Features of morphological changes of the liver’s tissue in cases of sudden cardiac death because of alcoholic cardiomyopathy

Abstract

A retrospective analysis of acts of forensic autopsies from the archives of St Petersburg GBOOSE BSME and histological examination of liver tissue in an amount of 152 cases (78 women and 74 men) with a statistical processing of the results for studying and evaluating the morphological changes of liver’s tissue in cases of sudden cardiac death from alcohol cardiomyopathy. Identified in the course of the study morphological changes in the endothelial lining of the microvasculature showed that in addition to direct cytotoxic effects of ethanol and its metabolites in the basis of damage to the endothelial lining of the microvasculature are the cellular responses associated with exposure to mediators, the release of which is due to irritation of reactive cells, which entails a swelling deformation and increased activity endothelial cell membranes with the expansion of intercellular spaces. The development of increased permeability of the endothelial lining of transport contributes to a violation of electrolytes and nutrients to the changes of the liver’s tissue trophism, which is a substrate for the occurrence of degenerative processes and necrobiotic major structural components of the body. In turn, a direct toxic effect of ethanol and its metabolites on the wall microvascular contributes to ischemia and necrosis of the hepatocytes with the development of severe inflammatory reactions in the surrounding liver tissue, which in turn is the direct cause of the disturbances regeneration nature and excessive proliferation connective tissue with the subsequent restructuring of the vascular bed. Identified and described the morphological criteria of changes in liver’s tissue in cases of death from alcoholic cardiomyopathy should be considered in conjunction with other visceral manifestations, being a reflection of the alcohol intoxication in chronic alcoholism.