Fornes P, Lecomte D, Nicolas G
Institut médico-légal de Paris.
Arch Mal Coeur Vaiss. 1994 Mar;87(3):319-24.
Autopsy studies of the heart of 221 subjects who suffered pre-hospital coronary sudden death were performed at the Paris Medico-Legal Institute over a period of 3 years to compare the lesions observed in subjects without known cardiovascular disease (Group A: n = 160; 72.4%) with those of subjects with known cardiovascular disease (Group B: n = 61). The proportion of men was greater in Group B (77%) that in Group A (62.5%). The average age of sudden death was the same in both groups: 65 years for men and 77 years for women. Sudden death usually occurred in the home (83%) at rest and, in one third of the cases, during sleep. Sudden death occurred in a context of severe coronary artery disease in both groups: significant triple vessel stenosis (> 75%) in 60% of subjects in both groups but thrombosis was found in only 13% of cases in Group A and 15% of cases in Group B. The mean weight of the heart was significantly greater than normal in both groups and in both sexes. In addition, the mean weight of the heart of subjects in Group B was significantly greater than that of subjects in Group A (p < 0.05). This autopsy study showed that prehospital coronary sudden death was the first sign of coronary disease in 70% of cases. Irrespective of whether the subject had known cardiovascular disease or not, sudden death occurred under similar circumstances and, in both cases, in the context of severe coronary artery disease.
巴黎法医学研究所对221名院外冠状动脉性猝死患者的心脏进行了尸检研究，为期3年，以比较无已知心血管疾病患者（A组：n = 160；72.4%）和有已知心血管疾病患者（B组：n = 61）的病变情况。B组男性比例（77%）高于A组（62.5%）。两组猝死的平均年龄相同：男性为65岁，女性为77岁。猝死通常发生在家中（83%），且处于休息状态，三分之一的病例发生在睡眠期间。两组猝死均发生在严重冠状动脉疾病的背景下：两组60%的受试者存在显著的三支血管狭窄（> 75%），但A组仅13%的病例发现血栓形成，B组为15%。两组男女的心脏平均重量均显著高于正常。此外，B组受试者的心脏平均重量显著高于A组（p < 0.05）。这项尸检研究表明，70%的病例中，院外冠状动脉性猝死是冠心病的首发症状。无论受试者是否有已知心血管疾病，猝死均在相似情况下发生，且两种情况下均发生在严重冠状动脉疾病的背景下。
