Investigation of Myocardial Substrate for Sudden Arrhythmic Death in Coronary Artery Disease Without Acute Coronary Thrombosis or Myocardial Infarction
Background This cohort study aimed to evaluate the potential myocardial arrhythmic substrate in people with coronary artery disease who died from sudden arrhythmic death (SAD) without acute coronary thrombosis or myocardial infarction. Methods and Results We performed histological analysis of the le...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-04-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.039624 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850129553165385728 |
|---|---|
| author | Duncan J. Campbell Victoria C. M. Francis Gregory R. Young Noel W. F. Woodford |
| author_facet | Duncan J. Campbell Victoria C. M. Francis Gregory R. Young Noel W. F. Woodford |
| author_sort | Duncan J. Campbell |
| collection | DOAJ |
| description | Background This cohort study aimed to evaluate the potential myocardial arrhythmic substrate in people with coronary artery disease who died from sudden arrhythmic death (SAD) without acute coronary thrombosis or myocardial infarction. Methods and Results We performed histological analysis of the left ventricular free wall obtained at autopsy from decedents with ≥1 coronary artery and ≥75% area stenosis who died suddenly from either noncardiac causes (25 men, 23 women) or SAD (25 men, 25 women), matched for age and sex. Decedents with acute coronary thrombosis, myocardial infarction, or other myocardial abnormality were excluded. Decedents with either noncardiac death or SAD had similar height, weight, and heart weight. Decedents with SAD had higher cumulative area stenosis of coronary arteries (mean, 162% versus 134%; mean difference, 29% [95% CI, 1%–56%], P=0.042) and a higher proportion of decedents with SAD had diabetes (mean, 10% versus 0%; mean difference, 10% [95% CI, 2%–18%], P=0.025) and chronic, nonocclusive, organized coronary artery thrombus (mean, 16% versus 0%; mean difference, 16% [95% CI, 6%–26%], P=0.0040). Moreover, decedents with SAD had lower cardiomyocyte width (mean, 18.6 μm versus 19.6 μm; mean difference, 1.0 μm [95% CI, 0.2–1.8], P=0.014) and higher capillary length density (mean, 3618 mm/mm3 versus 3164 mm/mm3; mean difference, 453 mm/mm3 [95% CI, 210–697], P=0.0003) than decedents with noncardiac death. Conclusions SAD in people with coronary artery disease without acute coronary thrombosis or myocardial infarction was associated with greater coronary artery plaque burden and cardiomyocyte atrophy that may have contributed to myocardial substrate for arrhythmia. |
| format | Article |
| id | doaj-art-19d462397f014f3da086a3b9dbc0fdc3 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-19d462397f014f3da086a3b9dbc0fdc32025-08-20T02:32:56ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-04-0114810.1161/JAHA.124.039624Investigation of Myocardial Substrate for Sudden Arrhythmic Death in Coronary Artery Disease Without Acute Coronary Thrombosis or Myocardial InfarctionDuncan J. Campbell0Victoria C. M. Francis1Gregory R. Young2Noel W. F. Woodford3St. Vincent’s Institute of Medical Research Fitzroy Victoria AustraliaDepartment of Forensic Medicine, School of Public Health and Preventive Medicine Monash University Southbank Victoria AustraliaDepartment of Forensic Medicine, School of Public Health and Preventive Medicine Monash University Southbank Victoria AustraliaDepartment of Forensic Medicine, School of Public Health and Preventive Medicine Monash University Southbank Victoria AustraliaBackground This cohort study aimed to evaluate the potential myocardial arrhythmic substrate in people with coronary artery disease who died from sudden arrhythmic death (SAD) without acute coronary thrombosis or myocardial infarction. Methods and Results We performed histological analysis of the left ventricular free wall obtained at autopsy from decedents with ≥1 coronary artery and ≥75% area stenosis who died suddenly from either noncardiac causes (25 men, 23 women) or SAD (25 men, 25 women), matched for age and sex. Decedents with acute coronary thrombosis, myocardial infarction, or other myocardial abnormality were excluded. Decedents with either noncardiac death or SAD had similar height, weight, and heart weight. Decedents with SAD had higher cumulative area stenosis of coronary arteries (mean, 162% versus 134%; mean difference, 29% [95% CI, 1%–56%], P=0.042) and a higher proportion of decedents with SAD had diabetes (mean, 10% versus 0%; mean difference, 10% [95% CI, 2%–18%], P=0.025) and chronic, nonocclusive, organized coronary artery thrombus (mean, 16% versus 0%; mean difference, 16% [95% CI, 6%–26%], P=0.0040). Moreover, decedents with SAD had lower cardiomyocyte width (mean, 18.6 μm versus 19.6 μm; mean difference, 1.0 μm [95% CI, 0.2–1.8], P=0.014) and higher capillary length density (mean, 3618 mm/mm3 versus 3164 mm/mm3; mean difference, 453 mm/mm3 [95% CI, 210–697], P=0.0003) than decedents with noncardiac death. Conclusions SAD in people with coronary artery disease without acute coronary thrombosis or myocardial infarction was associated with greater coronary artery plaque burden and cardiomyocyte atrophy that may have contributed to myocardial substrate for arrhythmia.https://www.ahajournals.org/doi/10.1161/JAHA.124.039624capillary length densitycardiomyocyte atrophycoronary artery diseasemyocardial fibrosissudden arrhythmic death |
| spellingShingle | Duncan J. Campbell Victoria C. M. Francis Gregory R. Young Noel W. F. Woodford Investigation of Myocardial Substrate for Sudden Arrhythmic Death in Coronary Artery Disease Without Acute Coronary Thrombosis or Myocardial Infarction Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease capillary length density cardiomyocyte atrophy coronary artery disease myocardial fibrosis sudden arrhythmic death |
| title | Investigation of Myocardial Substrate for Sudden Arrhythmic Death in Coronary Artery Disease Without Acute Coronary Thrombosis or Myocardial Infarction |
| title_full | Investigation of Myocardial Substrate for Sudden Arrhythmic Death in Coronary Artery Disease Without Acute Coronary Thrombosis or Myocardial Infarction |
| title_fullStr | Investigation of Myocardial Substrate for Sudden Arrhythmic Death in Coronary Artery Disease Without Acute Coronary Thrombosis or Myocardial Infarction |
| title_full_unstemmed | Investigation of Myocardial Substrate for Sudden Arrhythmic Death in Coronary Artery Disease Without Acute Coronary Thrombosis or Myocardial Infarction |
| title_short | Investigation of Myocardial Substrate for Sudden Arrhythmic Death in Coronary Artery Disease Without Acute Coronary Thrombosis or Myocardial Infarction |
| title_sort | investigation of myocardial substrate for sudden arrhythmic death in coronary artery disease without acute coronary thrombosis or myocardial infarction |
| topic | capillary length density cardiomyocyte atrophy coronary artery disease myocardial fibrosis sudden arrhythmic death |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.039624 |
| work_keys_str_mv | AT duncanjcampbell investigationofmyocardialsubstrateforsuddenarrhythmicdeathincoronaryarterydiseasewithoutacutecoronarythrombosisormyocardialinfarction AT victoriacmfrancis investigationofmyocardialsubstrateforsuddenarrhythmicdeathincoronaryarterydiseasewithoutacutecoronarythrombosisormyocardialinfarction AT gregoryryoung investigationofmyocardialsubstrateforsuddenarrhythmicdeathincoronaryarterydiseasewithoutacutecoronarythrombosisormyocardialinfarction AT noelwfwoodford investigationofmyocardialsubstrateforsuddenarrhythmicdeathincoronaryarterydiseasewithoutacutecoronarythrombosisormyocardialinfarction |