Histological and Morphometric Analysis with Grading of Atherosclerosis-Associated Myocardial Changes in Cases of Sudden Death at a Tertiary Care Hospital
DOI:
https://doi.org/10.55489/njmr.150320251125Keywords:
Coronary Atherosclerosis, Sudden Death, Ischaemic Heart Disease, Intima Media Ratio, Intimal Thickness IndexAbstract
Background: Sudden cardiac death (SCD) remains a significant public health concern worldwide, representing a considerable proportion of mortality linked to cardiovascular diseases. Atherosclerosis, a progressive disease characterized by the accumulation of lipids, fibrous elements, and inflammatory cells within the arterial walls, is a leading underlying cause of SCD.
Methodology: An observational study was conducted focusing on histology, morphometric analysis, and grading of atherosclerosis-associated myocardial findings in cases of sudden death in 194 cases over a period of 18 months in the Department of Pathology, SMIMER Medical College, Surat.
Results: The study involved 194 participants, with a notable gender imbalance favouring males, who represented 89.7% of the cohort. There was a clear trend of increasing coronary artery grade with advancing age. Ischemic Heart Disease (IHD) was the most prevalent myocardial finding, observed in 54.6% of the cases. 148 (76%) cases showed both the coronary involvement in patients with Ischaemic Heart Disease. For Ischemic Heart Disease (IHD), the AHA grades are predominantly VII (47.2%), V (21.7%), and VI (17.0%). As the coronary artery grade increases, there is a notable rise in both ITI and IMR values.
Conclusion: In conclusion, this study demonstrates that a comprehensive evaluation combining histological grading and morphometric analysis is crucial for a thorough understanding of atherosclerosis-related myocardial changes.
References
Yow AG, Rajasurya V, Ahmed I, et al. Sudden Cardiac Death. [Updated 2024 Mar 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507854/
Gusev E, Sarapultsev A. Atherosclerosis and Inflammation: Insights from the Theory of General Pathological Processes. Int J Mol Sci. 2023 Apr 26;24(9):7910. DOI: https://doi.org/10.3390/ijms24097910 PMid:37175617 PMCid:PMC10178362 DOI: https://doi.org/10.3390/ijms24097910
Sachdev V, Rosing DR, Thein SL. Cardiovascular complications of sickle cell disease. Trends Cardiovasc Med. 2021 Apr;31(3):187-193. DOI: https://doi.org/10.1016/j.tcm.2020.02.002 PMid:32139143 PMCid:PMC7417280 DOI: https://doi.org/10.1016/j.tcm.2020.02.002
Luca AC, David SG, David AG, Țarcă V, Pădureț IA, Mîndru DE, Roșu ST, Roșu EV, Adumitrăchioaiei H, Bernic J, Cojocaru E, Țarcă E. Atherosclerosis from Newborn to Adult-Epidemiology, Pathological Aspects, and Risk Factors. Life (Basel). 2023 Oct 14;13(10):2056. DOI: https://doi.org/10.3390/life13102056 PMid:37895437 PMCid:PMC10608492 DOI: https://doi.org/10.3390/life13102056
Harveen B, Vijaya C, Smita M, Atherosclerosis in coronary arteries and aorta by modified American heart association classification: An autopsy study. IP Arch Cytol Histopathol Res 2022;7(2):100-104. DOI: https://doi.org/10.18231/j.achr.2022.021 DOI: https://doi.org/10.18231/j.achr.2022.021
Bhanvadia VM, Desai NJ, Agarwal NM. Study of Coronary Atherosclerosis by Modified American Heart Association Classification of Atherosclerosis-An Autopsy Study. J Clin Diagn Res 2013;7(11):2494-7. DOI: https://doi.org/10.7860/JCDR/2013/6828.3588 PMid:24392381 PMCid:PMC3879834 DOI: https://doi.org/10.7860/JCDR/2013/6828.3588
Bhargava MK, Bhargava SK. Coronary atherosclerosis in North Karnatka. Indian J Pathol Microbiol. 1975 Apr;18(2):65-79. PMID: 1213818.
Tandon OP, Agrawal VC, Katiyar BC. Coronary and aortic atherosclerosis. (A study on 300 medicolegal postmortems). Indian Heart J. 1969 Jan;21(1):5-10. PMID: 5783200.
Birare SD, Swami DV, Gaikwad SS, Malpani RR. Study of the Histopathological Changes in the Heart in Postmortem/Autopsy Cases in Tertiary Care Center. Heart Views. 2024 Jan-Mar;25(1):9-12. DOI: https://doi.org/10.4103/heartviews.heartviews_45_23 PMid:38774551 PMCid:PMC11104543 DOI: https://doi.org/10.4103/heartviews.heartviews_45_23
Marwah N, Bhawna S, Sumiti G, Amrita D, Sunita S, Rajeev S. Histomorphological Spectrum of Various Cardiac Changes in Sudden Death: An Autopsy Study. Iranian Journal of Pathology, 2011; 6(4): 179-186.
Singh P, Satarkar RN, Kalhan S, Hasija S, Bhawna, Sangwaiya A, Chawla S. Correlation of coronary artery atherosclerosis typing and luminal narrowing with ischemic myocardial lesions in post mortem heart specimens: a four year retrospective study. Trop J Pathol Microbiol. 2018 Jul.3;4(3):248-57. DOI: https://doi.org/10.17511/jopm.2018.i03.03 DOI: https://doi.org/10.17511/jopm.2018.i03.03
Khiste JA, Kurdukar MD, Pandit GA, Kokate PS. Morphologic and morphometric analysis of atherosclerotic coronary arteries in Medicolegal Autopsies. International Journal of Current Research. 2018;10(04):67671-67674.
Jain S, Biligi DS. An Autopsy Study on Coronary Atherosclerosis with Morphological and Morphometric Analysis. International Journal of Science and Research 2013;4:2319-7064.
Chatzizisis YS, Giannoglou GD, Parcharidis GE, Louridas GE. Is left coronary system more susceptible to atherosclerosis than right? A pathophysiological insight. Int J Cardiol. 2007 Mar 2;116(1):7-13. DOI: https://doi.org/10.1016/j.ijcard.2006.03.029 PMid:16908081 DOI: https://doi.org/10.1016/j.ijcard.2006.03.029
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Prathana Patel, Smita Jhaveri, Parth Patel

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Author/s retain the copyright of their article, with first publication rights granted to Medsci Publications.