title: No inflammatory response related to pulmonary hemodynamics in children with systemic to pulmonary shunts.
abstract: OBJECTIVE
  The hypothesis was that the levels of circulating inflammatory mediators are related to the degree of volume and pressure stress on the pulmonary vasculature in children with congenital systemic to pulmonary shunts.
  
  
  METHODS
  Prospective, cross-sectional study.
  
  
  METHODS
  Tertiary center covering all pediatric heart surgery and interventions in Norway.
  
  
  METHODS
  Seventy-four children, aged 0-12 years, admitted for surgical or interventional treatment of congenital systemic to pulmonary shunts.
  
  
  METHODS
  Plasma levels of eight mediators of vascular inflammation and endothelial activation, sampled from different vascular compartments.
  
  
  RESULTS
  Patients with the most pronounced pulmonary flow and pressure stress demonstrated no elevation of inflammatory mediator levels when compared with healthy controls. No pulmonary production or uptake of the measured markers was found. Hemodynamic explanatory factors showed weak correlations to the inflammatory marker levels by univariate analysis. Age was the only factor that significantly explained inflammatory response in the multivariate model. The presence of Down syndrome, irrespective of hemodynamic category, was associated with elevated plasma levels of soluble tumor necrosis factor receptor I, when controlling for age.
  
  
  CONCLUSIONS
  Inflammatory mediators show no significant relationship to pulmonary hemodynamics in children with systemic to pulmonary shunts. Children with Down syndrome may have an increased inflammatory response.
authors: Unit for Pediatric Heart, Lung and Allergic Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway. henrik.brun@oslo-universitetssykehus.no
authors: Henrik
authors: H
authors: Brun
authors: Thor
authors: T
authors: Ueland
authors: Erik
authors: E
authors: Thaulow
authors: Jan K
authors: JK
authors: Damas
authors: Arne
authors: A
authors: Yndestad
authors: Pal
authors: P
authors: Aukrust
authors: Henrik
authors: H
authors: Holmstrøm
mesh_terms: D000367:Age Factors; D001794:Blood Pressure; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004314:Down Syndrome / Q000276:immunology / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000276:immunology; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007249:Inflammation / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood*; D016014:Linear Models; D008297:Male; D009664:Norway; D011446:Prospective Studies; D011652:Pulmonary Circulation; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D018836:Inflammation Mediators