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Earlobe creases and coronary atherosclerosis. The view from forensic pathology
Insights
The diagonal earlobe crease is linked to significant coronary artery narrowing. This autopsy study confirms the earlobe crease as a visible indicator of obstructive coronary atherosclerosis.
Area of Science:
- Cardiovascular Pathology
- Dermatology
- Forensic Medicine
Background:
- The diagonal earlobe crease (DELC) has been clinically associated with ischemic heart disease.
- Limited autopsy data exists correlating DELC with the severity of coronary atherosclerosis.
Purpose of the Study:
- To investigate the relationship between the degree of coronary atherosclerosis and the presence of DELC.
- To validate clinical observations using a large, diverse autopsy cohort.
Main Methods:
- Analysis of 800 consecutive medicolegal autopsies.
- Statistical evaluation using the chi-squared test to assess correlation.
- Quantification of coronary artery stenosis at necropsy.
Main Results:
- A statistically significant positive correlation (p < 0.01) was found between DELC and obstructive coronary atherosclerosis.
- Over 75% narrowing in at least one major coronary artery was associated with the presence of DELC.
- The study included a wide spectrum of subjects due to medicolegal case selection.
Conclusions:
- Autopsy findings support DELC as a cutaneous marker for obstructive coronary atherosclerosis.
- The presence of DELC indicates a higher likelihood of significant coronary artery disease.
- DELC can serve as a valuable, non-invasive indicator in clinical and forensic settings.
Abstract:
In several clinical studies, the diagonal earlobe crease has been statistically related to the presence of ischemic heart disease. Only one study of a relatively small number of hospitalized patients attempts to relate the earlobe crease with amount of stenotic coronary atherosclerosis demonstrated at necropsy. We examined the relationship between the degree of coronary atherosclerosis and the presence of a diagonal earlobe crease in 800 consecutive autopsies performed for medicolegal reasons and thus including a wide spectrum of subjects. Statistical analysis by the chi 2 test demonstrated a positive correlation (p less than 0.01) between the presence of the diagonal earlobe crease and obstructive coronary atherosclerosis narrowing on at least one major coronary artery greater than 75%. We conclude that the autopsy findings support the clinical observations that the diagonal earlobe crease is a cutaneous sign of obstructive coronary atherosclerosis and that the sign should be used accordingly.