SMOOTH-MUSCLE CONTRACTION BANDS IN THE MEDIA OF CORONARY-ARTERIES - A POSTMORTEM MARKER OF ANTEMORTEM CORONARY SPASM
SMOOTH-MUSCLE CONTRACTION BANDS IN THE MEDIA OF CORONARY-ARTERIES - A POSTMORTEM MARKER OF ANTEMORTEM CORONARY SPASM
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DOI：
10.1016/s0735-1097(85)80221-7
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发表时间：
1985-01-01
影响因子：
24
通讯作者：
CHO, S
中科院分区：
文献类型：
--
作者：
FACTOR, SM;CHO, S
到目前为止，还没有明确的形态标志可以在尸检时做出冠状动脉痉挛的诊断。本文对63例成人非心肌梗死患者的冠状动脉进行了尸检，发现这些血管内膜平滑肌收缩带的存在与其他血管改变、心肌病理改变及临床病史有关。这些收缩带以前在人类冠状动脉中还没有报道，但在儿茶酚胺诱导的实验性血管痉挛中发现了它们。结果发现，63例中有47例收缩带阳性。作为生前过程的证据，在25例患者中，这些变化与非闭塞性微血栓的存在有显著的相关性。收缩带也与动脉粥样硬化性斑块破裂和附壁斑块出血高度相关，这可能是冠状动脉痉挛继发的。在78.7%的收缩带阳性病例中，死亡原因与可能与高儿茶酚胺水平有关的诊断有关。根据实验证据和本研究确定的相关性，冠状动脉中膜平滑肌收缩带可能代表死前冠状动脉痉挛的死后标志。
To date, no unequivocal morphologic markers have been described that would allow the diagnosis of coronary artery spasm to be made at autopsy. The coronary arteries of 63 adult patients without myocardial infarction were examined at autopsy, and the presence of medial smooth muscle contraction bands in these vessels was correlated with other vascular changes, myocardial pathologic changes and clinical history. These contraction bands have not been reported previously in human coronary arteries, but they were identified in experimental vascular spasm induced with catecholamines. It was found that 47 of the 63 cases were positive for contraction bands. As evidence of an antemortem process, there was a significant correlation between these changes and the presence of nonocclusive microthrombi, found in 25 cases. Contraction bands were also highly correlated with atherosclerotic plaque ruptures and mural plaque hemorrhages, which may be secondary to coronary spasm. In 78.7% of the cases positive for contraction bands, the cause of death was related to a diagnosis possibly associated with high catecholamine levels. On the basis of experimental evidence and the correlations identified in this study, coronary artery medial smooth muscle contraction bands may represent a postmortem marker of antemortem coronary spasm.