Molina D Kimberley, DiMaio Vincent J M
Bexar County Medical Examiner's Office, San Antonio, TX 78229, USA.
Am J Forensic Med Pathol. 2012 Dec;33(4):362-7. doi: 10.1097/PAF.0b013e31823d298b.
It has been shown that cardiac enlargement, whether hypertrophic or dilated, is an independent risk factor for sudden cardiac death, although the definition of what constitutes cardiac enlargement is not universally established. This study was designed to address this issue and to determine normal cardiac weights in adult men. A prospective study was undertaken of healthy men dying from sudden traumatic deaths aged 18 to 35 years. Cases were excluded if there was a history of medical illness including illicit drug use; prolonged medical treatment was performed; there was a prolonged period between the time of injury and death; body length and weight could not be accurately assessed; there was significant cardiac injury; or any illness or intoxication was identified after gross and microscopic analysis, including evidence of systemic disease. A total of 232 cases met the criteria for inclusion in the study during the approximately 6-year period of data collection from 2005 to 2011. The decedents had an average age of 23.9 years and ranged in length from 146 to 193 cm with an average length of 173 cm. Their weights ranged from 48.5 to 153 kg with an average weight of 76.4 kg. Most decedents (87%) died of either ballistic or blunt force (including craniocerebral) injuries. Overall, their heart weights ranged from 188 to 575 g with an average of 331 g and an SD of 56.7 g. Regression analysis was performed to assess the relationship between heart weight and body weight, body length, and body mass index and found insufficient associations to enable predictability. The authors, therefore, propose establishing a reference range for heart weight in men, much like those in use for other laboratory tests including hemoglobin, hematocrit, or glucose. A reference range (95% inclusion) of 233 to 383 g for the adult male human heart is proposed.
研究表明，心脏增大，无论是肥厚性还是扩张性的，都是心源性猝死的独立危险因素，尽管心脏增大的构成定义尚未得到普遍确立。本研究旨在解决这一问题，并确定成年男性的正常心脏重量。对18至35岁因突发创伤性死亡的健康男性进行了一项前瞻性研究。如果有包括使用非法药物在内的病史；接受过长期治疗；受伤与死亡之间间隔时间过长；无法准确评估身长和体重；存在严重心脏损伤；或在大体和显微镜分析后发现任何疾病或中毒（包括全身性疾病的证据），则排除这些病例。在2005年至2011年约6年的数据收集期间，共有232例符合纳入研究的标准。死者的平均年龄为23.9岁，身长在146至193厘米之间，平均身长为173厘米。他们的体重在48.5至153千克之间，平均体重为76.4千克。大多数死者（87%）死于弹道伤或钝器伤（包括颅脑损伤）。总体而言，他们的心脏重量在188至575克之间，平均为331克，标准差为56.7克。进行回归分析以评估心脏重量与体重、身长和体重指数之间的关系，发现关联不足，无法进行预测。因此，作者提议为男性建立一个心脏重量的参考范围，类似于目前用于其他实验室检查（如血红蛋白、血细胞比容或血糖）的参考范围。建议成年男性心脏的参考范围（95%包含区间）为233至383克。
