Lino Rossi Research Center, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda, 19, 20122 Milan, Italy; Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Cardiovasc Pathol. 2020 Jul-Aug;47:107221. doi: 10.1016/j.carpath.2020.107221. Epub 2020 Apr 18.
Unexpected sudden cardiac death (SCD), sudden infant death syndrome (SIDS) and sudden intrauterine unexplained death (SIUD) are major unsolved, devastating forms of death that occur frequently. Obstructive sleep apnea (OSA) has been associated with increased cardiovascular and cerebrovascular morbidity and mortality, including sudden cardiac death (SCD). This editorial will review the pathology of SCD, including sudden infant death syndrome (SIDS) and sudden intrauterine unexplained death (SIUD); OSA with its cardiovascular consequences; the possible link between SCD and OSA, discussing the potential mechanisms underlying these two frequent, but yet overlooked pathologies. Finally, the possible preventive benefits of treating OSA and identifying patients at common risk for OSA and SCD and SIDS-SIUD to prevent unexpected deaths will be discussed. Post-mortem examination is of great importance in every case of SCD sine materia, with examination of the brainstem and cardiac conduction system on serial sections, when general autopsy fails, but it should be stressed that also the investigations of patients suffering from OSA should focus on the possibility of pathological findings in common with cases of SCD.
意外心源性猝死（SCD）、婴儿猝死综合征（SIDS）和不明原因的宫内胎儿死亡（SIUD）是经常发生的、尚未解决的、具有破坏性的主要死亡形式。阻塞性睡眠呼吸暂停（OSA）与心血管和脑血管发病率和死亡率的增加有关，包括心源性猝死（SCD）。本社论将回顾 SCD 的病理学，包括婴儿猝死综合征（SIDS）和不明原因的宫内胎儿死亡（SIUD）；伴有心血管后果的 OSA；SCD 和 OSA 之间可能存在的联系，讨论这两种常见但仍被忽视的病理之间的潜在机制。最后，将讨论治疗 OSA 和识别 OSA 及 SCD 和 SIDS-SIUD 常见风险患者的可能预防益处，以预防意外死亡。由于心源性猝死的原因不明，因此在每个 SCD 病例中，死后检查都非常重要，需要对脑干和心脏传导系统进行连续切片检查，如果一般尸检失败，但应强调的是，患有 OSA 的患者的调查也应侧重于与 SCD 病例共同出现的病理发现的可能性。
