Increased Epicardial Adipose Tissue and Heart Characteristics Are Correlated with BMI and Predict Silent Myocardial Infarction in Sudden Cardiac Death Subjects: An Autopsy Study

被引:5
作者
Hogea, Timur [1 ,2 ,3 ]
Noemi, Nagy [1 ]
Suciu, Bogdan Andrei [4 ]
Brinzaniuc, Klara [4 ]
Chinezu, Laura [5 ]
Arbanasi, Emil Marian [3 ,6 ,7 ]
Kaller, Reka [3 ,6 ]
Carasca, Cosmin [1 ,2 ]
Arbanasi, Eliza Mihaela [8 ]
Vunvulea, Vlad [4 ,9 ]
Halmaciu, Ioana [2 ,9 ]
Muresan, Adrian Vasile [6 ,7 ]
Russu, Eliza [6 ,7 ]
Ciucanu, Claudiu Constantin [6 ]
Radu, Casandra Maria [10 ]
Radu, Corina Carmen [1 ,2 ]
机构
[1] George Emil Palade Univ Med Pharm Sci & Technol Ta, Dept Forens Med, Targu Mures 540139, Romania
[2] Inst Forens Med, Targu Mures 540141, Romania
[3] George Emil Palade Univ Med Pharm Sci & Technol Ta, Doctoral Sch Med & Pharm, Targu Mures 540142, Romania
[4] George Emil Palade Univ Med Pharm Sci & Technol Ta, Dept Anat, Targu Mures 540139, Romania
[5] George Emil Palade Univ Med Pharm Sci & Technol Ta, Dept Histol, Targu Mures 540139, Romania
[6] Mures Cty Emergency Hosp, Clin Vasc Surg, Targu Mures 540136, Romania
[7] George Emil Palade Univ Med Pharm Sci & Technol Ta, Dept Vasc Surg, Targu Mures 540139, Romania
[8] George Emil Palade Univ Med Pharm Sci & Technol Ta, Fac Pharm, Targu Mures 540139, Romania
[9] Mures Cty Emergency Hosp, Dept Radiol, Targu Mures 540136, Romania
[10] Univ Oradea, Doctoral Sch Biol & Biomed Sci, 1 Univ St, Oradea 410087, Romania
关键词
silent myocardial infarction; coronary artery disease; sudden cardiac death; forensics; risk factors; epicardial adipose tissue; PREVALENCE; RISK; PROGNOSIS; ATHEROSCLEROSIS; UPDATE; QUANTIFICATION; EPIDEMIOLOGY; ASSOCIATION; PREVENTION; GUIDELINES;
D O I
10.3390/diagnostics13132157
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Sudden cardiac death (SCD) is a significant global public health issue and the leading cause of death worldwide. Its etiopathogenesis is complex and multilayered, involving dynamic factors interacting with a preexistent cardiovascular pathology, frequently unknown, and resulting in cardiac rhythm disorders and cardiac arrest; Methods: This study conducted a retrospective descriptive analysis over a one-year period, identifying 321 autopsy cases of sudden deaths from the Institute of Legal Medicine in Mures County, Romania, in 2019. From the 321 sudden death cases, 189 autopsy reports were selected for analysis based on inclusion and exclusion; Results: The autopsies had a mean age of 61.16 years and included 140 males and 49 females. No significant differences were found between the silent myocardial infarction (SMI) and no-SMI groups regarding demographic data. The SMI group exhibited higher thickness of LV (left ventricle), IV (interventricular septum), EAT LCx (epicardial adipose tissue at left circumflex artery), EAT LAD (epicardial adipose tissue at left anterior descending artery), heart weight, and BMI (body mass index). The left coronary artery showed a higher incidence of type V plaques, while the right coronary artery showed higher incidences of type V and type VI plaque. The SMI group also exhibited a higher incidence of moderate and severe valvular atherosclerosis, severe left ventricle dilatation, and a lower incidence of mild left ventricle dilatation. In addition, the SMI group showed a higher presence of contraction band necrosis on histological examination. Multivariate analysis revealed that type V and type VI plaques for the right and left coronary arteries, moderate and severe valvular atherosclerosis, severe left ventricle dilatation, heart weight, EAT LCx, EAT LAD, LV thickness, IV thickness, BMI, and the presence of contraction band necrosis are all independent predictors of SMI; Conclusions: The findings suggest that SCD is a complex condition, and its etiopathogenesis involves dynamic factors interacting with pre-existing cardiovascular pathology. The risk factors of SCD are similar to those of ischemic heart disease. The findings of this study could guide clinicians in identifying patients at risk of SCD and implementing preventive measures.
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页数:13
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