{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T14:55:00Z","timestamp":1789138500968,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100013365","name":"West China Hospital, Sichuan University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013365","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Right ventricular (RV) to left ventricular (LV) end\u2010diastolic volume ratio (RV\/LV) is a validated marker of RV dilation in pulmonary arterial hypertension (PAH), yet its impact on LV myocardial function and the underlying mediating pathway is incompletely characterized.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To investigate the association between RV\/LV volume ratio and LV dysfunction in PAH patients, with a focus on regional strain patterns and mediating pathways.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Retrospective.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n \n 188 PAH patients were divided into normal (ratio <\u20091.27,\n n<\/jats:italic>\n \u2009=\u200974) and elevated (ratio \u2265\u20091.27,\n n<\/jats:italic>\n \u2009=\u2009114) RV\/LV volume ratio groups, and 81 age\u2010 and sex\u2010matched controls.\n <\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n 3.0\u2010T\/balanced steady\u2010state free precession cine sequence.<\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n LV global longitudinal, circumferential, and radial strains (LVGLS, LVGCS, and LVGRS, respectively) and regional strains were measured using feature tracking. Strain parameters were compared among controls and PAH subgroups.<\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n One\u2010way ANOVA with Bonferroni\u2010corrected post hoc tests, Kruskal\u2010Wallis test, and Pearson or Spearman correlation. Multivariable linear regression was used to identify independent determinants and mediation analysis to examine the mediating pathways. A two\u2010tailed\n p<\/jats:italic>\n \u2009<\u20090.05 was deemed statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n PAH patients with elevated volume ratio had significantly reduced LVGCS and LVGLS. Regional analysis showed that the most extensive strain impairment was at the mid\u2010ventricular septum. The RV\/LV volume ratio was independently associated with LVGCS (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.194) and LVGLS (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.307). Mediation analysis demonstrated that the mPAP\u2013LVGLS relationship was statistically mediated by the RV\/LV volume ratio, with a significant indirect effect (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.192, 95% confidence interval: \u22120.302 to \u22120.096) and a non\u2010significant (\n p<\/jats:italic>\n \u2009=\u20090.544) direct effect.\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n Elevated RV\/LV volume ratio in PAH is associated with spatially heterogeneous LV strain impairment, with the mid\u2010septum being most vulnerable. The ratio mediates the adverse impact of pulmonary pressure on LV longitudinal strain and may serve as an imaging marker for assessing LV dysfunction.<\/jats:p>\n <\/jats:sec>\n \n Evidence Level<\/jats:title>\n 3.<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy<\/jats:title>\n Stage 3.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70541","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:02:07Z","timestamp":1788843727000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between\n MRI<\/scp>\n \u2010Derived Right\u2010to\u2010Left Ventricular Volume Ratio and Regional Left Ventricular Myocardial Dysfunction in Patients With Pulmonary Arterial Hypertension"],"prefix":"10.1002","author":[{"given":"Han","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3681-6186","authenticated-orcid":false,"given":"Yuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Feng","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi\u2010Qin","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Rong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Ke","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing\u2010Yi","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9341-7697","authenticated-orcid":false,"given":"Zhi\u2010Gang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital, Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"2200879","DOI":"10.1183\/13993003.00879-2022","article-title":"2022 ESC\/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension","volume":"61","author":"Humbert M.","year":"2023","journal-title":"European Respiratory Journal"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1093\/cvr\/cvx160","article-title":"The Overloaded Right Heart and Ventricular Interdependence","volume":"113","author":"Naeije R.","year":"2017","journal-title":"Cardiovascular Research"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1161\/CIRCHEARTFAILURE.112.000098","article-title":"Impaired Left Ventricular Mechanics in Pulmonary Arterial Hypertension: Identification of a Cohort at High Risk","volume":"6","author":"Hardegree E. 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