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Post-mortem ultrasound study of coronary circulation on ex-situ hearts
Santelli Simone1, Ridolfi Marcello2, Pirani Filippo1
1Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy.
Insights
Ultrasound (US) effectively characterizes coronary artery atherosclerosis and stenosis in ex situ hearts. This technique shows promise for preliminary screening in cardiac pathology, assessing disease impact on blood flow.
Area of Science:
- Cardiovascular Pathology
- Medical Imaging
- Diagnostic Ultrasound
Background:
- Sudden cardiac death is a major cause of mortality in industrialized nations, primarily due to coronary atherosclerosis.
- Atherosclerotic degeneration of the coronary circulation accounts for 70-80% of sudden cardiac death cases.
- Accurate morpho-functional characterization of coronary arteries is crucial for understanding disease progression.
Purpose of the Study:
- To evaluate the suitability of ultrasound (US) for morpho-functional characterization of coronary circulation in ex situ human hearts.
- To assess the capability of US and color Doppler in identifying atherosclerotic plaques and stenosis.
- To determine if US findings correlate with subsequent cardiopathological examinations.
Main Methods:
- Six human hearts were utilized, with coronary arteries cannulated and injected with an aqueous contrast medium.
- Ultrasound scanning (US) with color Doppler was performed for morphological and functional analysis of the coronary vessels.
- A comprehensive cardiopathological examination was conducted post-US for validation.
Main Results:
- US and color Doppler successfully characterized coronary vessels and atherosclerotic plaque morphology.
- The degree of vascular stenosis and associated dysfunctional blood flow (reduced or turbulent) were accurately identified.
- Cardiopathological examination confirmed the findings obtained through US.
Conclusions:
- Coronary ultrasound (US) is a promising diagnostic tool for preliminary screening in cardiac pathology.
- US enables pathologists to assess the impact of atherosclerotic disease on coronary blood flow.
- Further studies with larger sample sizes and comparative analyses with other techniques are warranted.
Abstract:
Sudden cardiac death is a leading cause of death in the 40-65 age group in industrialized countries. In approximately 70-80% of cases, it is attributable to atherosclerotic degeneration of the coronary circulation. This experimental study aims to evaluate the suitability of ultrasound for the morpho-functional characterization of the coronary circulation in ex situ hearts. The coronaries of six human hearts were cannulated with a vascular catheter, and an aqueous contrast medium was injected using an electric pump. The cannulated vessel underwent ultrasound scanning (US) for both morphological and functional study using US and color Doppler. Subsequently, a cardiopathological examination of each heart was performed. US and color Doppler allowed the characterization of the coronary vessels, the morphology of atherosclerotic plaques, the degree of vascular stenosis, and related dysfunctional, reduced or turbulent flow. Subsequent cardio-pathological examination confirmed the US findings. Preliminary results indicate coronary US as a promising diagnostic technique in cardio-pathology, as a preliminary screening test for subsequent targeted investigations, since it enables the pathologist to assess the dysfunctional implications of atherosclerotic disease on coronary flow. Future perspectives include extending the studied sample and comparing post-mortem US with other techniques commonly used for the study of coronary pathology.
