Myocardial contraction bands - Definition, quantification and significance in forensic pathology

被引:68
作者
Baroldi, G
Mittleman, RE
Parolini, M
Silver, MD
Fineschi, V
机构
[1] Univ Foggia, Osped Riuniti, Inst Legal Med, I-7110 Foggia, Italy
[2] Niguarda Hosp Milan, CNR, Inst Clin Physiol, Milan, Italy
[3] Univ Milan, Inst Biomed Sci, Milan, Italy
[4] Toronto Hosp, Dept Pathol, Toronto, ON M5T 2S8, Canada
[5] Univ Toronto, Fac Med, Toronto, ON, Canada
[6] Dist 19 Med Examiner, Ft Pierce, FL USA
关键词
contraction band necrosis; coagulative myocytolysis; catecholamine myotoxicity; sudden cardiac death; myocardial infarction; adrenergic stress;
D O I
10.1007/s004140100229
中图分类号
DF [法律]; D9 [法律]; R [医药、卫生];
学科分类号
0301 ; 10 ;
摘要
Pathological contraction bands affecting myocardial cells are observed in many different human conditions and in different experimental models. Their morphology was defined long ago but we need to understand the pathogenesis and functional meaning. A distinction between different histological forms of contraction bands and their quantification in a large spectrum of human diseases (262 cases) and a normal population sample where death was due to various types of accidental death (170 cases) produced the following conclusions: 1) The term "contraction band necrosis", as used presently, is ambiguous and should be reserved for a specific morpho-functional entity induced experimentally by intravenous catecholamine infusion and seen in equivalent human cases with pheochromocytoma. 2) In human pathology it may represent a sign of adrenergic stress linked with malignant arrhythmia/ventricular fibrillation. 3) Beyond a histological threshold of 37 +/- 7 foci and 322 +/- 99 myocells/100 mm(2), the lesion may indicate sympathetic overdrive in the natural history of a disease and associated arrhythmogenic supersensitivity. 4) The detection of few pathological contraction bands in normal subjects in some types of accidental death correlates with the survival time, suggesting an agonal adrenergic stimulation to promote the cardiac pump.
引用
收藏
页码:142 / 151
页数:10
相关论文
共 63 条
[61]  
WALLER BF, 1991, CARDIOVASC PATHOL, P1683
[62]   CARDIAC BETA-ADRENERGIC NEUROEFFECTOR SYSTEMS IN ACUTE MYOCARDIAL DYSFUNCTION RELATED TO BRAIN INJURY - EVIDENCE FOR CATECHOLAMINE-MEDIATED MYOCARDIAL DAMAGE [J].
WHITE, M ;
WIECHMANN, RJ ;
RODEN, RL ;
HAGAN, MB ;
WOLLMERING, MM ;
PORT, JD ;
HAMMOND, E ;
ABRAHAM, WT ;
WOLFEL, EE ;
LINDENFELD, J ;
FULLERTON, D ;
BRISTOW, MR .
CIRCULATION, 1995, 92 (08) :2183-2189
[63]  
ZIMMERMAN ARIAEN, 1967, CARDIOVASC RES, V1, P201, DOI 10.1093/cvr/1.3.201