Differences in pulmonary arterial flow hemodynamics between children and adults with pulmonary arterial hypertension as assessed by 4D-flow CMR studies.

Despite different developmental and pathological processes affecting lung vascular remodeling in both patient populations, differences in 4D MRI findings between children and adults with PAH have not been studied. The purpose of this study was to compare flow hemodynamic state, including flow-mediated shear forces, between pediatric and adult patients with PAH matched by severity of pulmonary vascular resistance index (PVRi). Adults ( = 10) and children ( = 10) with PAH matched by pulmonary vascular resistance index (PVRi) and healthy adult ( = 10) and pediatric ( = 10) subjects underwent comprehensive 4D-flow MRI to assess peak systolic wall shear stress (WSS) measured in the main (MPA), right (RPA), and left pulmonary arteries (LPA), viscous energy loss (E) along the MPA-RPA and MPA-LPA tract, and qualitative analysis of secondary flow hemodynamics.

Loss of follow-up in transition to adult CHD: a single-centre experience.

Lapses in care during transition in adult CHD patients lead to increased morbidity and mortality. Previous studies have investigated predictors of poor follow-up in universal healthcare paradigms and select American populations. We studied patients with a wide spectrum of CHD severity within a single American centre to identify factors associated with successful internal transition and maintenance of care.

Visceral adipose inflammation in obesity is associated with critical alterations in tregulatory cell numbers.

Background: The development of insulin resistance (IR) in mouse models of obesity and type 2 diabetes mellitus (DM) is characterized by progressive accumulation of inflammatory macrophages and subpopulations of T cells in the visceral adipose. Regulatory T cells (Tregs) may play a critical role in modulating tissue inflammation via their interactions with both adaptive and innate immune mechanisms. We hypothesized that an imbalance in Tregs is a critical determinant of adipose inflammation and investigated the role of Tregs in IR/obesity through coordinated studies in mice and humans.