{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T17:19:39Z","timestamp":1785345579378,"version":"3.55.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"MSD Life Science Foundation, Public Interest Incorporated Foundation. This work was also supported by Takeda Science Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>This study aimed to evaluate the prevalence and distribution of pulmonary venous systolic flow reversal (PVSFR) in patients with severe mitral regurgitation (MR), and to examine the relationship between PVSFR profile and cardiac parameters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>A total of 125 patients with severe MR who had transoesophageal echocardiography (TOE) performed were reviewed. Of these, 121 (96.8%) patients showed all four pulmonary venous (PV) flows by TOE. They were categorized into three groups by the MR aetiology: degenerative MR (DMR) (n\u2009=\u200972), ventricular functional MR (V-FMR) (n\u2009=\u200920), and atrial functional MR (A-FMR) (n\u2009=\u200916). Eighteen (16.7%) patients had PVSFR in all four PVs. Twenty-nine (26.9%) had PVSFR in three PVs, 23 (21.3%) in two PVs, and 23 (21.3%) in one PV. PVSFR appeared at right PVs more frequently compared with left PVs. A high number of PVSFR was significantly correlated with higher pulmonary capillary wedge pressure (PCWP) and 3D vena contracta area (3D-VCA). With regard to MR aetiology, the number of PVSFRs was correlated with high 3D-VCA in patients with DMR and A-FMR, while it was correlated with high PCWP in patients with V-FMR. Laminar-type PVSFR appeared more frequently in FMR compared with DMR, and it had a relationship with higher PCWP and lower right ventricular fractional area change (RVFAC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>All four PV were detected in 96.8%, and 16.8% patients had PVSFR in all four PVs. PCWP and 3D-VCA were correlated with the number of PVSFRs in severe MR patients. Laminar-type PVSFR was related to higher PCWP and lower RVFAC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeab098","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T19:13:04Z","timestamp":1619723584000},"page":"964-973","source":"Crossref","is-referenced-by-count":10,"title":["Prevalence, distribution, and determinants of pulmonary venous systolic flow reversal in severe mitral regurgitation"],"prefix":"10.1093","volume":"22","author":[{"given":"Kiho","family":"Itakura","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6587-9584","authenticated-orcid":false,"given":"Hiroto","family":"Utsunomiya","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Takemoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Takahari","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanako","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Ikenaga","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Hidaka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Nakano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,26]]},"reference":[{"key":"2021081716222536300_jeab098-B1","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/S0735-1097(03)00126-8","article-title":"Pulmonary venous flow by Doppler echocardiography: revisited 12 years later","volume":"41","author":"Tabata","year":"2003","journal-title":"J Am Coll Cardiol"},{"key":"2021081716222536300_jeab098-B2","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1016\/S0735-1097(97)00354-9","article-title":"Hemodynamic determinants of Doppler pulmonary venous flow velocity components: new insights from studies in lightly sedated normal dogs","volume":"30","author":"Appleton","year":"1997","journal-title":"J Am Coll Cardiol"},{"key":"2021081716222536300_jeab098-B3","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1152\/ajpheart.2000.279.2.H594","article-title":"Doppler echo evaluation of pulmonary venous-left atrial pressure gradients: human and numerical model studies","volume":"279","author":"Firstenberg","year":"2000","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2021081716222536300_jeab098-B4","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1016\/S0735-1097(99)00300-9","article-title":"The pulmonary venous systolic flow pulse - 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