Effect of stenosis shape on the post-stenotic pressure fluctuations and the sound emitted from a constricted blood vessel is studied numerically. Large eddy simulations are performed using OpenFOAM under pulsatile flow conditions with a non-Newtonian fluid model. Findings indicate that the high slope at the stenosis entrance and overlap of more than one stenosis shorten the length of the flow jet, trigger turbulence, and increase vortical activity, turbulent kinetic energy, and magnitude of pressure fluctuations at the post-stenotic region. Also, these morphological parameters strengthen the audible signal especially in the systolic phase of the pulsatile flow. On the other hand, asymmetry of the stenosis creates an opposite effect. Based on the wall pressure data, it is shown that the stenosis shape affects the intensity and the pattern of the murmurs generated. Stenosis shape is found to be an essential factor for the acoustic-based non-invasive diagnosis of stenosis.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Benjamin EJ, Virani SS, Callaway CW, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R and Ferranti SD (2018) “Heart disease and stroke statistics - 2018 update,” American Heart Association.
Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund K, Haase N, Ho M, Howard V, Kissela B, Kittner S, Lloyd-Jones D, McDermott M, Meigs J, Moy C, Nichol G, O’Donnell CJ, Roger V, Rumsfeld J, Sorlie P, Steinberger J, Thom T, Wasserthiel-Smoller S, Hong Y (2007) Heart disease and stroke statistics - 2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 115(5):69–171
Feigin V (2005) Stroke epidemiology in the developing world. Lancet 365(9478):2160–2161
Lees RS, Dewey CF (1970) Phonoangiography: a new noninvasive diagnostic method for studying arterial disease. Proc Natl Acad Sci U S A 67(2):935–942
Ask P, Hok B, Lyod D, Terio H (1995) Bio-acoustic signals from stenotic tube flow: state of the art and perspectives for future methodological development. Med Biol Engng Comput September 33(5):669–675
Fredberg J (1974) Pseudo-sound generation at atherosclerotic constrictions in arteries. Bull Math Biol 36(2):143–155
Jones SA, Fronek A (1987) Analysis of break frequencies downstream of a constriction in a cylindrical tube. J Biomech 20:319–327
Borisyuk AO (1999) Noise field in the human chest due to turbulent flow in a larger blood vessel. Flow Turbul Combust 61:269–284
Borisyuk AO (2002) Experimental study of noise produced by steady flow through a simulated vascular stenosis. J Sound Vib 256:475–498
Mittal R, Simmons S, Najjar F (2003) Numerical study of pulsatile flow in a constricted channel. J Fluid Mech 485:337–378
Kistler JP, Lees RS, Friedman J, Pressin M, Mohr JP, Roberson GS, Ojeman RG (1977) The bruit of carotid stenosis versus radiated basal heart murmurs. Circulation 57:975–981
Evans DH, Barrie WW, Asher MJ, Bentley S, Bell PRF (1980) The relationship between ultrasonic pulsatility index and proximal arterial stenosis in a canine model. Circ Res 46:470–475
Knox R, Breslau P, Strandness DE (1981) Quantitative carotid phonoangiography. Stroke 12:798–803
Johnson GR, Myers GS, Lees RS (1985) Evaluation of aortic stenosis by spectral analysis of the murmur. J Am Coll Cardiol 6(1):55–63
Sung PH, Kan CD, Chen WL, Jang LS, Wang JF (2015) Hemodialysis vascular access stenosis detection using auditory spectro-temporal features of phonoangiography. Med Biol Eng Comput 53:393–403
Lee SE, Lee SW, Fischer PF, Bassiouny HS, Loth F (2008) Direct numerical simulation of transitional flow in a stenosed carotid bifurcation. J Biomech 41:2551–2561
Seo JH, Mittal R (2012) A coupled flow-acoustic computational study of bruits from a modeled stenosed artery. Med Biol Eng Comput 50:1025–1035
Yazicioglu Y, Royston TJ, Spohnholtz T, Martin B, Loth F, Bassiouny HS (2005) Acoustic radiation from a fluid-filled, subsurface vascular tube with internal turbulent flow due to a constriction. J Acoust Soc Am 118(2):1193–1209
Salman HE, Sert C, Yazicioglu Y (2013) Computational analysis of high frequency fluid–structure interactions in constricted flow. Comput Struct 122:145–154
Salman HE, Yazicioglu Y (2017) Flow-induced vibration analysis of constricted artery models with surrounding soft tissue. J Acoust Soc Am 142:1913–1925
Ozden K, Sert C and Yazicioglu Y (2018) “Numerical investigation of wall pressure fluctuations downstream of ideal and realistic stenosed vessel models,” in CMBBE, Lisbon.
Mandal PK, Chakravarty S, Mandal A (2007) Numerical study of the unsteady flow of non- Newtonian fluid through differently shaped arterial stenoses. Int J Comp Math ISSN 84:1059–1077
Jeong WW, Rhee K (2009) Effects of surface geometry and non-newtonian viscosity on the flow field in arterial stenoses. J Mech Sci Technol 23:2424–2433
Singh S, Shah RR (2010) A numerical model for the effect of stenosis shape on blood flow through an artery using power-law fluid. Adv Appl Sci Res 1:66–73
Singh AK (2012) Effects of shape parameter and length of stenosis on blood flow through improved generalized artery with multiple stenoses. Adv Appl Math Biosci 3:41–48
Belzacq T, Avril S, Leriche E, Delache A (2014) Mechanical action of the blood onto atheromatous plaques: influence of the stenosis shape and morphology. Comp Methods Biomech Biomed Eng 17:527–538
Kelidis P, Konstantinidis E (2018) Pulsatile flow through a constricted tube: effect of stenosis morphology on hemodynamic parameters. Comput Methods Biomech Biomed Engin:1–9
Doutel E, Carneiro J, Campos JBLM, Miranda JM (2018) Artificial stenoses for computational hemodynamics. Appl Math Model 59:427–440
Lorenzini G, Casalena E (2008) CFD analysis of pulsatile blood flow in an atherosclerotic human artery with eccentric plaques. J Biomech 41:1862–1870
Bhaganagar K, Veeramachaneni C, Moreno C (2013) Significance of plaque morphology in modifying flow characteristics in a diseased coronary artery: numerical simulation using plaque measurements from intravascular ultrasound imaging. Appl Math Model 37:5381–5393
Sarfaraz K, Kalimuthu G, Badruddin IA, Badarudin A, Ahmed NS, Khan TMY (2014) Numerical investigation of the effect of stenosis geometry on the coronary diagnostic parameters. Sci World J 2014:1–7
van Hirtum A, Wu B, Gao H, Luo XY (2017) Constricted channel flow with different cross-section shapes. Eur J Mech B/Fluids 63:1–8
Jeon BJ, Chang HJ, Yoo YH, Choi HG (2018) A numerical study on the effect of trapezium stenosis shape on the axisymmetric flow field around stenosis. J Mech Sci Technol 32(6):2651–2658
Makaryus AN, Makaryus JN, Figgatt A, Mulholland D, Kushner H, Semmlow JL, Mieres J, Taylor AJ (2013) Utility of an advanced digital electronic stethoscope in the diagnosis of coronary artery disease compared with coronary computed tomographic angiography. Am J Cardiol 111(6):786–792
Nissen L, Winther S, Isaksen C, Ejlersen JA, Brix L, Urbonaviciene G, Frost L, Madsen LH, Knudsen LL, Schmidt SE, Holm NR, Maeng M, Nyegaard M, Bøtker HE, Bøttcher M (2016) Danish study of non-invasive testing in coronary artery disease (Dan-NICAD): study protocol for a randomized controlled trial. Trials 17:1–11
Azimpour F, Caldwell E, Tawfik P, Duval S, Wilson RF (2016) Audible coronary artery stenosis. Am J Med 129(5):515–521
Winther S, Schmidt SE, Holm NR, Toft E, Strujik JJ, Bøtker HE, Bøttcher M (2016) Diagnosing coronary artery disease by sound analysis from coronary stenosis induced turbulent blood flow: diagnostic performance in patients with stable angina pectoris. Int J Card Imaging 32(2):235–245
Thomas JL, Winther S, Wilson RF, Bottcher M (2017) A novel approach to diagnosing coronary artery disease: acoustic detection of coronary turbulence. Int J Cardiovasc Imaging 33:129–136
Shammas N (2007) Epidemiology, classification, and modifiable risk factors of peripheral arterial disease. Vasc Health Risk Manag 3(2):229–234
Huston J, Nichols DA, Luetmer PH, Rydberg CH, Lewis BD, Meyer FB, Brown RD, Schleck CD (1998) MR angiographic and sonographic indications for endraterectomy. Am J Neuroradiol 19:309–315
Cil BE, Akpınar E, Peynircioğlu B, Çekirge S (2004) Utility of covered stents for extracranial internal carotid artery stenosis. Am J Neuroradiol 25:1168–1171
Ferrari BF, Wolosker N, Rosoky RA, D’Ippolito G, Wolosker AMB, Puech-Leao P (2004) Natural history of stenosis in the iliac arteries in patients with intermittent claudication undergoing clinical tratment. Revista Do Hospital Das Clinicas 59:341–348
Ward P (2012) “MRI and CT provide substantial boost to ischemic stroke care,” in European Congress of Radiology.
Varghese SS, Frankel SH (2003) Numerical modeling of pulsatile turbulent flow in stenotic vessels. J Biomech Eng 125:445–460
Paul MC, Molla MM (2012) Investigation of physiological pulsatile flow in a model arterial stenosis using large eddy and direct numerical simulations. Appl Math Model 36:4393–4413
Varghese SS, Frankel SH, Fischer PF (2007) Direct numerical simulation of stenotic flows. Part 1. Steady flow. J Fluid Mech 582:253–280
Sristava VP, Mishra S, Rastogi R (2010) Non-Newtonian arterial blood flow through an overlapping stenosis. Appl Appl Math 5(1):225–238
Cho YI, Kensey KR (1991) Effects of non-Newtonian viscosity of blood on flows in a diseased arterial vessel. Part 1: steady flows. Biorheology 28:241–262
Razavi A, Shirani E, Sadeghi M (2011) Numerical simulation of blood pulsatile flow in a stenosed carotid artery using different rheological models. J Biomech 44(11):2021–2030
Wiwatanapataphee B, Poltern D, Wu YH, Lenbury Y (2006) Simulation of pulsatile flow of blood in stenosed coronary artery bypass with graft. Math Biosci Eng 3:371–383
Ku DN (1997) Blood flow in arteries. Annu Rev Fluid Mech 29:399–434
Zendehbudi GR, Moayeri MS (1999) Comparison of physiological and simple pulsatile flows through stenosed arteries. J Biomech 32:959–965
Barber TJ, Simmons A (2011) Large eddy simulation of a stenosed artery using a femoral artery pulsatile flow profile. Artif Organs 35(7):155–160
Celik I, Klein M, Janicka J (2009) Assessment measures for engineering LES applications. J Fluids Eng 131:1–10
Shinde VJ, Laval JP, Stanislas M (2014) Effect of mean pressure gradient on the turbulent wall pressure-velocity correlations. J Turbul 15(12):833–856
Howe M (2002) “Theory of vortex sound,” Cambridge University Press, p. 230.
Borisyuk AO (2002) Modeling of noise generation by a vascular stenosis. Int J Fluid Mech Res 29(1):65–86
Borisyuk AO (2004) Experimental study of wall pressure fluctuations in a pipe behind a cylindrical insertion with eccentricity. Int J Fluid Mech Res 31(2):160–175
Zhu C, Seo JH, Mittal R (2018) Computational modeling and analysis of haemodynamics in a simple model of aortic stenosis. J Fluid Mech 851:23–49
Olson HF (1975) Acoustical engineering. D. Van Nostrand, Princeton, p 15
van Loon R (2010) Towards computational modeling of aortic stenosis. Int J Numer Meth Biomed Engng 26:405–420
Duncan GW, Gruber JO, Dewey CF, Myers GS, Lees RS (1975) Evaluation of carotid stenosis by phonoangiography. N Engl J Med 293(22):1124–1128
Mittal R, Simmons SP, Udaykumar HS (2001) Application of large-eddy simulation to the study of pulsatile flow in a modeled arterial stenosis. J Biomech Eng 123:325–332
Spiers C (2012) Advanced auscultation: aortic stenosis and mitral regurgitation. Br J Cardiac Nurs 7(9):415–418
TUBİTAK ULAKBİM computing clusters are used for the simulations.
This work was internally supported by the Middle East Technical University, Scientific Research Project Grant No. BAP-03-02-2017-006.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Ozden, K., Sert, C. & Yazicioglu, Y. Effect of stenosis shape on the sound emitted from a constricted blood vessel. Med Biol Eng Comput (2020) doi:10.1007/s11517-020-02119-7
- Blood flow
- Stenosis shape
- Sound emission
- Large eddy simulation