Morphologic Differences in Myocardial Necrosis and Atherosclerotic Plaque. What is their Pathogenetic Meaning?

Abstract

Frequency and extension of different types of myocardial necrosis and variables of the coronary atherosclerotic plaque have been examined and statistically compared in 200 fatal acute infarct, 208 sudden unexpected death, 50 chronic ischemia cases and 97 healthy controls. In pratically all infarct cases the pathognomonic coagulation or infarct necrosis was associated with coagulative myocytolysis (contraction band necrosis) and in half of cases with colliquative myocytolysis. In sudden death and chronic ischemia coagulative myocytlysis prevailed. The three different morpho-functional types of myocardial cell death indicate that pathogenic mechanisms (adrenergic overstimulation or catecholamine depletion) other than ischemic heart disease. In respect of plaque variables many significant divergencies were shown among the ischemic groups and between the latters and healthy controls.