Evaluation of Shear-Induced Platelet Activation Models Under Constant and Dynamic Shear Stress Loading Conditions Relevant to Devices

摘要: The advent of implantable blood-recirculating devices such as left ventricular assist and prosthetic heart valves provides a viable therapy for patients with end-stage failure valvular disease. However, device-generated pathological flow patterns result in thromboembolic complications that require complex lifelong anticoagulant therapy, which entails hemorrhagic risks is not appropriate certain patients. Optimizing the thrombogenic performance utilizing numerical simulations requires development predictive platelet activation models account variations shear-loading rates characterizing blood through devices. Platelets were exposed vitro to both dynamic constant shear stress conditions emulating those found order determine their shear-induced sensitization response. Both these behaviors be dependent on loading rates, addition magnitude exposure time. We then critically examined several current evaluated capabilities using results. Shear rate terms included aspects are either ignored or partially considered by models, model parameters optimized. Independent optimization each two types tested resulted different sets best-fit constants, indicating universal may possible. Inherent limitations paradigm shift from integral-based discretized power law better address encountered