{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T05:19:38Z","timestamp":1793337578652,"version":"4.5.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T00:00:00Z","timestamp":1622592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T00:00:00Z","timestamp":1622592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19K08229"],"award-info":[{"award-number":["19K08229"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We used 4D-flow MRI to investigate circulation, an area integral of vorticity, in the main pulmonary artery (MPA) as a new hemodynamic parameter for assessing patients with a repaired Tetralogy of Fallot (TOF). We evaluated the relationship between circulation, right ventricular (RV) function and the pulmonary regurgitant fraction (PRF). Twenty patients with a repaired TOF underwent cardiac MRI. Flow-sensitive 3D-gradient sequences were used to obtain 4D-flow images. Vortex formation in the MPA was visualized, with short-axis and longitudinal vorticities calculated by software specialized for 4D flow. The RV indexed end-diastolic\/end-systolic volumes (RVEDVi\/RVESVi) and RV ejection fraction (RVEF) were measured by cine MRI. The PR fraction (PRF) and MPA area were measured by 2D phase-contrast MRI. Spearman \u03c1 values were determined to assess the relationships between circulation, RV function, and PRF. Vortex formation in the MPA occurred in 15 of 20 patients (75%). The longitudinal circulation (11.7\u2009\u00b1\u20095.1\u00a0m\n                    <jats:sup>2<\/jats:sup>\n                    \/s) was correlated with the RVEF (\u03c1\u2009=\u2009\u2212\u20090.85, p\u2009=\u20090.0002), RVEDVi (\u03c1\u2009=\u20090.62, p\u2009=\u20090.03), and RVESVi (\u03c1\u2009=\u20090.76, p\u2009=\u20090.003) after adjusting for the MPA size. The short-axis circulation (9.4\u2009\u00b1\u20093.4\u00a0m\n                    <jats:sup>2<\/jats:sup>\n                    \/s) in the proximal MPA was positively correlated with the MPA area (\u03c1\u2009=\u20090.61, p\u2009=\u20090.004). The relationships between the PRF and circulation or RV function were not significant. Increased longitudinal circulation in the MPA, as demonstrated by circulation analysis using 4D flow MRI, was related to RV dysfunction in patients with a repaired TOF.\n                  <\/jats:p>","DOI":"10.1038\/s41598-021-91125-2","type":"journal-article","created":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T06:08:04Z","timestamp":1622614084000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Circulation derived from 4D flow MRI correlates with right ventricular dysfunction in patients with tetralogy of Fallot"],"prefix":"10.1038","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2556-8287","authenticated-orcid":false,"given":"Nanae","family":"Tsuchiya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6049-8857","authenticated-orcid":false,"given":"Michinobu","family":"Nagao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumi","family":"Shiina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shohei","family":"Miyazaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Inai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadayuki","family":"Murayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Sakai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,2]]},"reference":[{"key":"91125_CR1","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1007\/s11748-018-0931-0","volume":"66","author":"H Tatewaki","year":"2018","unstructured":"Tatewaki, H. & Shiose, A. Pulmonary valve replacement after repaired Tetralogy of Fallot. Gen. Thorac. Cardiovasc. Surg. 66, 509\u2013515 (2018).","journal-title":"Gen. Thorac. Cardiovasc. Surg."},{"key":"91125_CR2","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.12688\/f1000research.17174.1","volume":"8","author":"J van der Ven","year":"2019","unstructured":"van der Ven, J., van den Bosch, E., Bogers, A. & Helbing, W. A. Current outcomes and treatment of tetralogy of Fallot. F1000Research. 8, 1530. https:\/\/doi.org\/10.12688\/f1000research.17174.1 (2019).","journal-title":"F1000Research."},{"key":"91125_CR3","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.ejrad.2017.05.027","volume":"93","author":"PH Wu","year":"2017","unstructured":"Wu, P. H., Chung, H. W., Wu, M. T. & Ko, C. W. Pixel-wise derivation of pulmonary regurgitation index could influence clinical decision: A phase-contrast MR imaging study on patients with repaired tetralogy of Fallot. Eur. J. Radiol. 93, 46\u201351 (2017).","journal-title":"Eur. J. Radiol."},{"key":"91125_CR4","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1007\/s00330-011-2108-4","volume":"21","author":"J Geiger","year":"2011","unstructured":"Geiger, J. et al. 4D-MR flow analysis in patients after repair for tetralogy of Fallot. Eur. Radiol. 21, 1651\u20131657 (2011).","journal-title":"Eur. Radiol."},{"key":"91125_CR5","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/1532-429X-14-16","volume":"14","author":"CJ Fran\u00e7ois","year":"2012","unstructured":"Fran\u00e7ois, C. J. et al. 4D cardiovascular magnetic resonance velocity mapping of alterations of right heart flow patterns and main pulmonary artery hemodynamics in tetralogy of Fallot. J. Cardiovasc. Magn. Reason. 14, 16 (2012).","journal-title":"J. Cardiovasc. Magn. 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