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In Glenn patients, we quantified pulsatility loss in each dimension of force (flow, pressure, and stretch) using cardiac catheterization and MRI. To model and investigate the individual impact of each dimension of pulsatility loss on the pulmonary vasculature, we applied isolated pulsatile and non-pulsatile mechanical stimuli to pulmonary arterial endothelial cells (ECs) in vitro. We found that each dimension of force triggered distinct transcriptional responses, revealing force-specific regulation of structural and signaling pathways. Pulsatile stretch uniquely stimulated EC secretion of PDGFB, a key driver of vascular smooth muscle cell (vSMC) recruitment. In a rat Glenn model, loss of pulsatility led to vascular wall thinning, confirming\n                  <jats:italic>in vivo<\/jats:italic>\n                  relevance. Our findings uncover a mechanistic link between endothelial stretch sensing and PDGFB-mediated EC-vSMC crosstalk, essential for maintaining pulmonary artery architecture. Clinically, these insights suggest that restoring or mimicking pulsatile forces may help preserve vascular integrity and prevent remodeling in SV-CHD patients.\n                <\/jats:p>","DOI":"10.1101\/2025.06.30.662470","type":"posted-content","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T17:20:18Z","timestamp":1751476818000},"source":"Crossref","is-referenced-by-count":0,"title":["Pulsatile flow dynamics maintain pulmonary arterial architecture"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0615-7626","authenticated-orcid":false,"given":"Stephen","family":"Spurgin","sequence":"first","affiliation":[{"name":"Department of Molecular Biology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas, USA 75390"},{"name":"Department of Pediatrics, Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas, USA 75390"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Thai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas, USA 75390"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Cardiology, Medical College of Wisconsin, Children\u2019s Wisconsin, Herma Heart Institute, Milwaukee, Wisconsin, USA"},{"name":"Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4144-4180","authenticated-orcid":false,"given":"Christopher P.","family":"Chaney","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Division of Nephrology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas, USA 75390"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0549-2473","authenticated-orcid":false,"given":"Mitzy A.","family":"Cowdin","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas, USA 75390"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suren V.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas, USA 75390"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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