Lack of Correlation between Coronary Plaque Burden and Heart Weight at Forensic Autopsy.
Julia Shields, Ling Li, David R Fowler, Yang Zhang, Allen P Burke. University of Maryland, Baltimore; Maryland Office of the Chief Medical Examiner, Baltimore; University of Maryland School of Medicine, Baltimore
Background: It is unclear if extent of coronary atherosclerosis is associated with increase in heart muscle mass.
Design: We retrospectively reviewed autopsy reports of sudden coronary deaths occurring in a statewide medical examiner system over a one-year period. Cardiomegaly was assessed by body weight and height, and given a score of 0-4 based on amount above the upper limit of normal range. Hypertension was assessed by history or renal vasculature findings. Coronary disease was quantitated as number of epicardial arteries (left main, left anterior descending, left circumflex and right coronary and their major branches) with ≥ 75% cross sectional luminal narrowing, for a score of 1-4.
Results: There were 178 men (50±11 years) and 58 women (57± 18 years). There were 100 hearts with 1-vesel disease (66 men, 34 women), 77 with 2 vessel disease (59 men, 18 women), and 59 with three- or four vessel disease (53, men, 6 women). Extent of disease was less in women than men (p=.004). Hypertension was present in 36% of men, and 45% of women. Body mass index was 30 ± 6 in men, and 27 ± 6 in women. Healed infarcts were present in 14% of women and 28% of men. Cardiomegaly was present in 50% of women, and 69% of men. By univariate analysis, cardiomegaly score increased with number of stenosed arteries (p=.02) as well as % of hearts with cardiomegaly (p=.004), in patients without hypertension. However, by multivariate analysis, only age (p=.008), body mass index (p<.0001) and presence of healed infarct (p=.06) were associated with cardiomegaly score, extent of coronary disease showing no correlation (p=0.9).
Conclusions: There is no significant correlation between extent of coronary atherosclerosis and cardiac hypertrophy independent of age and body mass index in sudden coronary deaths. These data do not support a causative association between chronic ischemia and cardiomegaly.
Monday, February 28, 2011 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 2, Monday Morning