Vikhert A M, Sokolova R I, Zhdanov V S
Arkh Patol. 1988;50(1):65-9.
Prevalence and severity of arterial hypertension in 345 sudden cardiac death (SCD) cases have been assessed basing on post-mortem morphologic examination of the kidneys involving special staining and quantitation of renal arteriolar lesion. Incidence rate for arterial hypertension was determined both for the whole group of cases and subgroups recognized by a variant of myocardial damage, i.e. alcoholic cardiomyopathy, recent myocardial infarction, thrombosis, microfocal or postinfarction cardiosclerosis. SCD was found to be closely associated with arterial hypertension, evidenced by common parenchymal affections similar to chronic pyelonephritis, or rare diabetic glomerulosclerosis. The occurrence and severity of arterial hypertension varied for different subgroups, being a more frequent finding in microfocal versus postinfarction cardiosclerosis and thrombosis (52.6, 31.6 and 28.2%, respectively), and minimal in alcoholic cardiomyopathy. Comparison of arterial hypertension severity and chronic pyelonephritis incidence for the two most numerous groups demonstrated the gravest condition in postinfarction cardiosclerosis than in microfocal one. The potential role of arterial hypertension in the mechanism of cardiac sudden death is discussed.
基于对肾脏进行的尸检形态学检查(包括特殊染色和肾小动脉病变定量分析),评估了345例心脏性猝死(SCD)病例中动脉高血压的患病率和严重程度。确定了整个病例组以及根据心肌损伤类型(即酒精性心肌病、近期心肌梗死、血栓形成、微灶性或梗死后心肌硬化)划分的亚组中动脉高血压的发病率。发现SCD与动脉高血压密切相关,表现为类似于慢性肾盂肾炎的常见实质病变,或罕见的糖尿病肾小球硬化。不同亚组中动脉高血压的发生情况和严重程度各不相同,在微灶性心肌硬化、梗死后心肌硬化和血栓形成中更为常见(分别为52.6%、31.6%和28.2%),在酒精性心肌病中最少见。对两个病例数最多的组的动脉高血压严重程度和慢性肾盂肾炎发病率进行比较,结果显示梗死后心肌硬化组的病情比微灶性心肌硬化组更为严重。文中讨论了动脉高血压在心脏性猝死机制中的潜在作用。