Left atrial LA size is a known predictor of adverse cardiovascular events. Echocardiography is the modality of choice for the evaluation of atrial size; however, cardiac magnetic resonance imaging cMRI remains the "gold standard.
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The atrial length and area were measured in standard apical two-chamber and four-chamber planes. Measured values were indexed to body surface area BSA. CMRI measurements were obtained from prospectively gated steady-state free precession cine stack images obtained in a standard four-chamber plane. Slice thickness ranged from 5 to 7 mm with contiguous slices of 5 to 7 mm.
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Clemont then comments that it must have been from the previous night when Ash got soaked and that he must have caught a bad cold. Pikachu becomes worried about Ash, but Clemont says that he'll go and get Ash some medicine and Bonnie agrees to go with him. Serena tells them that there's a pharmacy around and that they should take her guide book to help them get there and Clemont and Bonnie leave Serena to take care of Ash while they get medicine. Pancham and Braixen gather water for Serena so she can continue to help bring Ash's temperature down.
Jimmy asks Serena if the Pikachu belongs to Ash Ketchum from Pallet Town and mentions that he's heard it is really strong. Serena attempts to get Jimmy to keep the noise down so that he doesn't wake Ash up, but Jimmy then challenges Ash to a battle, Pikachu against Pikachu. Serena agrees to go get Ash, but once inside the tent, she realises that if she tells Ash that someone has challenged him, he'll jump up to accept it, even if he's not in any fit state to do so, and just then, Ash moves, startling everyone, but everyone is relieved when they find out he was just dreaming as he talks in his sleep about telling his Greninja to use Double Team before he begins snoring again and is back to sleep.
She then notices Ash's clothes, to which she picks them up, staring at them.
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Serena and Jimmy prepare to begin their battle. Jimmy comments on how his Pikachu Spike is the ultimate Pikachu, and Serena is relieved that Jimmy bought her disguise as Ash and tries to remain calm. Pikachu informs Serena that he's willing to assist her during the battle against Jimmy. Team Rocket watches from a nearby tree as they're impressed by Jimmy's determination to find Ash's Pikachu, but Jessie shows annoyance towards him because he thinks he can beat Ash's Pikachu.
Sceptical that Jimmy can win against Ash's Pikachu, James mentions that if Jimmy's Pikachu turns out to be strong, they could capture Ash's Pikachu once Jimmy has weakened it.
Serena imitates Ash's catchphrase as she sends Pikachu into battle. Jimmy offers Serena the first move as the battle begins with Serena commanding Quick Attack as Jimmy orders his Pikachu to use the same attack. Serena orders Pikachu to use Thunderbolt this time, but Spike manages to escape using Dig. Serena begins to panic as she wonders where Spike will attack from next, but after help from Pikachu, she remembers what Ash would do in this situation and orders Pikachu to use Iron Tail, to which Pikachu slams the attack on the ground, bringing Spike to the surface and amazing Jimmy.
Serena orders Pikachu to use another Iron Tail and it hits Spike hard, bringing him to the ground. Jimmy is enjoying the battle as Serena continues her Ash impression, while secretly amazed that it worked. Team Rocket continue to watch on as Jessie comes up with the idea of capturing both Pikachu if Jimmy's is just as strong as Ash's, as Meowth thinks it's a good idea. Meowth then focuses on how Giovanni will reward him if he gets the two Pikachu, only this time, it won't be a dream.
Jessie snap Meowth out of his daydream, and Meowth tells them they should begin the plan of capturing the Pikachu. In town, Clemont and Bonnie have bought the medicine and begin to make their way back to the forest where they can help Ash get better with it.
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Upon arriving back at the clearing, Clemont and Bonnie notice Serena battling, but mistake her for Ash at first, until Clemont looks closer and notices it is Serena. Bonnie shouts over to Serena and begins to ask why she's dressed up like Ash, but is cut off by Serena screaming to prevent her cover being blown. Bonnie then tries to ask again but Serena screams again, this time joined by Ash's Pikachu. Jimmy then asks if they are her friends and she tells him they are before she goes to Clemont, asking if he's got the medicine for Ash, to which he says he has and Ash will be better in no time, but then begins to wonder about her due to her behavior.
Serena then explains the situation, which helps Clemont to understand to some extent. Clemont then tells her that she can leave the rest to him regarding Ash before leaving with Bonnie, only for the latter to return to tease Serena by wishing her luck and calling her "Ash", embarrassing Serena before she turns her attention to the battle once more, much to Jimmy's pleasure. In the tent, Clemont gives Ash the medicine as Bonnie hopes he gets better soon. Back to the battle, Serena commands Pikachu to use Thunderbolt as Jimmy commands Spike to use Thunderbolt as well; both attacks collide causing an explosion.
As both Serena and Jimmy command the Pikachu to use Quick Attack, they're stopped and caught by two mechanical hands before the moves can make contact, which shocks the two trainers. Just then, a truck tears through the foliage and is in clear view in the middle of the clearing. Two people emerge from the top of the truck on a stage and begin singing, before asking if they want to know who they are as they remove their disguises and they are revealed to be Team Rocket. With their identities now known, Jimmy recognizes them, surprising Serena as Jimmy tells her that they are the people who informed him about Ash's Pikachu in the first place.
Team Rocket then reveal their plans for capturing Pikachu, but after noticing something isn't right, Jessie then questions if it is Serena dressed up as Ash, which gets James and Meowth talking about why she would do that. Jimmy, hearing everything, questions what's going on, which makes Serena nervous as she's been caught out. The two Pikachu attempt to escape using Thunderbolt, but it's no use and Team Rocket make their escape by driving off in the truck with them both.
As Serena and Jimmy chase after the truck, it is suddenly stopped by Water Shurikens. Once the smoke has cleared, Team Rocket questions what just happened as Ash reveals it was him and his Greninja. Serena asks if Ash is alright as he was so ill earlier, but Ash replies that thanks to Clemont and Bonnie he is alright. Ash mentions to Serena that she battled in place of him, which causes Jimmy to ask what's going on, and Ash tells him he'll explain later as saving the Pikachu is the priority right now.
With her act now blown, Serena mentions to Jimmy that she meant no harm with what she did as she removes Ash's hat, surprising Jimmy as he recognizes her as the girl from earlier.