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Histopathological findings of cardiac conduction system of 150 Finns
Y Song1, H Laaksonen, P Saukko
1Department of Forensic Pathology, Sun Yat-sen University of Medical Sciences, Guangzhou, PR China.
Insights
Histopathological changes in the cardiac conduction system (CCS) of Finnish individuals show age-related increases in fibrous and fatty tissue. Calcium deposition can compress critical CCS components, impacting forensic pathology diagnoses.
Area of Science:
- Forensic Medicine
- Cardiovascular Pathology
- Histopathology
Background:
- The cardiac conduction system (CCS) is vital for heart rhythm.
- Understanding age-related changes and pathologies in the CCS is crucial for forensic analysis.
- Previous studies on CCS histopathology in Finnish populations are limited.
Purpose of the Study:
- To investigate histopathological changes in the CCS of Finnish individuals.
- To determine the forensic pathological significance of these changes.
- To correlate CCS findings with age and potential causes of death.
Main Methods:
- Autopsy heart specimens (n=150) from Finnish individuals were examined.
- Histopathological analysis focused on the CCS, including nodes and bundles.
- Age, sex, and cause of death were recorded for each case.
Main Results:
- Increased fibrous and fatty tissue in the CCS was observed with aging.
- Calcium deposition occurred in the central fibrous body and interventricular septum in approximately 50% of cases.
- Seven cases showed compression of the atrioventricular node (AVN), His bundle (HB), or bundle branches (RBB, LBB) due to calcification.
- Other observed pathologies included hemorrhage, inflammation, amyloidosis, tumors, and malformations in 31 cases.
- No CCS involvement was noted in 28 cases of myocardial infarction.
Conclusions:
- Routine examination of the CCS aids in identifying diseases of this system.
- Histopathological findings in the CCS can enhance the accuracy of forensic pathological diagnoses.
- Age-related changes and calcification are significant findings in the forensic evaluation of the CCS.
Abstract:
One hundred and fifty heart specimens were collected from the cases submitted for autopsy in the Department of Forensic Medicine in the University of Turku in March-May 1995 and May-July 1996, respectively. The cardiac conduction system (CCS) of these hearts were examined in order to find out the histopathological changes in the CCS of Finnish persons and their forensic pathological significance. There were 94 males and 56 females. Almost all age groups were included. The results revealed that in most of the persons the fibrous tissue and fatty tissue in the CCS increased with aging. In about half of the persons, there was deposition of calcium in the central fibrous body, pars membranacea, and the top of the musculature in the interventricular septum. In seven cases, the atrioventricular node (AVN), His bundle (HB) or bundle branches (RBB, LBB) were compressed by the calcium deposition. Hemorrhage, inflammation, amyloidosis, tumor, fatty infiltration and developmental malformations were observed in 31 cases. Twenty-eight cases died of myocardial infarct, among them, no involvement of the CCS could be observed. The authors concluded that routine examination of the CCS is helpful for revealing diseases of the CCS and improving the quality of forensic pathological diagnosis.