Three-dimensional blood flow in bifurcations : computational and experimental analyses and clinical applications

In this report, the issues discussed at a multidisciplinary symposium on blood flow in bifurcations are summarized. Topics adressed are (1) flow analysis in vitro models, using visualization and laser Doppler anemometer techniques, and numerical models; (2) the influence of (physiological) factors, such as vessel wall distensibility and vessel geometry, on the flow field; (3) the noninvasive assessment of arterial wall properties in humans, and (4) the noninvasive determination of flow patterns in humans, paying special attention to ultrasound techniques and magnetic resonance imaging. It was empasized that it is of utmost importance to obtain more detailed information, preferably three-dimensional, about flow field in bifurcations, not only from a diagnostic point of view but also to get more insight into the relation, if any, in between flow patterns and atheregenesis. It was agreed that plaque geometry and dynamics should be studied in more detail, especially in relation to plaque fissuring and rupturing. There is a need for the noninvasive assessment of wall shear rate and, hence, to be able to calculate wall shear stress, because these parameters have been shown to be important determinants of endothelial cell function

Human genetics and genomics a decade after the release of the draft sequence of the human genome

10.1186/1479-7364-5-6-577Human Genomics56577-62

Exome sequencing: A transient technology for molecular diagnostics?

10.1586/erm.12.3Expert Review of Molecular Diagnostics123211-214ERMD

The 'sequence everything' approach and personalized clinical decision challenges

10.1586/erm.12.20Expert Review of Molecular Diagnostics124319-322ERMD

From the periphery to centre stage: De novo single nucleotide variants play a key role in human genetic disease

10.1136/jmedgenet-2013-101519Journal of Medical Genetics504203-211JMDG

Haemodynamic flow conditions at the initiation of high-shear platelet aggregation: a combined in vitro and cellular in silico study

The influence of the flow environment on platelet aggregation is not fully understood in high-shear thrombosis. The objective of this study is to investigate the role of a high shear rate in initial platelet aggregation. The haemodynamic conditions in a microfluidic device are studied using cell-based blood flow simulations. The results are compared with in vitro platelet aggregation experiments performed with porcine whole blood (WB) and platelet-rich-plasma (PRP). We studied whether the cell-depleted layer in combination with high shear and high platelet flux can account for the distribution of platelet aggregates. High platelet fluxes at the wall were found in silico. In WB, the platelet flux was about twice as high as in PRP. Additionally, initial platelet aggregation and occlusion were observed in vitro in the stenotic region. In PRP, the position of the occlusive thrombus was located more downstream than in WB. Furthermore, the shear rates and stresses in cell-based and continuum simulations were studied. We found that a continuum simulation is a good approximation for PRP. For WB, it cannot predict the correct values near the wall