Histopathologic profiles of coronary atherosclerosis by myocardial bridge underlying myocardial infarction
Histopathologic profiles of coronary atherosclerosis by myocardial bridge underlying myocardial infarction
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DOI：
10.1016/j.atherosclerosis.2012.10.037
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发表时间：
2013-01-01
期刊：
影响因子：
5.3
通讯作者：
Ishii, Toshiharu
中科院分区：
文献类型：
--
作者：
Ishikawa, Yukio;Akasaka, Yoshikiyo;Ishii, Toshiharu
目的：心肌桥（MB）的解剖学特性有时通过改变冠状动脉左升支（LAD）的动脉粥样硬化分布而导致心肌梗死（MI）。方法：对150例心肌梗死（MI）心脏进行尸检，其中67例有心肌梗死（MI+），67例无心肌梗死（MI+），150例无心肌梗死（MI+），150例无心肌梗死（MI+），150例无心肌梗死（MI+），150例无心肌梗死（MI+）。n 83]和100例正常心肌桥心肌[MI（-）MB（+）]、左前降支（LAD）以5 mm间隔连续横切。结合MB的解剖学特性，如其厚度、长度、位置和MB肌肉体积负荷，对每个切片中最晚期的内膜病变和不稳定斑块相关病变特征（UPLC）进行组织病理学评价（MMV：MB厚度的总体积乘以MB长度）。MI（+）MB（+）的MB厚度（P = 0.0090）、长度（P = 0.0300）和MMV（P = 0.0019）显著大于MI（-）MB（+）。MI（+）MB（+）组急性MI病例的平均年龄显著低于MI（+）MB（-）组（P = 0.0227）。MI（+）MB（+）急性心肌梗死患者的近端LAD斑块破裂/破裂频率显著高于MI（+）MB（-）患者。结论：MI（+）MB（+）患者的UPLCs位于近端，且靠近MB近端的斑块易破裂，导致MI发生于年轻人。(C)2012爱思唯尔爱尔兰有限公司保留所有权利。
Objective: Anatomic properties of myocardial bridge (MB) are sometimes responsible for myocardial infarction (MI) through the changes in the atherosclerosis distribution in the left ascending coronary artery (LAD). The purpose of this study was to investigate histopathologic profiles of atherosclerotic lesions resulting from the MB presence in the LAD in the MI cases.Methods: In 150 consecutive autopsied MI hearts either with MBs [MI(+) MB(+); n = 67] or without MBs [MI(+) MB(-); n 83] and 100 normal hearts with MBs [MI(-) MB(+)], LADs were consecutively cross-sectioned at 5-mm intervals. The most advanced intimal lesion and unstable plaque-related lesion characteristics (UPLCs) in each section were histopathologically evaluated in conjunction with the anatomic properties of the MB, such as its thickness, length, location, and MB muscle volume burden (MMV: the total volume of MB thickness multiplied by MB length).Results: The MB showed a significantly greater thickness (P = 0.0090), length (P = 0.0300), and MMV (P = 0.0019) in MI(+) MB(+) than in MI(-) MB(+). Mean age of acute MI cases was significantly younger (P = 0.0227) in MI(+) MB(+) than in MI(+) MB(-). Frequency of plaque fissure/rupture in the proximal LAD was significantly higher in acute MI cases of MI(+) MB(+) than in MI(+) MB(-). UPLCs tended to be located proximally in MI(+) MB(+) and frequent 2.0 cm or more proximal to the MB entrance in MI(+) MB(+).Conclusion: In MI(+) MB(+), UPLCs tend to be located more proximally, and a plaque in the LAD proximal to the MB is prone to rupture, resulting in MI at younger age. (C) 2012 Elsevier Ireland Ltd. All rights reserved.