Aims Hypertension is a risk factor for intracranial aneurysm rupture. We analysed whether the intake of drugs from specific classes of anti-hypertensive medications affects haemodynamic parameters of intracranial aneurysm dome. Methods and results We recorded medical history including medications and the in-hospital blood pressure values. We then obtained 3D reconstruction of each patients’ aneurysm dome and the feeding artery. Using OpenFOAM software, we performed Computational Fluid Dynamics analysis of blood flow through the modelled structures. Blood was modelled as Newtonian fluid, using the incompressible transient solver. As the inlet boundary condition, we used the patient-specific Internal Carotid Artery blood velocity waves obtained with Doppler ultrasound. We calculated haemodynamic parameters of the aneurysm dome. All presented analyses are cross-sectional. We included 72 patients with a total of 91 unruptured intracranial aneurysms. The history of β-blocker intake significantly influenced haemodynamic parameters of aneurysm dome. The patients on β-blockers had significantly smaller aneurysm domes (5.09 ± 2.11 mm vs. 7.41 ± 5.89 mm; P = 0.03) and did not have aneurysms larger than 10 mm (0% vs. 17.0%; P = 0.01). In the Computational Fluid Dynamics analysis, walls of aneurysms in patients who took β-blockers were characterized by lower Wall Shear Stress Gradient (1.67 ± 1.85 Pa vs. 4.3 ± 6.06 Pa; P = 0.03), Oscillatory Shear Index (0.03 ± 0.02 vs. 0.07 ± 0.10; P = 0.04), and Surface Vortex Fraction (16.2% ± 5.2% vs. 20.0% ± 6.8%; P < 0.01). After controlling for covariates, we demonstrated difference of Surface Vortex Fraction (F[1, 48] = 4.36; P = 0.04) and Oscillatory Shear Index (F[1, 48] = 6.51; P = 0.01) between patients taking and not taking β-blockers, respectively. Conclusion Intake of β-blockers might contribute to more favourable haemodynamics inside aneurysmal sac. Other anti-hypertensive medication classes were not associated with differences in intracranial aneurysm parameters.

中文翻译：

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β阻滞剂能预防颅内动脉瘤破裂吗？：来自计算流体动力学分析的见解


目的 高血压是颅内动脉瘤破裂的危险因素。我们分析了特定类别的抗高血压药物的摄入是否会影响颅内动脉瘤穹顶的血流动力学参数。方法和结果：我们记录了病史，包括药物和院内血压值。然后，我们获得了每个患者的动脉瘤圆顶和供血动脉的 3D 重建。使用 OpenFOAM 软件，我们对通过建模结构的血流进行了计算流体动力学分析。使用不可压缩瞬态求解器将血液建模为牛顿流体。作为入口边界条件，我们使用了多普勒超声获得的患者特异性颈内动脉血流波。我们计算了动脉瘤穹顶的血液动力学参数。所有提出的分析都是横截面的。我们纳入了 72 例患者，共 91 个未破裂的颅内动脉瘤。β阻滞剂摄入史显着影响动脉瘤穹顶的血流动力学参数。β阻滞剂组患者的动脉瘤圆顶显著较小 （5.09 ± 2.11 mm vs. 7.41 ± 5.89 mm;P = 0.03），并且没有大于 10 mm 的动脉瘤 （0% vs. 17.0%;P = 0.01）。在计算流体动力学分析中，服用 β 阻滞剂的患者的动脉瘤壁特征是较低的壁剪切应力梯度 （1.67 ± 1.85 Pa vs. 4.3 ± 6.06 Pa;P = 0.03）、振荡剪切指数 （0.03 ± 0.02 对 0.07 ± 0.10;P = 0.04）和表面涡旋分数 （16.2% ± 5.2% 对 20.0% ± 6.8%;P < 0.01）。在控制协变量后，我们证明了表面涡旋分数 （F[1， 48] = 4.36;P = 0.04） 和振荡剪切指数 （F[1， 48] = 6.51;P = 0。01） 分别在服用和不服用 β 阻滞剂的患者之间。结论 摄入 β 受体阻滞剂可能有助于动脉瘤囊内更有利的血流动力学。其他抗高血压药物类别与颅内动脉瘤参数的差异无关。