Armed Forces Institute of Pathology, University of Maryland, USA.
Arq Bras Cardiol. 2010 Feb;94(2):143-9, 153-9, 145-51. doi: 10.1590/s0066-782x2010000200003.
There have been few autopsy studies relating sites of thin cap atheroma (TCFA) to sites of acute plaque rupture in culprit arteries, and sites of maximal narrowing in non-culprit arteries.
We aimed to quantify and locate the frequency of TCFA related to the sites of maximal stenosis in atherosclerotic plaques.
We studied 88 hearts in victims of sudden death dying with coronary thrombus overlying acute plaque rupture. Thin cap atheromas were defined as fibrous cap < 65 microns overlying a necrotic core. Percent luminal narrowing was determined at the sites of plaque rupture and thin cap atheromas.
There were 81 men and 7 women, mean age 50 years +/- 9 SD. The plaque rupture was the site of maximal luminal narrowing in 47% of culprit arteries. TCFAs were present in 67 hearts (83%). Of these, 49 (73%) demonstrated TCFAs in the culprit artery; 17 (25%) in the culprit artery only, 32 (48%) in the culprit artery and in a non-culprit artery, and 18 (27%) only in a non-culprit artery. In non-culprit arteries, TCFAs represented the maximal site of stenosis in 44% of arteries. The acute rupture site is the site of maximal luminal narrowing in the involved vessel in 47% of hearts from patients dying with acute plaque rupture.
These data may suggest that luminal narrowing is not a reliable marker for TCFA.
关于易损斑块的薄帽纤维粥样硬化（TCFA）与罪犯动脉中急性斑块破裂部位以及非罪犯动脉中最大狭窄部位之间的关系，以前的尸检研究很少。
我们旨在定量分析并确定与动脉粥样硬化斑块最大狭窄部位相关的 TCFA 的发生频率和位置。
我们研究了 88 例因冠状动脉血栓伴急性斑块破裂而猝死的患者的 88 颗心脏。薄帽纤维粥样硬化定义为纤维帽<65μm，覆盖在坏死核心上。在斑块破裂和薄帽纤维粥样硬化部位测量管腔狭窄的百分比。
81 名男性和 7 名女性，平均年龄 50 岁±9 标准差。47%的罪犯动脉中，斑块破裂是管腔最狭窄的部位。67 颗心脏（83%）存在 TCFA。其中，49 颗（73%）在罪犯动脉中存在 TCFA；17 颗（25%）仅在罪犯动脉中存在 TCFA；32 颗（48%）在罪犯动脉和非罪犯动脉中存在 TCFA；18 颗（27%）仅在非罪犯动脉中存在 TCFA。在非罪犯动脉中，TCFA 占狭窄最严重部位的 44%。在伴有急性斑块破裂死亡的患者中，47%的心脏中，急性破裂部位是受累血管中管腔最狭窄的部位。
这些数据表明，管腔狭窄可能不是 TCFA 的可靠标志物。
