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The calf muscle pump is a mechanism which increases venous return and thereby compensates for the fluid shift towards the lower body during standing. During a muscle contraction, the embedded deep veins collapse and venous return increases. In the subsequent relaxation phase, muscle perfusion increases due to increased perfusion pressure, as the proximal venous valves temporarily reduce the distal venous pressure (shielding). The superficial and deep veins are connected via perforators, which contain valves allowing flow in the superficial-to-deep direction. The aim of this study is to investigate and quantify the physiological mechanisms of the calf muscle pump, including the effect of venous valves, hydrostatic pressure, and the superficial venous system. Using a one-dimensional pulse wave propagation model, a muscle contraction is simulated by increasing the extravascular pressure in the deep venous segments. The hemodynamics are studied in three different configurations: a single artery–vein configuration with and without valves and a more detailed configuration including a superficial vein. Proximal venous valves increase effective venous return by 53% by preventing reflux. Furthermore, the proximal valves shielding function increases perfusion following contraction. Finally, the superficial system aids in maintaining the perfusion during the contraction phase and reduces the refilling time by 37%. © 2015 The Authors. International Journal for Numerical Methods in Biomedical Engineering published by John Wiley & Sons Ltd.

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To assess in clinical practice arterial blood volume flow (BVF) from ultrasound measurements, the assumption is commonly made that the velocity profile can be approximated by a quasi-static Poiseuille model. However, pulsatile flow behaviour is more accurately described by a Womersley model. No clinical studies have addressed the consequences on the estimated dynamics of the BVF when Poiseuille rather than Womersley models are used. The aim of this study is to determine the influence of assumed Poiseuille profile instead of Womersley profile on the estimation and intrasubject variability of dynamical parameters of the BVF. For this purpose, a low number of volunteers sufficed. Brachial artery centerline velocity waveform and vessel diameter were measured with ultrasound within a small group of six volunteers. Within subjects, the intra-and inter-registration variability of BVF parameters estimates did not significantly differ. Poiseuille profiles compared to Womersley underestimates the maximum BVF by 19%, the maximum retrograde volume flow by 32% and the rise time by 18%. It can be concluded that when estimating in a straight vessel the dynamic properties of the BVF, Womersley profiles should preferably be chosen.

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