Frequency dependence of dynamic curvature effects on flow through coronary arteries

The flow through a curved tube model of a coronary artery was investigated computationally to determine the importance of time-varying curvature on flow patterns that have been associated with the development of atherosclerosis. The entry to the tube was fixed while the radius of curvature varied sinusoidally in time at a frequency of 1 or 5 Hz. Angiographic data from other studies suggest that the radius of curvature waveform contains significant spectral content up to 6 Hz. The overall flow patterns were similar to those observed in stationary curved tubes; velocity profile skewed toward the outer wall, secondary flow patterns, etc. The effects of time-varying curvature on the changes in wall shear rate were expressed by normalizing the wall shear rate amplitude with the shear rate calculated at the static mean radius of curvature. It was found that the wall shear rate varied as much as 94 percent of the mean wall shear rate at the mid wall of curvature for a mean curvature ratio of 0.08 and a 50 percent change in radius of curvature. The effects of 5 Hz deformation were not well predicted by a quasi-static approach. The maximum values of the normalized inner wall shear rate amplitude were found to scale well with a dimensionless parameter equivalent to the product of the mean curvature ratio (delta), normalized change in radius of curvature (epsilon), and a Womersley parameter (alpha). This parameter was less successful at predicting the amplitudes elsewhere in the tube, thus additional studies are necessary. The mean wall shear rate was well predicted with a static geometry. These results indicate that dynamic curvature plays an important role in determining the inner wall shear rates in coronary arteries that are subjected to deformation levels of epsilon delta alpha > 0.05. The effects were not always predictable with a quasi-static approach. These results provide guidelines for constructing more realistic models of coronary artery flow for atherogenesis research.     

Numerical simulation of sinusoidal flow in a straight elastic tube: effects of phase angles

Numerical simulations of flow in straight elastic (moving wall) tubes subjected to a sinusoidal pressure gradient were performed for conditions prevailing in large and medium sized arteries. The effects of varying the phase angle between the pressure gradient and the tube radius, the amplitude of wall motion, and the unsteadiness parameter (alpha) on flow rate and wall shear stress were investigated. Mean and peak flow rates and shear stresses were found to be strongly affected by the phase angle between the pressure gradient and the tube radius with greater sensitivity at higher diameter variation and higher alpha. In large artery simulations (alpha = 12), means flow rate was found to be 60% higher and peak flow rate to be 73% higher than corresponding rigid tube values for certain phase angles, while a threefold increase in mean wall shear stress and sevenfold increase in peak wall shear stress were observed in a sensitive phase angle range. Significant reversal in the wall shear stress direction occurred in the sensitive phase angle range even when there was negligible flow rate reversal. All effects were greatly diminished in simulations of medium sized vessels (alpha = 4). Some experimental evidence to support the predictions of a strong effect of phase angle on wall shear stress in large vessels is presented. Finally, physiological implications of the present work are discussed from a basis of aortic input impedance data, and a physical explanation for the extreme sensitivity of the flow field to small amplitude wall motion at high alpha is given.     

The impedance of curved artery models

The impedance (pressure drop/flow rate) of four curved artery models has been determined experimentally for steady and periodic flows simulating conditions in the aortic arch. Steady flow results indicate that very short entry lengths are required for flow development in curved artery models, and impedance is elevated above straight tube values by a factor of 3-4 for mean flow conditions in the aortic arch. Results for periodic flow with a nonzero mean show a significant elevation of mean flow impedance relative to values for steady flow at the mean flow rate--a factor of 2-3 for aortic arch flow conditions. The impedance of the first harmonic of periodic flows follows straight tube theory at high values of the unsteadiness parameter in agreement with available theory for curved tubes. The implications of the impedance measurements for wall shear stress in the aortic arch are discussed.     

Effect of hematocrit on wall shear rate in oscillatory flow: do the elastic properties of blood play a role?

Porcine blood was used to examine the relationship between hematocrit levels and wall shear rate patterns in straight and curved artery models under fixed oscillatory flow conditions characteristic of larger arteries. It is demonstrated that porcine blood models both the viscous and elastic components of the 2 Hz complex viscosity of human blood quite accurately over a broad range of shear rates (1-1000 s-1) and hematocrits (20%-80%). For a fixed oscillatory flow waveform (Poiseuille peak shear rate = 168 s-1; mean shear rate 84 s-1), increases in hematocrit produced a decrease in the peak wall shear rate in both the straight and curved artery models and a corresponding decrease in wall shear rate reversal on the inside wall of the curved artery model. The same trends were also observed for oscillatory flows of aqueous glycerin solutions of increasing viscosity in the range of viscosity of the blood samples tested. Aqueous glycerin solutions produced wall shear rate waveforms of the same magnitude and shape as the porcine blood. This indicates that variations in the shear rate, and therefore the shear stress, were caused primarily by changes in the viscous and not the elastic properties of blood. The results suggest that simple Newtonian fluids may be sufficient for in vitro determination of the first order effects to be expected of human blood flow in large vessels having complex geometries and shear rates in or above the range of the present study.     

Measurement of oscillatory flow pressure gradient in an elastic artery model

In vitro experiments were conducted to measure the oscillatory flow pressure gradient along an elastic tube in order to assess the recent nonlinear theory of Wang and Tarbell. According to this theory, in an elastic tube with oscillatory flow, the mean (time-averaged) pressure gradient cannot be calculated using Poiseuille's law. The effect of wall motion creates a nonlinear convective acceleration, and an induced mean pressure gradient is required to balance the convective acceleration. The induced mean pressure gradient depends on the diameter variation over a cycle, the pulsatility and unsteadiness of the flow, and the phase difference between the pressure wave form and the flow wave form. The amplitude of the pressure gradient also depends on these parameters and may deviate significantly from Womersley's rigid tube theory. A flow loop was constructed to produce oscillatory flow in an elastic tube. Flow wave forms were measured with an ultrasonic flow probe, and ultrasonic diameter crystals were used to measure wall movement. A special device for pressure drop measurement was constructed using Millar catheter tip transducers to obtain both forward and backward pressure drops that were then averaged. This averaging method eliminated the static error of the pressure transducers. The pressure-flow phase angle was varied by clamping a distal elastic section at various locations. Pressure gradients were obtained for a range of phase angles between −55 ° and +49 °. The mean and amplitude of the measured pressure gradient were compared to theoretical values. Both positive and negative induced mean pressure gradients were measured over the range of phase angles. The measured pressure gradient amplitudes were always lower than predicted by Womersley's rigid tube theory. The experimental means and amplitudes are in good agreement with the elastic tube theoretical values. Thus, the experiments verify the theory of Wang and Tarbell.     

Pressure drop and flow rate measurements in a human aortic bifurcation cast for steady and pulsatile flow

Pressure drop and flow rate measurements in a rigid cast of a human aortic bifurcation under both steady and physiological pulsatile flow conditions are reported. Integral momentum and mechanical energy balances are used to calculate impedance, spatially averaged wall shear stress and viscous dissipation rate from the data. In the daughter branches, steady flow impedance is within 30% of the Poiseuille flow prediction, while pulsatile flow impedance is within a factor of 2 of fully developed, oscillatory, straight tube flow theory (Womersley theory). Estimates of wall shear stress are in accord with measurements obtained from velocity profiles. Mean pressure drop and viscous dissipation rate are elevated in pulsatile flow relative to steady flow at the mean flow rate, and the exponents of their Reynolds number dependence are in accord with available theory.     

Dynamic curvature strongly affects wall shear rates in a coronary artery bifurcation model

This study was motivated by the need for a better understanding of coronary artery blood flow patterns and their possible role in atherosclerosis formation. Of particular interest in this study was the effects of the dynamic deformation due to myocardial contraction on wall shear rate patterns in the coronary arteries. A better understanding of these effects on wall shear rate in a bifurcation geometry and an evaluation of the importance of these effects was desired. A three-dimensional computer model of a bifurcation lying on the surface of a sphere with time-varying radius of curvature was employed to simulate the motion and deformation of the arteries. The results indicated low mean shear rates along the myocardial wall and very high shear rate variations (over 100% of the static mean shear rate) along the outer wall. The results obtained using a quasi-static analysis were found to underestimate the dynamic wall shear rate variation along the myocardial and outer walls. It was concluded that dynamic geometry effects are important in determining sites of low mean and oscillating wall shear that have been associated with atherogenesis in curved, bifurcating arteries.     

Numerical analysis of flow in an elastic artery model.

Oscillatory and pulsatile flows of Newtonian fluids in straight elastic tubes are simulated numerically with the aid of Ling and Atabek's "local flow" assumption for the nonlinear convective acceleration terms. For the first time, a theoretical assessment of the local flow assumption is presented, and the range of validity of the assumption is estimated by comparison with perturbation solutions of the complete flow problem. Subsequent simulations with the local flow model indicate that the flow field and associated wall shear stress are extremely sensitive to the phase angle between oscillatory pressure and flow waves (impedance phase angle). This phase angle, which is a measure of the wave reflection present in the system, is known to be altered by arterial disease (e.g., hypertension) and vasoactive drugs. Thus, the paper elucidates a mechanism by which subtle changes in systemic hemodynamics (i.e., phase angles) can markedly influence local wall shear stress values.     

Effects of wall shear stress and its gradient on tumor cell adhesion in curved microvessels

Tumor cell adhesion to vessel walls in the microcirculation is one critical step in cancer metastasis. In this paper, the hypothesis that tumor cells prefer to adhere at the microvessels with localized shear stresses and their gradients, such as in the curved microvessels, was examined both experimentally and computationally. Our in vivo experiments were performed on the microvessels (post-capillary venules, 30–50 μm diameter) of rat mesentery. A straight or curved microvessel was cannulated and perfused with tumor cells by a glass micropipette at a velocity of ~1mm/s. At less than 10 min after perfusion, there was a significant difference in cell adhesion to the straight and curved vessel walls. In 60 min, the averaged adhesion rate in the curved vessels (n = 14) was ~1.5-fold of that in the straight vessels (n = 19). In 51 curved segments, 45% of cell adhesion was initiated at the inner side, 25% at outer side, and 30% at both sides of the curved vessels. To investigate the mechanical mechanism by which tumor cells prefer adhering at curved sites, we performed a computational study, in which the fluid dynamics was carried out by the lattice Boltzmann method , and the tumor cell dynamics was governed by the Newton’s law of translation and rotation. A modified adhesive dynamics model that included the influence of wall shear stress/gradient on the association/dissociation rates of tumor cell adhesion was proposed, in which the positive wall shear stress/gradient jump would enhance tumor cell adhesion while the negative wall shear stress/gradient jump would weaken tumor cell adhesion. It was found that the wall shear stress/gradient, over a threshold, had significant contribution to tumor cell adhesion by activating or inactivating cell adhesion molecules. Our results elucidated why the tumor cell adhesion prefers to occur at the positive curvature of curved microvessels with very low Reynolds number (in the order of 10⁻²) laminar flow.     

The effect of angle and flow rate upon hemodynamics in distal vascular graft anastomoses: an in vitro model study.

A steady flow, in vitro model of distal arterial bypass graft junctions was used to examine the effects of junction angle and flow rate on the local velocity field. Three test sections were fabricated from Plexiglas tubing having anastomotic junction angles of either 30, 45, or 60 deg. Flow visualization revealed velocity profiles skewed toward the outer wall with a flow split around a clear stagnation point along the outer wall. Laser Doppler anemometry [LDA] measurements confirmed a distinct stagnation point at the outer wall and both reverse and forward shear were detected immediately upstream and downstream, respectively, of this site. Axial velocities and shear rates along the outer wall were higher than along the inner wall and occurred in the junction angle order: 45, 60, and 30 deg. This study clearly identified changes in wall shear which varied with the anastomotic angle and flow rate.     

Oscillatory flow of blood in a stenosed artery

In order to understand the abnormal flow conditions of blood in a locally constricted blood vessel, the analytical results are obtained for the oscillatory flow of blood which behaves as a Newtonian fluid. It is here assumed that the surface roughness is cosine-shaped and the maximum height of the roughness is very small compared with the radius of the unconstricted tube. Numerical solutions are presented for the instantaneous flow rate, resistive impedance, wall shear stress and phase lag.     

Computational fluid dynamics study of common stent models inside idealised curved coronary arteries

The haemodynamic behaviour of blood inside a coronary artery after stenting is greatly affected by individual stent features as well as complex geometrical properties of the artery including tortuosity and curvature. Regions at higher risk of restenosis, as measured by low wall shear stress (WSS < 0.5 Pa), have not yet been studied in detail in curved stented arteries. In this study, three-dimensional computational modelling and computational fluid dynamics methodologies were used to analyse the haemodynamic characteristics in curved stented arteries using several common stent models. Results in this study showed that stent strut thickness was one major factor influencing the distribution of WSS in curved arteries. Regions of low WSS were found behind struts, particularly those oriented at a large angle relative to the streamwise flow direction. These findings were similar to those obtained in studies of straight arteries. An uneven distribution of WSS at the inner and outer bends of curved arteries was observed where the WSS was lower at the inner bend. In this study, it was also shown that stents with a helical configuration generated an extra swirling component of the flow based on the helical direction; however, this extra swirl in the flow field did not cause significant changes on the distribution of WSS under the current setup.     

Laser Doppler anemometer measurements of pulsatile flow in a model carotid bifurcation

Hemodynamics at the human carotid bifurcation is important to the understanding of atherosclerotic plaque initiation and progression as well as to the diagnosis of clinically important disease. Laser Doppler anemometry was performed in a large scale model of an average human carotid. Pulsatile waveforms and physiologic flow divisions were incorporated. Disturbance levels and shear stresses were computed from ensemble averages of the velocity waveform measurements. Flow in the common carotid was laminar and symmetric. Flow patterns in the sinus, however, were complex and varied considerably during the cycle. Strong helical patterns and outer wall flow separation waxed and waned during each systole. The changing flow patterns resulted in an oscillatory shear stress at the outer wall ranging from -13 to 9 dyn cm-2 during systole with a time-averaged mean of only -0.5 dyn cm-2. This contrasts markedly with an inner wall shear stress range of 17-50, (mean 26) dyn cm-2. The region of transient separation was confined to the carotid sinus outer wall with no reverse velocities detected in the distal internal carotid. Notable disturbance velocities were also time-dependent, occurring only during the deceleration phase of systole and the beginning of diastole. The present pulsatile flow studies have aided in identifying hemodynamic conditions which correlate with early intimal thickening and predict the physiologic level of flow disturbances in the bulb of undiseased internal carotid arteries.     

Mechanical mechanisms of thrombosis in intact bent microvessels of rat mesentery

The hypothesis that thrombus can be induced by localized shear stresses/rates, such as in the bent/stretched microvessels, was tested both experimentally and computationally. Our newly designed in vivo experiments were performed on the microvessels (post-capillary venules, 20-50mum diameter) of rat mesentery. These microvessels were bent/stretched with no/minimum injuries. In less than 60min after the microvessels were bent/stretched, thrombi were formed in 19 out of 61 bent locations (31.1%). Interestingly, thrombi were found to be initiated at the inner wall of the curvature in these bent/stretched vessels. To investigate the mechanical mechanisms of thrombus induction, we performed a 3-D computational simulation using commercial software, FLUENT. To simulate the bending and stretching, we considered the vessels with different curvatures (0 degrees , 90 degrees and 180 degrees ) as well as different shaped cross-sections (circular and elliptic). Computational results demonstrated that the highest shear stress/rate and shear stress/rate gradient are located at the inner wall of the curved circular-shaped vessels. They are located at the two apexes of the wall with shorter axis for the 0 degrees (straight) elliptic-shaped vessel and towards the inner side when the vessels are bent. The differences of the shear stresses/rates and of the shear stress/rate gradients between the inner and outer walls become larger in more bent and elliptic-shaped microvessels. Comparison of our experimental and numerical simulation results suggests that the higher shear stress/rate and the higher shear stress/rate gradient at the inner wall are responsible for initiating the thrombosis in bent post-capillary venules.     

Convection-diffusion interaction for oscillatory flow in a tapered tube

Transport of soluble material is analyzed for volume-cycle oscillatory flow in a tapered tube. The equations of motion are solved using a regular perturbation method for small taper angle and order unity amplitude over a range of the Womersley parameter. The transport equation is also solved by a regular perturbation method where uniform end concentrations and no wall flux are assumed. The time-averaged axial transport of solute is calculated for several tapered tubes. There is substantial modification of transport compared to the straight tube case and the results are interpreted with respect to pulmonary gas exchange.     

The Influence of Drag on Nonlinear Oscillatory Flow through Concentric Annulus

A mathematical model has been developed to study the effect of particle drag parameter and frequency parameter on velocity and pressure gradient in nonlinear oscillatory two phase flow. The main purpose is to apply the model to study the combined effect of introduction of the catheter and elastic properties of the arterial wall on the pulsatile nature of the blood flow. We model the artery as an isotropic thin walled elastic tube and the catheter as a coaxial flexible tube. Blood is modeled as an incompressible particulate viscous Newtonian fluid. Perturbation technique has been applied to find the approximations for velocity and pressure gradient up to second order. Numerical solutions are investigated with graphical presentations to understand the effects of drag parameter, frequency parameter and phase angle on velocity along radial direction and pressure gradient along axial directions. As the drag parameter increases, mean pressure gradient and mean velocity will be decreased. As frequency parameter increases mean velocity profile bends near the outer wall. Due to elastic nature of artery wall, a thin catheter experience small oscillations and a thick catheter remains stationary inside the artery. Finally, the effect of catheterization on various physiologically important flow rate characteristics—mean velocity, mean pressure gradient are studied for a range of different catheter sizes, particle drag parameter and frequency parameters.     

Influence of bifurcations on forced oscillations in an airway model.

Forced oscillations is a technique to determine respiratory input impedance from small amplitude sinusoidal pressure excursions introduced at the airway opening. Models used to predict respiratory input impedance typically ignore the direct effect of bifurcations on the flow, and treat airway branches as individual straight tubes placed appropriately in parallel and series. The flow within the individual tubes is assumed equivalent to that which would occur in infinitely long tubes. In this study we examined the influence of bifurcations on impedance for conditions of the forced oscillatory technique. We measured input impedance using forced oscillations in straight tubes and in an anatomically-relevant, four generation physical model of a human airway network. The input impedance measured experimentally compared well to that obtained theoretically using model predictions. The predictive scheme was based on appropriate parallel and series combinations of theoretically computed individual tube impedances, which were computed from solutions to oscillatory flow of a compressible gas in an infinitely long rigid tube. The agreement between experimental measurements and predictions indicates that bifurcations play a relatively minor direct role on the flow impedance for conditions of the forced oscillations technique. These results are explained in terms of the small tidal volumes used, whereby the axial distance traveled by a fluid particle during an oscillation cycle is appreciably smaller than branch segment lengths. Accordingly, only a small fraction of fluid particles travel through the bifurcation region, and the remainder experience an environment approaching flow in an infinite straight tube. The relevance of the study to the prediction of impedances in the human lung during forced oscillations is discussed.     

Oscillatory flow and gas transport through a symmetrical bifurcation

Axial gas transport due to the interaction between radial mixing and radially nonuniform axial velocities is responsible for gas transport in thick airways during High-frequency oscillatory ventilation (HFO). Because the airways can be characterized by a bifurcating tube network, the secondary flow in the curved portion of a bifurcating tube contributes to cross-stream mixing. In this study the oscillatory flow and concentration fields through a single symmetrical airway bifurcating tube model were numerically analyzed by solving three-dimensional Navier-Stokes and mass concentration equations with the SIMPLER algorithm. The simulation conditions were for a Womersley number, alpha = 9.1 and Reynolds numbers in the parent tube between 200 and 1000, corresponding to Dn2/alpha 4 in the curved portion between 2 and 80, where Dn is Dean number. For comparison with the results from the bifurcating tube, we calculated the velocity and concentration fields for fully developed oscillatory flow through a curved tube with a curvature rate of 1/10, which is identical to the curved portion of the bifurcating tube. For Dn2/alpha 4 < or = 10 in the curved portion of the bifurcating tube, the flow divider and area changes dominate the axial gas transport, because the effective diffusivity is greater than in either a straight or curved tube, in spite of low secondary velocities. However, for Dn2/alpha 4 > or = 20, the gas transport characteristics in a bifurcation are similar to a curved tube because of the significant effect of secondary flow.     

Blood flow in small curved tubes

Blood flow in small curved tubes is modeled by the two-fluid model where a relatively cell-free fluid layer envelops a fluid core of higher viscosity. The parameters in the model are successfully curve fitted to experimental data for straight tubes. The curved tube equations are then solved by perturbation theory. It was found that curvature in general lowers the tube resistance, but increases the shear stress near the inside wall.     

Numerical investigation of physiologically realistic pulsatile flow through arterial stenosis

Numerical simulations of pulsatile blood flow in straight tube stenosis models were performed to investigate the poststenotic flow phenomena. In this study, three axisymmetrical and three asymmetrical stenosis models with area reduction of 25%, 50% and 75% were constructed. A measured human common carotid artery blood flow waveform was used as the upstream flow condition which has a mean Reynold's number of 300. All calculations were performed with high spatial and temporal resolutions. Flow features such as velocity profiles, flow separation zone (FSZ), and wall shear stress (WSS) distributions in the poststenotic region for all models are presented. The results have demonstrated that the formation and development of FSZs in the poststenotic region are very complex, especially in the flow deceleration phase. In axisymmetric stenoses the poststenotic flow is more sensitive to changes in the degree of stenosis than in asymmetric models. For severe stenoses, the stenosis influence length is shorter in asymmetrical models than in axisymmetrical cases. WSS oscillations (between positive and negative values) have been observed at various downstream locations in some models. The amplitude of the oscillation depends strongly on the axial location and the degree of stenosis.