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Quantitative Analysis and Characterization of Atherosclerotic Lesions in the Murine Aortic Sinus
Published on: December 7, 2013
A histopathological analysis of the epidemiology of coronary atherosclerosis: an autopsy study
Negin Abedinzadeh1, Behnam Pedram2, Yasan Sadeghian3
1Graduate, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Negin.abedinzadeh@gmail.com.
Insights
Autopsy findings reveal that coronary atherosclerotic lesions in individuals over 50 are linked to sudden cardiac death (SCD). Age is a significant risk factor for coronary atherosclerosis, aiding in SCD prediction.
Area of Science:
- Cardiovascular Pathology
- Forensic Pathology
- Atherosclerosis Research
Background:
- Atherosclerosis is a major contributor to cardiovascular morbidity and mortality.
- This study investigates the link between coronary atherosclerotic lesion characteristics and sudden cardiac death (SCD) risk.
Purpose of the Study:
- To correlate histopathological features of coronary atherosclerotic plaques with the risk of sudden cardiac death.
- To identify potential predictors of SCD based on coronary artery pathology.
Main Methods:
- Autopsy analysis of 13 sudden cardiac death cases (aged >50 years) from March 2010 to December 2013.
- Histopathological examination of excised coronary artery segments (RCA, LADA, LCA).
- Evaluation of plaque characteristics including necrosis, calcification, inflammation, and arterial wall thickness.
Main Results:
- Atherosclerotic plaques were found in 6.5% of specimens, predominantly in males (69.34%).
- Plaques showed increased necrosis, calcification, cholesterol crystals, giant cells, and inflammatory cell counts.
- Higher intima-media thickness and increased lipid deposition/collagen content correlated with lesion severity.
Conclusions:
- Age over 50 is a risk factor for coronary atherosclerosis and may predict SCD.
- Understanding atherosclerotic plaque pathobiology can aid in early risk identification and inform new diagnostic/therapeutic strategies for coronary artery disease.
Background:
Atherosclerosis accounts for a large proportion of cardiovascular system associated morbidity and mortality. We studied the possible association between the histopathological changes of the coronary atherosclerotic lesions and the risk of sudden cardiac death (SCD) using autopsy cases.
Methods:
We performed an autopsy analysis (n = 13, 4 women, 9 men mean age 67.5 years; age range 56-93 years) of SCD which occurred in patients aged over 50 years during March 2010 to December 2013. The following variables were considered: sex, age, medical history, autopsy findings to macroscopic and histological evaluation of the heart. The autopsies were performed according to standard techniques. In all subjects, the heart was dissected following standard autopsy protocol and a 5 cm section of the right coronary artery (RCA) in the atrio-ventricular groove from its origin, a 5 cm segment of the left anterior descending artery (LADA) distal to the origin of the circumflex artery, but including the region of origin of the circumflex branch and left coronary artery (LCA) from its origin till the circumflex branch were excised, dissected out, fixed in 10% formalin, marked for identification and sent for histopathological analysis.
Results:
Atherosclerotic plaques were identified in 6.5% of specimens, 69.34% of males and 30.66% of female. Such plaques were typically concentric and more represented with necrosis, calcification, cholesterol crystals, and giant cells, as well as had a higher inflammatory cell count. Furthermore, intima and media thickness of coronary arteries were significantly higher in studied specimens with visualize the connective tissue layers of the adventitia and the fatty acid containing adipose cells in the periadventitial tissue. Furthermore, the degree of microscopic lesion of atherosclerosis increased proportionally with the increase in the intensity of lipid deposition and with the percentage of collagen in the atherosclerotic plaques.
Conclusion:
In this study, age estimate to be a risk factor for coronary atherosclerosis in individuals more than 50 years old and may be used to predict SCD. Altogether, an enhanced understanding of the pathobiologic processes responsible for atherosclerotic changes might allow for early identification of a high-risk coronary plaque and thereby provide a rationale for innovative diagnostic and/or therapeutic strategies for the management of coronary patients and prevention of acute coronary syndromes.
