Tavora Fabio, Li Ling, Ripple Mary, Fowler David, Burke Allen
Deparment of Cardiovascular Pathology, Armed Forces Institute of Pathology, 6825 16th Street NW, Building 54, Washington, DC 20306, USA.
Patholog Res Int. 2010;2010:628247. doi: 10.4061/2010/628247. Epub 2009 Nov 5.
There are few pathologic descriptions of fatal coronary artery disease in the young. The morphologic characteristics of sudden coronary deaths in 47 hearts from patients younger than 40 years were studied. Numbers of plaques with necrotic cores were quantitated in each heart. Compared to 194 sudden coronary deaths >40 years, heart weight was lower, acute plaque erosions more frequent, and extent of disease less in the ≤40 years group. Plaque burden was less in hearts with erosions, and healed infarcts more common in hearts with stable plaque. The numbers of fibroatheromas increased with age until the 6th decade (P < .0001) as well as the proportion of total plaques that were atheromatous. Plaques in younger patients have fewer lipid-rich cores. Most thrombi show areas of organization, with layering frequent in erosions, suggesting a possible method of plaque enlargement in the absence of necrotic core formation.
关于年轻患者致命性冠状动脉疾病的病理学描述较少。对47例年龄小于40岁患者的心脏进行了研究，以了解其猝死时的形态学特征。对每颗心脏中带有坏死核心的斑块数量进行了定量分析。与194例年龄大于40岁的冠状动脉猝死患者相比，年龄小于等于40岁组的心脏重量更低，急性斑块侵蚀更为常见，疾病范围更小。侵蚀性斑块的斑块负荷更小，而稳定斑块的心脏中愈合性梗死更为常见。纤维粥样斑块数量随年龄增长而增加，直至第六个十年（P < 0.0001），动脉粥样硬化斑块在总斑块中所占比例也随年龄增加。年轻患者的斑块富含脂质的核心较少。大多数血栓显示有组织化区域，侵蚀部位分层常见，这表明在没有坏死核心形成的情况下，斑块可能存在一种增大的方式。
