FREQUENCY OF ACUTE AND HEALED MYOCARDIAL INFARCTS IN FATAL CARDIAC AMYLOIDOSIS

尿道（累及超过内半部分） 心肌壁）左室坏死或纤维化最多 通常继发于重度（超过75%的横截面积） 1个或多个主要动脉粥样硬化斑块导致狭窄 心外膜冠状动脉 也可能发生心肌梗塞 心外膜冠状动脉没有明显狭窄， 几种情况，包括肥厚型心肌病，扩张型 心肌病、左或右室流出道梗阻，以及 冠状动脉起源或路线异常。 另一个条件 与无显著狭窄的心肌梗死相关 1条或多条心外膜冠状动脉为心脏冠状动脉 淀粉样变性 61例尸检患者年龄21 ~ 97岁（平均64岁）， 心脏淀粉样变性严重到足以导致心脏功能障碍 在过去的28年里，在这个实验室里研究的，3个（5%） 5例（8%）左侧有透壁性坏死， 室壁无坏死或纤维化者53例（87%）。 1例坏死，3例纤维化，9例均无 坏死或纤维化和1个或多个心外膜冠状动脉 因动脉粥样硬化斑块而严重狭窄 两例 坏死和2例纤维化，加上44例均无，没有 心外膜冠状动脉狭窄超过75%， 动脉粥样硬化斑块的截面积。

Transmural (involvement of more than the inner one-half of the myocardial wall) left ventricular necrosis or fibrosis is most often secondary to severe (more than 75% cross-sectional area) narrowing by atherosclerotic plaques of 1 or more of the major epicardial coronary arteries. Myocardial infarction also may occur without significant narrowing of an epicardial coronary artery in several conditions, including hypertrophic cardiomyopathy, dilated cardiomyopathy, left or right ventiruclar outflow obstruction, and anomalies of coronary arterial origin or course. Another condition associated with myocardial infarction without significant narrowing of 1 or more of the epicardial coronary arteries is cardiac amyloidosis. Of 61 necrospy patients aged 21 to 97 years (mean 64) with cardiac amyloidosis severe enough to cause cardiac dysfunction studied in this laboratory during the past 28 years, 3 (5%) had transmural necrosis and 5 (8%) had transmural fibrosis of the left ventricular wall, and 53 (87%) had neither necrosis nor fibrosis. One patient with necrosis, 3 with fibrosis, and 9 with neither necrosis nor fibrosis and 1 or more epicardial coronary arteries severely narrowed by atherosclerotic plaque. Two patients with necrosis and 2 with fibrosis, plus 44 with neither, had no epicardial coronary artery narrowed more than 75% in cross- sectional area by atherosclerotic plaque.