severity of seizures, before and after surgery was recorded in detail as well as postoperative safety events. Results: Of the 31 epilepsy patients who confirmed PFO observed (27 cases were drug‐resistant epilepsy, 87.10%), average age of surgery was 23.74 years, and 12 cases were female (38.71%). After one‐year follow‐up, 26 patients (83.87%) achieved remission of seizure frequency, and 22 of whom (70.97%) experienced a remission of more than 50%. Additionally, compared to before surgery, 22 cases (70.97%) reported a decrease in the average seizure duration, and 20 cases (64.52%) reported a reduction in seizure severity. In the seizure indicators of frequency, average duration and severity, significant differences were identified between preoperative and postoperative comparisons with all test p values were <0.05. Furthermore, no serious safety events were reported except for one patient who briefly reported chest pain, and all patients expressed effective PFO closure. Significance: The PFO closure has been shown for the first time to result in a significant reduction in the frequency, duration, and severity of seizures. Patients with drug‐resistant epilepsy and PFO with a large shunt are ideal candidates for undergoing PFO closure. Plain Language Summary: Since PFO closure was found to have a good therapeutic effect on cryptogenic stroke and migraine, it has become a credible complementary therapy for the treatment of neurological diseases, and drug‐resistant epilepsy with PFO is expected to become the next target disease that PFO closure could significantly improve. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI) reference ranges for ventricular morphology and function in the Chinese population are lacking. Purpose: To establish the MRI reference ranges of left and right ventricular (LV and RV) morphology and function based on a large multicenter cohort. Study Type: Prospective. Population: One thousand and twelve healthy Chinese Han adults. Field Strength/Sequence: Balanced steady‐state free procession cine sequence at 3.0 T. Assessment: Biventricular end‐diastolic, end‐systolic, stroke volume, and ejection fraction (EDV, ESV, SV, and EF), LV mass (LVM), end‐diastolic and end‐systolic dimension (LVEDD and LVESD), anteroseptal wall thickness (AS), and posterolateral wall thickness (PL) were measured. Body surface area (BSA) and height were used to index biventricular parameters. Parameters were compared between age groups and sex. Statistical Tests: Independent‐samples t‐tests or Mann–Whitney U test to compare mean values between sexes; ANOVA or Kruskal–Wallis test to compare mean values among age groups; linear regression to assess the relationships between cardiac parameters and age (correlation coefficient, r). A P value <0.05 was considered statistically significant. Results: The biventricular volumes, LVM, LVEDD, RVEDV/LVEDV ratio, LVESD, AS, and PL were significantly greater in males than in females, even after indexing to BSA or height, while LVEF and RVEF were significantly lower in males than in females. For both sexes, age was significantly negatively correlated with biventricular volumes (male and female: LVEDV [r = −0.491; r = −0.373], LVESV [r = −0.194; r = −0.184], RVEDV [r = −0.639; r = −0.506], RVESV [r = −0.270; r = −0.223]), with similar correlations after BSA normalization. LVEF (r = 0.043) and RVEF (r = 0.033) showed a significant correlation with age in females, but not in males (P = 0.889; P = 0.282). Data Conclusion: MRI reference ranges for biventricular morphology and function in Chinese adults are presented and show significant associations with age and sex. Level of Evidence: 2 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Summary: This paper focuses on the remote estimation problem for cyber‐physical systems under the round‐Robin protocol. A round‐Robin protocol‐based Kalman filter is deployed to estimate the real system states on the remote side. When sensor measurements are transmitted by communication networks, the round‐Robin protocol with the zero‐input‐holder strategy is adopted to determine which sensor measurements are transmitted, reducing the communication burden and risk of being attacked. Both the protocol‐based open‐loop and closed‐loop estimation scenarios are considered. The delay resulting from adopting the protocol with the zero‐input‐holder strategy is handled effectively. Corresponding filtering algorithms are proposed, and the estimation error covariance is proved to be converged. Finally, in addition to the effectiveness of the proposed round‐Robin protocol‐based filtering algorithms, simulation results are given to demonstrate that the performance of the proposed filtering algorithms can match that of the classical Kalman filter. [ABSTRACT FROM AUTHOR]

In the production of doxofylline, the common occurrence of toxic p‐toluene sulfonate generation prompted the development and validation of a method using HPLC with ultraviolet detection (HPLC‐UV). This method is designed for detecting four potential genotoxic impurities (PGIs) present in both doxofylline drug substance and tablets, with a focus on the UV‐absorbing group p‐toluene sulfonate. The four impurities were methyl 4‐methylbenzenesulfonate (PGI‐1), ethyl 4‐methylbenzenesulfonate (PGI‐2), 2‐hydroxyethyl 4‐methylbenzenesulfonate (PGI‐3), and 2‐(4‐methylphenyl)sulfonyloxyethyl 4‐methylbenzenesulfonate (PGI‐4). In this method, chromatographic separation was achieved using a Waters Symmetry C18 column (250 mm × 4.6 mm, 5 μm). The mobile phases consisted of 20% acetonitrile as mobile phase A and pure acetonitrile as mobile phase B, operating in gradient elution mode at a flow rate of 1.0 mL/min. According to the guidelines of the International Conference on Harmonization, it was determined that this method could quantify four PGIs at 0.0225 μg/mL in samples containing 60 mg/mL. The validated approach demonstrated excellent linearity (R2 > 0.999) across the concentration range of 30%–200% (relative to 0.075 μg/mL doxofylline) for the four PGIs. The accuracy of this method for the four PGIs ranged from 94.8% to 100.4%. The reverse‐phase‐HPLC‐UV analytical method developed in this study is characterized by its speed and precision, making it suitable for the sensitive analysis of benzene sulfonate PGIs in doxofylline drug substances and tablets. [ABSTRACT FROM AUTHOR]

Background: The clinical application of coronary MR angiography (MRA) remains limited due to its long acquisition time and often unsatisfactory image quality. A compressed sensing artificial intelligence (CSAI) framework was recently introduced to overcome these limitations, but its feasibility in coronary MRA is unknown. Purpose: To evaluate the diagnostic performance of noncontrast‐enhanced coronary MRA with CSAI in patients with suspected coronary artery disease (CAD). Study Type: Prospective observational study. Population: A total of 64 consecutive patients (mean age ± standard deviation [SD]: 59 ± 10 years, 48.4% females) with suspected CAD. Field Strength/Sequence: A 3.0‐T, balanced steady‐state free precession sequence. Assessment: Three observers evaluated the image quality for 15 coronary segments of the right and left coronary arteries using a 5‐point scoring system (1 = not visible; 5 = excellent). Image scores ≥3 were considered diagnostic. Furthermore, the detection of CAD with ≥50% stenosis was evaluated in comparison to reference standard coronary computed tomography angiography (CTA). Mean acquisition times for CSAI‐based coronary MRA were measured. Statistical Tests: For each patient, vessel and segment, sensitivity, specificity, and diagnostic accuracy of CSAI‐based coronary MRA for detecting CAD with ≥50% stenosis according to coronary CTA were calculated. Intraclass correlation coefficients (ICCs) were used to assess the interobserver agreement. Results: The mean MR acquisition time ± SD was 8.1 ± 2.4 minutes. Twenty‐five (39.1%) patients had CAD with ≥50% stenosis on coronary CTA and 29 (45.3%) patients on MRA. A total of 885 segments on the CTA images and 818/885 (92.4%) coronary MRA segments were diagnostic (image score ≥3). The sensitivity, specificity, and diagnostic accuracy were as follows: per patient (92.0%, 84.6%, and 87.5%), per vessel (82.9%, 93.4%, and 91.1%), and per segment (77.6%, 98.2%, and 96.6%), respectively. The ICCs for image quality and stenosis assessment were 0.76–0.99 and 0.66–1.00, respectively. Data Conclusion: The image quality and diagnostic performance of coronary MRA with CSAI may show good results in comparison to coronary CTA in patients with suspected CAD. Evidence Level: 1. Technical Efficacy: 2. [ABSTRACT FROM AUTHOR]

Pulmonary arterial hypertension (PAH) still remains a life‐threatening disorder with poor prognosis. The right ventricle (RV) adapts to the increased afterload by a series of prognostically significant morphological and functional changes, the adaptive nature should also be understood in the context of ventricular interdependence. We hypothesized that left ventricle (LV) underfilling could serve as an important imaging marker for identifying maladaptive changes and predicting clinical outcomes in PAH patients. We prospectively enrolled patients with PAH who underwent both cardiac magnetic resonance and right heart catheterization between October 2013 and December 2020. Patients were categorized into four groups based on their LV and RV mass/volume ratio (M/V). LV M/V was stratified using the normal value (0.7 g/mL for males and 0.6 g/mL for females) to identify patients with LV underfilling (M/V ≥ normal value), while RV M/V was stratified based on the median value. The primary endpoint was all‐cause mortality, and the composite endpoints included all‐cause mortality and heart failure‐related readmissions. A total of 190 PAH patients (53 male, mean age 37 years) were included in this study. Patients with LV underfilling exhibited higher NT‐proBNP levels, increased RV mass, larger RV but smaller LV, lower right ventricular ejection fraction, and shorter 6‐min walking distance. Patients with LV underfilling had a 2.7‐fold higher risk of mortality than those without and LV M/V (hazard ratio [per 0.1 g/mL increase]: 1.271, 95% confidence interval: 1.082–1.494, p = 0.004) was also independent predictors of all‐cause mortality. Moreover, patients with low LV M/V had a better prognosis regardless of the level of RV M/V. Thus, LV underfilling is an independent predictor of adverse clinical outcomes in patients with PAH, and it could be an important imaging marker for identifying maladaptive changes in these patients. [ABSTRACT FROM AUTHOR]

Background: Investigation of the factors influencing dilated cardiomyopathy (DCM) prognosis is important as it could facilitate risk stratification and guide clinical decision‐making. Purpose: To assess the prognostic value of magnetic resonance imaging (MRI) radiomics analysis of native T1 mapping in DCM. Study Type: Prospective. Subjects: Three hundred and thirty consecutive patients with non‐ischemic DCM (mean age 48.42 ± 14.20 years, 247 males). Field Strength/Sequence: Balanced steady‐state free precession and modified Look‐Locker inversion recovery T1 mapping sequences at 3 T. Assessment: Clinical characteristics, conventional MRI parameters (ventricular volumes, function, and mass), native myocardial T1, and radiomics features extracted from native T1 mapping were obtained. The study endpoint was defined as all‐cause mortality or heart transplantation. Models were developed based on 1) clinical data; 2) radiomics data based on T1 mapping; 3) clinical and conventional MRI data; 4) clinical, conventional MRI, and native T1 data; and 5) clinical, conventional MRI, and radiomics T1 mapping data. Each prediction model was trained according to follow‐up results with AdaBoost, random forest, and logistic regression classifiers. Statistical Tests: The predictive performance was evaluated using the area under the receiver operating characteristic curve (AUC) and F1 score by 5‐fold cross‐validation. Results: During a median follow‐up of 53.5 months (interquartile range, 41.6–69.5 months), 77 patients with DCM experienced all‐cause mortality or heart transplantation. The random forest model based on radiomics combined with clinical and conventional MRI parameters achieved the best performance, with AUC and F1 score of 0.95 and 0.89, respectively. Data Conclusion: A machine‐learning framework based on radiomics analysis of T1 mapping prognosis prediction in DCM. Level of Evidence: 1 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Patent foramen ovale (PFO) is a congenital defect in the partition between two atria, which may cause right‐to‐left shunt (RLS), leading to neurological chronic diseases with episodic manifestations (NCDEMs), such as migraine and epilepsy. However, whether PFO closure was effective in improving NCDEMs and the mechanism were unclear. Twenty‐eight patients with migraine or epilepsy who underwent PFO closure were recruited. Notably, approximately half of patients received 50% or more reduction in seizure or headache attacks. Meanwhile, the postoperative blood oxygen partial pressure and oxygen saturation were elevated after PFO closure. Multisite (peripheral, right, and left atrial) and multitimepoint (before and after surgery) plasma proteomics from patients showed that the levels of free hemoglobin and cell adhesion molecules (CAMs) were significantly increased after PFO closure, which may be related to the relief of the hypoxic state. Furtherly, the omics data from multiple brain regions of mice revealed that a large number of proteins were differentially expressed in the occipital region in response to PFO, including redox molecules and CAMs, suggesting PFO‐caused hypoxia may have great impacts on occipital region. Collectively, PFO may cause NCDEMs due to RLS‐induced hypoxia, and PFO closure could prevent RLS to improve migraine and epilepsy. [ABSTRACT FROM AUTHOR]

Fire and explosion accidents and reduced energy utilization due to poor cycling stability of lithium‐ion batteries (LIBs) caused by inevitable internal temperature rise during high‐rate operations have become a growing concern. Herein, a dual‐functional carbon nanotube/hygroscopic salt (DFCNT/HS) film with effective passive cooling performance and fire insulation for the safe usage of practical LIBs under extremely fast discharging conditions is reported. The DFCNT/HS film based on the cooling mechanism of self‐adaptive moisture absorption/desorption delivers a high cooling power of 32.9 W m−2 K−1, which can reduce the maximum temperature of a 18650–3.6 V/2.0 Ah LIB by 11.2 and 17.4 °C at discharging rates of 10 and 15 C, respectively. Covering the cooling film, the battery discharges 23.6 Ah more total capacity at 10 within 500 cycles. What is challenging, almost three‐fold extended lifetime of 425 cycles is achieved at 15 C with an extra total capacity of 467.2 Ah. Meanwhile, the developed film also shows an excellent high‐temperature resistance up to 540 °C, which can alleviate the devastating fire propagation. The fast heat dissipation and excellent fire insulation as well as the mechanical flexibility and manufacturing scalability make this new material promising for safe usage of high‐rate LIBs with zero energy consumption. [ABSTRACT FROM AUTHOR]

Background: The identification of combined precapillary and postcapillary pulmonary hypertension (CpcPH) in patients with pulmonary hypertension (PH) due to left heart disease (LHD) can influence therapy and outcome and is currently based on invasively determined hemodynamic parameters. Purpose: To investigate the diagnostic value of MRI‐derived corrected pulmonary transit time (PTTc) in PH‐LHD sub‐grouped according to hemodynamic phenotypes. Study Type: Prospective observational study. Population: A total of 60 patients with PH‐LHD (18 with isolated postcapillary PH [IpcPH] and 42 with CpcPH), and 33 healthy subjects. Field Strength/Sequence: A 3.0 T/balanced steady‐state free precession cine and gradient echo‐train echo planar pulse first‐pass perfusion. Assessment: In patients, right heart catheterization (RHC) and MRI were performed within 30 days. Pulmonary vascular resistance (PVR) was used as the diagnostic "reference standard." The PTTc was calculated as the time interval between the peaks of the biventricular signal‐intensity/time curve and corrected for heart rate. PTTc was compared between patient groups and healthy subjects and its relationship to PVR assessed. The diagnostic accuracy of PTTc for distinguishing IpcPH and CpcPH was determined. Statistical Tests: Student's t‐test, Mann–Whitney U‐test, linear and logistic regression analysis, and receiver‐operating characteristic curves. Significance level: P < 0.05. Results: PTTc was significantly prolonged in CpcPH compared with IpcPH and normal controls (17.28 ± 7.67 vs. 8.82 ± 2.55 vs. 6.86 ± 2.11 seconds), and in IpcPH compared with normal controls (8.82 ± 2.55 vs. 6.86 ± 2.11 seconds). Prolonged PTTc was significantly associated with increased PVR. Furthermore, PTTc was a significantly independent predictor of CpcPH (odds ratio: 1.395, 95% confidence interval: 1.071–1.816). The area under curve was 0.852 at a cut‐off value of 11.61 seconds for PTTc to distinguish between CpcPH and IpcPH (sensitivity 71.43% and specificity 94.12%). Data Conclusion: PTTc may be used to identify CpcPH. Our findings have potential to improve selection for invasive RHC for PH‐LHD patients. Evidence Level: 3 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Background and objective: Nationally representative reports on the characteristics and long‐term survival of pulmonary arterial hypertension (PAH) from developing countries are scarce. The applicability of the current main risk stratifications and the longitudinal changes in goal‐oriented treatments have yet to be elucidated in real‐world settings. Therefore, we aimed to provide insights into the characteristics, goal‐oriented treatments and survival of PAH in China and to explore the applicability of the main risk stratifications in our independent cohort. Methods: PAH patients were consecutively enrolled from a national prospective multicentre registry. Data on baseline, follow‐up re‐evaluation and therapeutic changes were collected. Results: A total of 2031 patients were enrolled, with congenital heart disease (CHD)‐PAH (45.2%) being the most common aetiology. The mean age was 35 ± 12 years, and 76.2% were females. At baseline, approximately 20% of the patients with intermediate or high risk received combination treatment. At follow‐up, approximately half of the re‐evaluated patients did not achieve low‐risk profiles, and even among patients who received combination therapy at baseline, 4% of them still worsened. The rate of combination therapy increased significantly from 6.7% before 2015 to 35.5% thereafter. The main risk assessment tools demonstrated good performance for predicting survival both at baseline and at follow‐up. Conclusion: Chinese PAH patients show both similar and distinct features compared to other countries. Current main risk stratifications can significantly discriminate patients at different risk levels. There were still many patients not achieving low‐risk profiles at follow‐up, indicating more aggressive treatment should be implemented to optimize the goal‐oriented treatment strategy. This Chinese registry study revealed that Chinese patients with pulmonary arterial hypertension showed both similar and distinct features compared to other countries. Many patients did not achieve low‐risk profiles at follow‐up, indicating more aggressive treatment should be implemented to optimize goal‐oriented therapy for these patients. [ABSTRACT FROM AUTHOR]

Background: Congenital shunt location is related to Eisenmenger syndrome (ES) survival. Moreover, right ventricular (RV) remodeling is associated with poor survival in pulmonary hypertension. Purpose: To investigate RV remodeling using comprehensive magnetic resonance imaging (MRI) techniques and identify its relationship with prognosis in ES subgroups classified by shunt location. Study Type: Prospective observational study. Population: Fifty‐four adults with ES (16 with pre‐tricuspid shunt and 38 with post‐tricuspid shunt). Field Strength/Sequence: 3.0 T/cine MRI with balanced steady‐state free precession sequence, late gadolinium enhancement with inversion recovery segmented gradient echo sequence and phase‐sensitive reconstruction, and T1 mapping with modified Look‐Locker inversion recovery sequence. Assessment: Demographics, clinical characteristics, hemodynamics, RV remodeling features (morphology, systolic function, RV–pulmonary artery (PA) coupling and myocardial fibrosis), and prognosis were compared between ES subgroups. The adverse endpoint was all‐cause mortality or readmission for heart failure. Statistical Tests: The independent samples t‐test, Fisher's exact test or Chi‐squared test, and the Kaplan–Meier method were used. P < 0.05 was considered significant. Results: Compared to patients with post‐tricuspid shunt, patients with pre‐tricuspid shunt were significantly older and had higher N‐terminal pro‐B‐type natriuretic peptide concentrations and poorer exercise tolerance. Pre‐tricuspid shunt showed significantly larger RV dimensions (end‐diastolic volume index: 185.81 ± 37.49 vs. 98.20 ± 36.26 mL/m2), worse RV ejection fraction (23.54% ± 12.35% vs. 40.82% ± 10.77%), and RV–PA decoupling (0.35 ± 0.31 vs. 0.72 ± 0.29). Biventricular myocardial fibrosis was significantly more severe in pre‐tricuspid shunt than post‐tricuspid shunt (extracellular volume, left ventricle: 35.85% ± 2.58% vs. 29.10% ± 5.20%; RV free wall: 30.93% ± 5.65% vs. 26.75% ± 5.15%). In addition, pre‐tricuspid shunt demonstrated a significantly increased risk of adverse endpoint (hazard ratio: 2.938, 95% confidence interval: 1.204–7.172). Data Conclusion: ES with pre‐tricuspid shunt might be a unique subtype with worse clinically decompensated RV remodeling and poor prognosis. Level of Evidence: 2 Technical Efficacy Stage: 5 [ABSTRACT FROM AUTHOR]

MXene, an emerging family of 2D transition metal carbides/nitride (MXene) materials, has attracted growing attention since its initial discovery in 2011. Owing to their extraordinary electrical conductivity, high mechanical stability, various functional groups, and large interlayer space, MXene and MXene‐based nanomaterials have shown significant energy‐storage capability. Firstly, research progress on the preparation strategies and properties of MXene are summarized. Secondly, the current state‐of‐the‐art advances of MXene and MXene‐based nanomaterials as advanced electrodes for energy storage devices, including lithium‐ion batteries, sodium‐ion batteries, potassium‐ion batteries, and supercapacitors are reviewed. Finally, the key challenges and perspectives for further enhancing their electrochemical performances are also outlined. This Progress Report offers a reference and scientific inspiration for the design and preparation of high‐performance MXene and MXene‐based nanomaterials to meet the increasing need for next‐generation energy‐storage systems. [ABSTRACT FROM AUTHOR]

This is the first multicentre prospective registry reporting baseline characteristics and estimated survival of patients with chronic thromboembolic pulmonary hypertension (CTEPH) in China. A total of 593 patients with CTEPH were included. The long‐term survival rates are similar to those of patients in the international and Spanish registries. Pulmonary endarterectomy is an independent predictor of survival. See relatedEditorial Background and objective: The purpose of this study was to report the characteristics and long‐term survival of patients with CTEPH treated in three distinct ways: PEA, BPA and medical therapy. Methods: Patients diagnosed with CTEPH were included in the registry that was set up in 18 centres from August 2009 to July 2018. The characteristics and survival of patients with CTEPH receiving the different treatments were reported. Prognostic factors were evaluated by Cox regression model. Results: A total of 593 patients with CTEPH were included. Eighty‐one patients were treated with PEA, 61 with BPA and 451 with drugs. The estimated survival rates at 1, 3, 5 and 8 years were, respectively, 95.2%, 84.6%, 73.4% and 66.6% in all patients; 92.6%, 89.6%, 87.5% and 80.2% in surgical patients; and 95.4%, 88.3%, 71.0% and 64.1% in medically treated patients. The estimated survival rates at 1, 3, 5 and 7 years in patients treated with BPA were 96.7%, 88.1%, 70.0% and 70.0%, respectively. For all patients, PEA was an independent predictor of survival. Other independent risk factors were CHD, cardiac index, PVR, big endothelin‐1, APE and 6MWD. Conclusion: This is the first multicentre prospective registry reporting baseline characteristics and estimated survival of patients with CTEPH in China. The long‐term survival rates are similar to those of patients in the international and Spanish registries. PEA is an independent predictor of survival. [ABSTRACT FROM AUTHOR]

Background: The phenotype via conventional cardiac MRI analysis of MYH7 (β-myosin heavy chain)- and MYBPC3 (β-myosin-binding protein C)-associated hypertrophic cardiomyopathy (HCM) groups is similar. Few studies exist on the genotypic-phenotypic association as assessed by machine learning in HCM patients.Purpose: To explore the phenotypic differences based on radiomics analysis of T1 mapping images between MYH7 and MYBPC3-associated HCM subgroups.Study Type: Prospective observational study.Subjects: In all, 102 HCM patients with pathogenic, or likely pathogenic mutation, in MYH7 (n = 68) or MYBPC3 (n = 34) genes.Field Strength/sequence: Cardiac MRI was performed at 3.0T with balanced steady-state free precession (bSSFP), phase-sensitive inversion recovery (PSIR) late gadolinium enhancement (LGE), and modified Look-Locker inversion recovery (MOLLI) T1 mapping sequences.Assessment: All patients underwent next-generation sequencing and Sanger genetic sequencing. Left ventricular native T1 and LGE were analyzed. One hundred and fifty-seven radiomic features were extracted and modeled using a support vector machine (SVM) combined with principal component analysis (PCA). Each subgroup was randomly split 4:1 (feature selection / test validation).Statistical Tests: Mann-Whitney U-tests and Student's t-tests were performed to assess differences between subgroups. A receiver operating characteristic (ROC) curve was used to assess the model's ability to stratify patients based on radiomic features.Results: There were no significant differences between MYH7- and MYBPC3-associated HCM subgroups based on traditional native T1 values (global, basal, and middle short-axis slice native T1 ; P = 0.760, 0.914, and 0.178, respectively). However, the SVM model combined with PCA achieved an accuracy and area under the curve (AUC) of 92.0% and 0.968 (95% confidence interval [CI]: 0.968-0.971), respectively. For the test validation dataset, the accuracy and AUC were 85.5% and 0.886 (95% CI: 0.881-0.901), respectively.Data Conclusion: Radiomic analysis of native T1 mapping images may be able to discriminate between MYH7- and MYBPC3-associated HCM patients, exceeding the performance of conventional native T1 values.Level Of Evidence: 3 TECHNICAL EFFICACY STAGE: 2 J. MAGN. RESON. IMAGING 2020;52:1714-1721. [ABSTRACT FROM AUTHOR]

Background: Right ventricular (RV) dysfunction is common in patients with amyloid light-chain (AL) amyloidosis. While cardiac MRI is the reference standard tool for RV assessment, there are a number of measures of RV function that can be evaluated and it is yet unknown which of these results in the highest prognostic performance in AL amyloidosis.Purpose: To examine the prognostic value of various measures of RV function in a bid to find which best predicts outcome in AL amyloidosis.Study Type: Single-center, prospective.Subjects: In all, 129 patients (mean age, 58 ± 11 years; 61.2% men) with biopsy-proven AL amyloidosis.Field Strength/sequence: 3.0T / balanced steady-state free-precession cine.Assessment: RV ejection fraction (EF), RV fractional area change (FAC), RV long axis strain (LAS), RV free wall longitudinal strain (FWS), RV global longitudinal strain (GLS), and tricuspid annular plane systolic excursion (TAPSE).Statistical Tests: Mann-Whitney U-tests, Student's t-tests, receiver-operating characteristic curves, Kaplan-Meier curves, Cox proportional hazards regression models, and C-statistics.Results: During the median follow-up period of 38.0 months (interquartile range, 18.5-58.0 months), all-cause mortality occurred in 95 patients (73.6%). The RVEF, RVGLS, TAPSE, RVFAC, and RVFWS were significant predictors of outcome in univariate Cox regression (all P < 0.001). After adjusting for New York Heart Association (NYHA) class, Mayo staging 2004, left ventricular (LV) EF, and LV mass index, RVFWS (HR [hazard ratio] =1.074; 95% CI [confidence interval]: 1.041-1.108; P < 0.001) was an independent predictor of all-cause mortality and had a higher C-statistic (0.753) compared to the model including RVEF (C-statistic = 0.724, P = 0.034), the model including RVFAC (C-statistic = 0.723, P = 0.033), and the model including RVGLS (C-statistic =0.733, P = 0.011).Data Conclusion: RV dysfunction appears to be an independent determinant of outcome in patients with AL amyloidosis. RVFWS is a better predictor of all-cause mortality than RVEF, RVFAC, or RVGLS.Evidence Level: 2 TECHNICAL EFFICACY STAGE: 5. [ABSTRACT FROM AUTHOR]

Identification of patients with non‐ischaemic dilated cardiomyopathy (NICM) who are at risk of sudden cardiac death (SCD) and could benefit from an implantable cardioverter defibrillator (ICD) is challenging. The study aims to systematically assess the prognostic value of left ventricular (LV) midwall late gadolinium enhancement (LGE) pattern in patients with NICM and further explore its value on predicting SCD events. The study was prospectively registered in PROPSERO (CRD42019138468). We systematically searched PubMed, Ovid Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov to identify studies that evaluated the association between LV midwall LGE and clinical outcomes (all‐cause mortality, cardiovascular mortality, and SCD or aborted SCD endpoint) in NICM patients. A meta‐analysis was performed to determine pooled odds ratio (OR) for these adverse events. Seven studies including 1827 NICM patients over a mean follow‐up duration of 36.1 ± 19.3 months were included. The presence of LV midwall LGE pattern was observed in 562 (30.8%) patients. The pooled OR was 3.37 [95% confidence intervals (CIs): 1.35–8.42] for all‐cause mortality, 5.56 (95% CI: 1.23–25.22) for cardiovascular mortality, and 2.25 (95% CI: 1.16–3.16) for SCD or aborted SCD. In a subgroup analysis with mean ejection fraction cut‐off point of 35%, the pooled OR for SCD or aborted SCD was 2.06 (95% CI: 1.32–3.22) for LV ejection fraction (LVEF) > 35% and 2.49 (95% CI: 1.48–4.20) for LVEF ≤ 35%. In addition, our study indicated that LV midwall LGE showed an excellent negative predictive value in identifying high‐risk NICM patients and that the number needed to treat with ICD implantation in NICM patients with midwall LGE is 7. The presence of LV midwall on LGE is a significant prognosticator of adverse events in NICM patients. Additionally, patients with LV midwall LGE may be considered for ICD therapy irrespective of LVEF. [ABSTRACT FROM AUTHOR]

Background: The Selvester QRS score can identify the presence and extent of myocardial scar in ischemic and nonischemic cardiomyopathy, but its performance in patients with hypertrophic cardiomyopathy (HCM) has not been assessed.Methods: Consecutive patients with HCM referred to our hospital between January 2012 and July 2016 were prospectively enrolled. All patients underwent cardiac magnetic resonance (CMR) and 12-lead electrocardiography. The Selvester QRS score was used to evaluate the presence and extent of myocardial scarring, and the results were compared with that obtained with the gold standard-late gadolinium enhancement (LGE) on CMR.Results: A total of 135 HCM patients were enrolled. LGE was present in 93 of 135 (69%) patients. The median LGE mass was 5 (0-14) g, and the median proportion of total left ventricular mass showing LGE was 4% (0%-10%). A total of 92 patients had Selvester score ≥1. The highest score recorded was 13; the median score was 1 (0-3). In receiver operating curve analysis, Selvester score ≥1 was identified as the optimum score for predicting presence of LGE enhancement; the area under the curve was 0.826 (95% CI, 0.752-0.900; p < .001). Significant positive correlation was seen between the Selvester score and the extent of LGE enhancement (Spearman ρ, .572; p < .001). The Selvester scoring system correctly identified all LGE segments in 13 of 93 (14%) patients and some LGE segments in 39 (41.9%) patients.Conclusions: The Selvester QRS score appears to be a convenient and reliable method to determine the presence and extent of myocardial scar in patients with HCM. [ABSTRACT FROM AUTHOR]

Background: Polymyositis (PM) and dermatomyositis (DM) are common types of idiopathic inflammatory myopathy (IIM), wherein patients are prone to adverse cardiovascular events.Purpose: To explore the value of cardiac magnetic resonance imaging (MRI) for detecting cardiac involvement in PM/DM patients using a T1 mapping technique.Study Type: Prospective observational study.Population: In all, 25 PM/DM patients free of cardiovascular symptoms and preserved ventricular systolic function and 25 healthy volunteers matched for age and sex served as controls.Field Strength/sequence: Cardiac MRI at 3T, including steady-state free precession (SSFP) cine imaging, late gadolinium enhancement (LGE), and T1 mapping with modified Look-Locker inversion recovery (MOLLI).Assessment: Myocardial native T1 and extracellular volume (ECV) of the left ventricle as well as the correlations with disease activity were analyzed.Statistical Tests: Independent sample's t-test, Fisher's exact test, or chi-square test, Pearson's correlation (r) were applied. P ≤ 0.05 was considered significant.Results: Left ventricular end-diastolic/end-systolic volume index (P = 0.643, P = 0.325, respectively), mass index (P = 0.719), and ejection fraction (P = 0.144) were not significantly different between PM/DM patients and controls. LGE was found in 19% of PM/DM patients and none of the control subjects. PM/DM patients showed significantly higher native T1 values (1263.7 ± 84.0 msec vs. 1200.6 ± 43.0 msec, P = 0.002) and expanded extracellular volume (ECV) (32.6 ± 3.7% vs. 26.7 ± 2.3%, P < 0.001) compared with control subjects. ECV values in PM/DM patients had a high proportion (60%) over the 95% percentile of normal controls. Meanwhile, there was a significant correlation between native T1 (r = 0.710, P = 0.0001) or ECV (r = 0.508, P = 0.01) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP).Data Conclusion: T1 mapping of cardiac MRI is valuable to detect subclinical myocardial involvement in PM/DM patients, and both myocardial native T1 and ECV could serve as early imaging markers for myocardial impairment in PM/DM.Level Of Evidence: 2 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2018;48:415-422. [ABSTRACT FROM AUTHOR]

Background: Segmental myocardial strain using feature tracking (FT) cardiac MRI is not acceptable due to poor reproducibility.Purpose: To assess the reproducibility of left ventricle (LV) segmental myocardial strain measured by deformation registration algorithm (DRA).Study Type: Prospective clinical trial.Subjects: Sixteen healthy volunteers and 28 hypertrophic cardiomyopathy (HCM) patients.Field Strength/sequence: Retrospective ECG gating cardiac MRI imaging was performed at 3.0T with a steady-state free precession (SSFP) sequence.Assessment: LV global and segmental myocardial strains were analyzed by DRA, FT, and speckle tracking echocardiography (STE) by two experienced observers and the reproducibility of global and segmental strains were compared.Statistical Tests: Reproducibility was tested by coefficient of variation (COV) and intraclass correlation coefficient (ICC). Receiver operator curves as well as comparison of areas under the curve (AUC) were analyzed.Results: DRA showed the best observer agreement on segmental strain evaluated by ICC, LS (longitudinal strain): intraobserver variability range (0.98,1.00), interobserver variability range (0.83,0.92), CS (circumferential strain): intraobserver variability range (0.90,0.99), interobserver variability range (0.80,0.97), RS (radial strain): intraobserver variability range (0.84,0.99), interobserver variability range (0.85,0.99). Segmental LS, CS, and RS agreements evaluated by COV for FT and STE were poor. LV global myocardial strain of HCM was significantly lower than controls for all applied techniques, but global CS by DRA had better accuracy compared to FT or STE for distinguishing HCM from healthy subjects: AUC 0.880 (DRA) vs. 0.577 (FT) or 0.736 (STE), P < 0.05.Data Conclusions: DRA is a reliable and robust analysis tool for segmental myocardial strain. Global CS by DRA allows discrimination between HCM and normal controls with better accuracy compared with FT and STE.Level Of Evidence: 1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2018;48:404-414. [ABSTRACT FROM AUTHOR]

Background: The outcomes and prognosis of revascularization by either coronary artery bypass grafting (CABG) surgery or percutaneous coronary intervention (PCI) in patients with noninsulin-treated type 2 diabetes mellitus (NITDM) have not yet been well established.Methods: Randomized controlled trials (RCTs) were identified by searching Pubmed, EMBASE, and Cochrane library from inception until May 2016. Heterogeneity was evaluated, and the pooled hazard ratio (HR) was calculated by using a fixed-effect model. A random-effect model was used when statistically significant heterogeneity was observed (I2  ≥ 50%). All data analyses were carried out by using RevMan 5.3 and STATA software 12.0.Results: A total of 4 RCTs involving 5 studies, consisting of 2270 patients with noninsulin-treated type 2 diabetes mellitus, were identified. Compared with CABG-treated patients, PCI-treated patients had significantly higher all-cause mortality (HR 1.39; 95% CI 1.01 to 1.91; P = .04), myocardial infarction (HR 2.14; 95% CI 1.40 to 3.27; P = .0004), repeated revascularization (HR 2.52; 95% CI 1.77 to 3.57; P < .00001), and major adverse cardiovascular and cerebrovascular events (HR 1.50; 95% CI 1.20-1.87; P = .0004). However, PCI was associated with lower incidence of stoke (HR 0.47; 95% CI 0.24 to 0.90; P = .02).Conclusions: In NITDM patients, our study suggests that CABG surgery is associated with reduced risk of mortality and morbidity, although with increased incidence of stroke compared with percutaneous coronary intervention. The decision if to have percutaneous coronary intervention or CABG surgery should factor the risk for stroke of the patients when considering CABG over percutaneous coronary intervention. Adequately powered RCTs are needed to confirm the results of this meta-analysis. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the feasibility of a proposed cardiorespiratory-resolved analysis in left ventricular (LV) function quantification from real-time cines in a cohort of cardiac patients.Materials and Methods: Electrocardiograph (ECG)-free free-breathing real-time cine imaging based on the balanced steady-state free precession technique was performed on short-axis slices of 20 cardiac patients at 3T. K-means cluster segmentation was used to delineate the endocardial contours, from which the LV centroid and cavity area were determined. Respiratory and cardiac signals were respectively resolved from the filtered LV centroid displacement and time-varied LV cavity area to identify end-expiratory end-diastolic (ED) and end-systolic (ES) images. The obtained LV cavity areas and derived volumetric function indices, including ED volume (EDV), ES volume (ESV), stroke volume (SV), and ejection fraction (EF), were compared with those measured from manual analysis using two-tailed paired Student's t-tests, linear regression analyses, and Bland-Altman plots. Interobserver variability was calculated.Results: The LV cavity area was strongly correlated between the proposed and conventional manual methods (r > 0.87) for three representative slices at the base, middle ventricle, and apex. The average differences between the two methods were 0.66 ± 3.22 mL for EDV, -0.02 ± 2.68 mL for ESV, 0.67 ± 3.73 mL for SV, and 0.17 ± 2.30% for EF. All paired measures exhibited strong correlations (r > 0.96) without significant differences (P = 0.38-0.98). Acceptable interobserver variability (0.19-3.55%) and strong correlations (r > 0.96) were shown for all measures between the two observers.Conclusion: The proposed method is feasible for efficient measurement of LV function from real-time cines.Level Of Evidence: 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;46:905-914. [ABSTRACT FROM AUTHOR]

Purpose: To establish normal reference values of left ventricular (LV) and right ventricular (RV) dimension, volume, mass, and ejection fraction in a Chinese population using cardiac magnetic resonance imaging (MRI).Materials and Methods: A total of 120 (60 males; 60 females; 23-83 years) healthy Han Chinese subjects without cardiovascular disease or risk factors were recruited. They underwent comprehensive MRI examination at 3.0T. LV/RV morphology and function were evaluated by steady-state free-procession (SSFP) sequence. Parameters were analyzed according to a standard postprocessing protocol.Results: Significant differences in LV size, mass, volume, and ejection fraction (EF) between sexes were noted (all P < 0.05). After indexing using body surface area (BSA), LV end-diastolic volume (EDV), and LV mass index were greater in males than in females (76.5 vs. 68.7 mL/m, P < 0.001; 52.9 vs. 45.1 g/m, P < 0.001; respectively). LVEF was lower in males than in females (64.6% vs. 67.1%, P = 0.007, respectively). RV volume was higher and RVEF lower in males compared with females (75.3 vs. 62.7 mL/m, P < 0.001; 59.9% vs. 62.6%, P = 0.001, respectively). Age was associated significantly with indices of LV and RV volume in females (left ventricular end-diastolic volume index: r = -0.41 P = 0.001; left ventricular end-systolic volume index: r = -0.37 P = 0.004; left ventricular end-diastolic volume index: r = -0.53 P < 0.001; right ventricular end-systolic volume index: r = -0.43 P < 0.001), but not in males (all P > 0.05).Conclusion: These data suggest that sex and age affect ventricular parameters in healthy Han Chinese subjects without cardiovascular disease or risk factors.Level Of Evidence: 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1684-1692. [ABSTRACT FROM AUTHOR]

Background: To develop and assess an efficient method to identify end-expiratory end-diastolic (ED) and end-systolic (ES) images for accurate quantification of left ventricular (LV) function in real-time cine imaging.Methods: ECG-free free-breathing real-time cine imaging was performed on short-axis slices of thirteen healthy volunteers at 3 Tesla. K-means cluster segmentation was applied to delineate the endocardial contour, from which the LV centroid and cavity area were determined in each cine image. LV centroid displacement along the superior-inferior direction was filtered to extract respiratory motion in each slice. End-expiratory ED and ES images were then identified and used for LV function quantification. Accuracy was evaluated with that measured from the slice-matched standard ECG-gated breathhold segmented cines using two-tail paired Student's t-tests, linear regression analyses and Bland-Altman plots. Intra- and interobserver variability was calculated for each imaging technique.Results: Qualitatively, end-expiratory ED and ES images identified with the proposed method agreed with those determined by frame-by-frame visual inspection in 97.5% of cases (P > 0.05). Quantitatively, good agreement of LV function indices between the real-time cine and the standard segmented cine was observed with averaged differences of 0.1 ± 0.9 g for myocardium mass, -0.3 ± 1.0 mL for ED volume, 0.2 ± 1.2 mL for ES volume, -0.2 ± 1.3 mL for stroke volume, and -0.3 ± 0.8% for ejection fraction. Paired LV function values exhibited strong correlation (r ≥ 0.96) and no significant difference (P > 0.05). The real-time cine and the standard segmented cine showed similar intra- (1.2-3.3% and 1.1-2.8%, respectively) and interobserver variability (2.6-6.9% and 1.8-4.8%, respectively) with all P-values > 0.05. All the variability was comparable with published results.Conclusion: Compared with the laborious frame-by-frame visual inspection, as conventionally adopted, the proposed method is efficient in analyzing real-time cines for the accurate quantification of LV function without excessively manual interactions. [ABSTRACT FROM AUTHOR]

We have developed a novel head-up display (HUD) system with 13.7% transmittance by combining RGBW design, LCs with negative dielectric anisotropy and local dimming backlight. With high transmittance, high contrast ratio and low power, the newly designed HUD system could be more suitable for automotive vehicles. [ABSTRACT FROM AUTHOR]

Despite the established efficacy of statin therapy, the risk of cardiovascular events remains high in many patients. We examined high-density lipoprotein (HDL) subclass distribution profiles among statin-treated coronary heart disease (CHD) patients undergoing percutaneous coronary intervention (PCI). Plasma HDL subclasses were measured in 85 patients with established CHD and quantified by two-dimensional gel electrophoresis and immunoblotting. In CHD patients with statin treatment, the mean value of total cholesterol (TC) reached the desirable level and the triacylglycerol level (TAG) was borderline high. Moreover, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoproteinA-I, and apolipoproteinB-100 levels in these patients resembled those in normolipidemic healthy subjects. The HDL subclass did not show a normal distribution and was characterized by the lower large-sized HDL contents and higher contents of small-sized preβ-HDL in CHD patients, compared to those in normolipidemic control subjects. Multiple stepwise regression analysis revealed that the severity of coronary stenosis, determined by the Gensini Score, was significantly and independently predicted by HDL and HDL. Statin therapy was effective in modifying plasma lipids levels, but not adequate as a monotherapy to normalize the HDL subclass distribution phenotype of patients with CHD undergoing PCI. The HDL subclass distribution may aid in risk stratification, especially in patients with CHD and therapeutic LDL-C and HDL-C levels. [ABSTRACT FROM AUTHOR]

Manganese (II) coordinated polyaniline (PANI‐Mn) is designed as an energy‐storage electrode to improve electrochemical cycling stability of conductive polymer‐based supercapacitors. A PANI‐Mn electrode is synthesized through electro‐polymerization and hydrothermal coordination processes. A tetrahedron coordination structure is formed between manganese (II) dichloride and neighboring imino nitrogen to enforce the bonding strength of conjoint aniline units, restraining excessive volume expansion of the PANI molecule chain. Specific capacitance is enhanced from 350 F g−1 of PANI to 810 F g−1 of PANI‐Mn at 1 A g−1. Cycling capacitance retention is improved from 61% of PANI to 88% of PANI‐Mn at 5 A g−1 for 1000 cycles. PANI‐Mn shows larger response current than PANI at the same potential. First principle calculations prove that PANIs‐Mn exhibits higher density of state at Fermi level than PANI. The conjugated electron delocalization is strengthened in transitional metal‐coordinated conductive polymer, causing the improved conductivity of PANI‐Mn. Furthermore, an all‐solid‐state symmetric supercapacitor based on a PANI‐Mn electrode exhibits an energy density of 51.38 Wh kg−1 at a power density of 850 W kg−1 and a considerable cycling life of 82% after 1000 cycles at 5 A g−1. PANI‐Mn coordination polymer exhibits enhanced electrochemical stability, thus showing promise for energy storage application. [ABSTRACT FROM AUTHOR]

Background Right heart failure may lead to impaired liver perfusion and venous congestion, resulting in different extents of liver fibrosis. However, whether hepatic tissue deterioration determined by native T1 mapping and extracellular volume fraction using cardiac magnetic resonance imaging is associated with poor outcomes in patients with pulmonary arterial hypertension remains unclear. Methods and Results A total of 131 participants with pulmonary arterial hypertension (mean age, 36±13 years) and 64 healthy controls (mean age, 44±18) between October 2013 and December 2019 were prospectively enrolled. Hepatic native T1 and extracellular volume fraction values were measured using modified Look-Locker inversion recovery T1 mapping sequences. The primary end point was all-cause mortality; the secondary end point was all-cause mortality and repeat hospitalization attributable to heart failure. Cox regression models and Kaplan-Meier survival analysis were used to identify the association between variables and clinical outcome. During a median follow-up of 34.5 months (interquartile range: 25.3-50.8), hepatic native T1 (hazard ratio per 30-ms increase, 1.22 [95% CI, 1.07-1.39]; P =0.003) and extracellular volume fraction (hazard ratio per 3% increase, 1.18 [95% CI, 1.04-1.34]; P =0.010) values were associated with a higher risk of death. In the multivariate Cox model, hepatic native T1 value (hazard ratio per 30-ms increase, 1.15 [95% CI, 1.04-1.27]; P =0.009) remained as an independent prognostic factor for the secondary end point. Conclusions Hepatic T1 mapping values were predictors of adverse cardiovascular events in participants with pulmonary arterial hypertension and could be novel imaging biomarkers for poor prognosis recognition.