Clinical and pathologic studies on contraction band lesion: relation to acute myocardial infarction and unexplained sudden death.

The relation between contraction band lesion (CBL) and major cause of death was investigated through the use of hearts from 500 serialized autopsy cases. Acute myocardial infarction (AMI), unexplained sudden death (USD), cardiac surgery death, cancer, infection, cerebrovascular disease, and ruptured aortic aneurysm were examined with respect to age, sex, heart weight, and CBL localization patterns. CBL was observed frequently with AMI, USD, and cardiac surgery death, but virtually unseen with cancer or in the remaining disease categories. In a comparison of average heart weight among the various groups, there appeared to be a correlation between heavy heart weight and increased frequency of CBL. In a second investigational phase, the relation between CBL and application of cardiopulmonary resuscitation techniques was investigated in 100 separate autopsy cases. There was no significant difference between treated and untreated patients regarding frequency and pathology of CBL. We hypothesize that CBL-AMI and CBL-USD belong to the same disease group and that CBL develops before the onset of death with no connection to the mechanical and pharmacologic effects of cardiopulmonary resuscitation.