A numerical study of flow in curved tubes simulating coronary arteries

Numerical simulations of pulsatile flow in coronary arteries which take into account the curvature associated with the bending of arteries over the surface of the heart are presented for resting, excited and drug induced states. The study was motivated by reported observations of atherosclerotic plaque localization on the inner curvature of coronary arteries. The simulated flow field appears quasi-steady under resting conditions with wall shear stress always highest on the outside wall and only a single secondary flow vortex in the half tube. However, reversal of wall shear stress direction at the inside wall does occur under resting flow conditions and this is not a quasi-steady characteristic. The flow field is markedly unsteady under excited conditions with wall shear stress sometimes peaking on the inside wall and an increase in the magnitude of wall shear stress reversal on the inside wall. However, only a single secondary flow vortex in the half tube is observed. Implications of the simulations for the role of fluid mechanics in coronary artery atherosclerosis are also discussed.