Cardiovascular Pathology, Azienda Ospedaliera, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua 35121, Italy.
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Eur Heart J. 2022 Jul 7;43(26):2461-2468. doi: 10.1093/eurheartj/ehac220.
Historically, autopsy contributed to our current knowledge of cardiovascular anatomy, physiology, and pathology. Major advances in the understanding of cardiovascular diseases, including atherosclerosis and coronary artery disease, congenital heart diseases, and cardiomyopathies, were possible through autopsy investigations and clinicopathological correlations. In this review, the importance of performing clinical autopsies in people dying from cardiovascular disease, even in the era of advanced cardiovascular imaging is addressed. Autopsies are most helpful in the setting of sudden unexpected deaths, particularly when advanced cardiovascular imaging has not been performed. In this setting, the autopsy is often the only chance to make the correct diagnosis. In previously symptomatic patients who had undergone advanced cardiovascular imaging, autopsies still play many roles. Post-mortem examinations are important for furthering the understanding of key issues related to the underlying diseases. Autopsy can help to increase the knowledge of the sensitivity and specificity of advanced cardiovascular imaging modalities. Autopsies are particularly important to gain insights into both the natural history of cardiovascular diseases as well as less common presentations and therapeutic complications. Finally, autopsies are a key tool to quickly understand the cardiac pathology of new disorders, as emphasized during the recent coronavirus disease 2019 pandemic.
从历史上看，尸检有助于我们目前对心血管解剖、生理学和病理学的了解。通过尸检调查和临床病理相关性，对心血管疾病的主要进展，包括动脉粥样硬化和冠状动脉疾病、先天性心脏病和心肌病，有了更深入的了解。在这篇综述中，讨论了即使在先进的心血管成像时代，对死于心血管疾病的人进行临床尸检的重要性。尸检在突发意外死亡的情况下最有帮助，特别是当未进行先进的心血管成像时。在这种情况下，尸检通常是做出正确诊断的唯一机会。对于先前有症状且已接受先进心血管成像检查的患者，尸检仍然有很多作用。死后检查对于进一步了解与基础疾病相关的关键问题很重要。尸检有助于提高对先进心血管成像方式的敏感性和特异性的认识。尸检对于深入了解心血管疾病的自然史以及不太常见的表现和治疗并发症尤为重要。最后，尸检是了解新疾病心脏病理学的关键工具，正如在最近的 2019 年冠状病毒病大流行期间所强调的那样。
