Molina D Kimberley, DiMaio Vincent J M
From the Bexar County Medical Examiner's Office, San Antonio, TX.
Am J Forensic Med Pathol. 2015 Sep;36(3):176-81. doi: 10.1097/PAF.0000000000000174.
Cardiac enlargement is a well-known independent risk factor for sudden cardiac death, though the definition of what constitutes cardiac enlargement is not universally established. A previous study was undertaken to establish a normal range for male hearts to address this issue; the present study was designed to address the issue and to determine normal cardiac weights in adult human females. A prospective study was undertaken of healthy females 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; if there was significant cardiac injury; or if any illness or intoxication was identified after gross, microscopic, and toxicologic analysis, including evidence of systemic disease. A total of 102 cases met criteria for inclusion in the study during the approximately 10-year period of data collection from 2004 to 2014. The decedents had an average age of 24.4 years and ranged in length from 141 to 182 cm (56.4 to 72.8 in.) with an average length of 160 cm (64 in.). The weight ranged from 35.9 to 152 kg (79 to 334 lbs) with an average weight of 65.3 kg (143 lbs). The majority of the decedents (86%) died from either ballistic or blunt force (including craniocerebral) injuries. Overall, the heart weights ranged from 156 to 422 g with an average of 245 g and a standard deviation of 52 g. Regression analysis was performed to assess the relationship between heart weight and body weight, body length, and body mass index, respectively, and found insufficient associations to enable predictability. The authors, therefore, propose establishing a normal range for heart weight in women of 148 to 296 g.
心脏增大是心源性猝死的一个众所周知的独立危险因素,尽管心脏增大的构成定义尚未得到普遍确立。之前曾开展一项研究来确定男性心脏的正常范围以解决这一问题;本研究旨在解决该问题并确定成年女性的正常心脏重量。对年龄在18至35岁之间因突发创伤性死亡的健康女性进行了一项前瞻性研究。若存在以下情况则排除病例:有内科疾病史,包括使用非法药物;接受过长时间的内科治疗;受伤时间与死亡时间间隔过长;无法准确评估身长和体重;存在严重心脏损伤;或在大体、显微镜和毒理学分析后发现任何疾病或中毒情况,包括全身性疾病的证据。在2004年至2014年约10年的数据收集期间,共有102例病例符合纳入该研究的标准。死者的平均年龄为24.4岁,身长范围为141至182厘米(56.4至72.8英寸),平均身长为160厘米(64英寸)。体重范围为35.9至152千克(79至334磅),平均体重为65.3千克(143磅)。大多数死者(86%)死于弹道伤或钝器伤(包括颅脑伤)。总体而言,心脏重量范围为156至422克,平均为245克,标准差为52克。分别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,作者提议将女性心脏重量的正常范围确定为148至296克。