[Morphological and morphometrical changes in nervous apparatus of the adrenal medulla after sudden death of patients with various cardiac pathology].

Adrenal glands were studied at early autopsy of 28 men aged 35-60 years after their sudden cardiac death. According to the presence and character of pathologic manifestations detected in myocardium, three groups of cases were distinguished: group 1 (control) included the people without myocardial pathology (traffic accident victims), group 2 consisted of the patients with ischemic heart disease (IHD) in association with recent myocardial infarction, group 3 included the patients with IHD and hypertension. The study was performed using the methods of silver impregnation of nerve terminals and planimetric point-counting method. Analysis of density of distribution of nerve plexuses in adrenal medulla in the groups studied has shown a tendency towards its reduction in group 2 and a significant decrease in group 3. Reactive-degenerative changes in the nervous structures of adrenal medulla were detected in these two groups, while in group 3 these were accompanied by the compensatory-adaptive changes in glandular nervous apparatus. However, despite the pronounced changes found in the nervous structures of adrenal medulla, their function remained high enough, that could be explained by a transition from nervous control of adrenal activity to a humoral one.