Wall shear stress as measured in vivo: consequences for the design of the arterial system

Based upon theory, wall shear stress (WSS), an important determinant of endothelial function and gene expression, has been assumed to be constant along the arterial tree and the same in a particular artery across species. In vivo measurements of WSS, however, have shown that these assumptions are far from valid. In this survey we will discuss the assessment of WSS in the arterial system in vivo and present the results obtained in large arteries and arterioles. In vivo WSS can be estimated from wall shear rate, as derived from non-invasively recorded velocity profiles, and whole blood viscosity in large arteries and plasma viscosity in arterioles, avoiding theoretical assumptions. In large arteries velocity profiles can be recorded by means of a specially designed ultrasound system and in arterioles via optical techniques using fluorescent flow velocity tracers. It is shown that in humans mean WSS is substantially higher in the carotid artery (1.1–1.3 Pa) than in the brachial (0.4–0.5 Pa) and femoral (0.3–0.5 Pa) arteries. Also in animals mean WSS varies substantially along the arterial tree. Mean WSS in arterioles varies between about 1.0 and 5.0 Pa in the various studies and is dependent on the site of measurement in these vessels. Across species mean WSS in a particular artery decreases linearly with body mass, e.g., in the infra-renal aorta from 8.8 Pa in mice to 0.5 Pa in humans. The observation that mean WSS is far from constant along the arterial tree implies that Murray’s cube law on flow-diameter relations cannot be applied to the whole arterial system. Because blood flow velocity is not constant along the arterial tree either, a square law also does not hold. The exponent in the power law likely varies along the arterial system, probably from 2 in large arteries near the heart to 3 in arterioles. The in vivo findings also imply that in in vitro studies no average shear stress value can be taken to study effects on endothelial cells derived from different vascular areas or from the same artery in different species. The cells have to be studied under the shear stress conditions they are exposed to in real life

A 4 year follow-up study of cognitive functioning in patients with type 2 diabetes mellitus

Contains fulltext : 90777.pdf (publisher's version ) (Open Access)AIMS/HYPOTHESIS: Type 2 diabetes mellitus is associated with moderate decrements in cognitive functioning, mainly in verbal memory, information-processing speed and executive functions. How this cognitive profile evolves over time is uncertain. The present study aims to provide detailed information on the evolution of cognitive decrements in type 2 diabetes over time. METHODS: Sixty-eight patients with type 2 diabetes and 38 controls matched for age, sex and estimated IQ performed an elaborate neuropsychological examination in 2002-2004 and again in 2006-2008, including 11 tasks covering five cognitive domains. Vascular and metabolic determinants were recorded. Data were analysed with repeated measures analysis of variance, including main effects for group, time and the group x time interaction. RESULTS: Patients with type 2 diabetes showed moderate decrements in information-processing speed (mean difference in z scores [95% CI] -0.37 [-0.69, -0.05]) and attention and executive functions (-0.25 [-0.49, -0.01]) compared with controls at both the baseline and the 4 year follow-up examination. After 4 years both groups showed a decline in abstract reasoning (-0.16 [-0.30, -0.02]) and attention and executive functioning (-0.29 [-0.40, -0.17]), but there was no evidence for accelerated cognitive decline in the patients with type 2 diabetes as compared with controls (all p > 0.05). CONCLUSIONS/INTERPRETATION: In non-demented patients with type 2 diabetes, cognitive decrements are moderate in size and cognitive decline over 4 years is largely within the range of what can be viewed in normal ageing. Apparently, diabetes-related cognitive changes develop slowly over a prolonged period of time.8 p

An IGF-I promoter polymorphism modifies the relationships between birth weight and risk factors for cardiovascular disease and diabetes at age 36

OBJECTIVE: To investigate whether IGF-I promoter polymorphism was associated with birth weight and risk factors for cardiovascular disease (CVD) and type 2 diabetes (T2DM), and whether the birth weight – risk factor relationship was the same for each genotype. DESIGN AND PARTICIPANTS: 264 subjects (mean age 36 years) had data available on birth weight, IGF-I promoter polymorphism genotype, CVD and T2DM risk factors. Student's t-test and regression analyses were applied to analyse differences in birth weight and differences in the birth weight – risk factors relationship between the genotypes. RESULTS: Male variant carriers (VCs) of the IGF-I promoter polymorphism had a 0.2 kg lower birth weight than men with the wild type allele (p = 0.009). Of the risk factors for CVD and T2DM, solely LDL concentration was associated with the genotype for the polymorphism. Most birth weight – risk factor relationships were stronger in the VC subjects; among others the birth weight – systolic blood pressure relationship: 1 kg lower birth weight was related to an 8.0 mmHg higher systolic blood pressure CONCLUSION: The polymorphism in the promoter region of the IGF-I gene is related to birth weight in men only, and to LDL concentration only. Furthermore, the genotype for this polymorphism modified the relationships between birth weight and the risk factors, especially for systolic and diastolic blood pressure

Improving the thermal dimensional stability of flexible polymer composite backing materials for ultrasound transducers

Novel ultrasound backing materials based on polymer composites with improved dimensional stability and low coefficient of thermal expansion are being developed and analyzed. For this purpose a filled epoxy resin (Stycast1265), a commonly used backing material, was considered reference material and polyurethane composites (PU2305, PU2350) were proposed as better alternatives. When compared to the reference, the PU2350 filled with a mixture of Al2O3 and tungsten exhibited an approximately 15 times lower glassy transition temperature and a 2.5 time lower longitudinal thermal expansion at 20 °C. This ensures that within the entire operational temperature range the backing material is flexible, minimizing the thermal stresses induced onto transducer elements soldered joints and piezoceramic core. For the same material, the attenuation at 5 MHz was similar to the reference material while at 7 and 8.5 MHz it was 33% and 54% higher respectively. From these analyses it is concluded that the newly developed polyurethane composites outperform the reference backing with respect to the thermal dimensional stability as well as to the damping properties. An integrated rigorous mechano-acoustical approach is being proposed as an appropriate passive material design path. It can be easily extended to any other passive materials used for ultrasound transducer conception. © 2009 Elsevier B.V. All rights reserved

Assessment of wall shear rate measurements with ultrasound

An experimental investigation of steady flow of a red blood cell suspension downstream of a backward-racing step is presented. The velocity and shear rate distribution in this geometry can be regarded as representative for flow in large- and medium-sized curved and bifurcation arteries. The velocity distribution is measured by means of ultrasound velocimetry. In analogy to clinical procedures, the maximum value of the first derivative of measured velocity profile relative to the vessel diameter is used to estimate wall shear rate. A numerical investigation of the velocity field is presented to validate the procedure to determine the wall shear rate. Both an inelastic non-Newtonian shear thinning model, accounting for the shear-rate-dependent viscosityn of the red blood cell suspension, and a Newtonian model, based on a characteristic viscosity, are applied to compute the velocity field. In general, comparison of the numerical and experimental results reveals that the velocity distribution of the red blood cell suspension can be described quite accurately by the computational models. At near-wall sites, however, some deviations are found that can be attributed to the experimental technique. The clinical procedure to determine shear rates yields an accurate prediction of the shear rate in central part of the channel. At a certain distance from the wall, however, the procedure underestimates shear rates. This distance is related to the dimensions of the ultrasound sample volume. Thew actual wall shear rate in fully dveloped flow in the experimental setup is underestimated by approximately 25

Nonuniform multilayered phased array for medical imaging

No abstract