Infection-associated intimal thickening in the coronary arteries of children.
OBJECTIVE
based on autopsy material from children this study investigated the possible relationship of clinically evident infection prior to death with intimal thickening of the coronary arteries.


BACKGROUND
viral infections are suggested to be associated with intimal thickening in the coronary arteries both in animals and man.


METHODS
the coronary arteries were examined in 175 autopsied children 0-15 years of age (median 7 days). Semi-serial cross sections of the coronary arteries were screened for maximal intimal thickening at 0.2 mm intervals. The length of the internal elastic lamina, the areas of arterial media and intima were measured from cross-sections. Irregular linings of the arteries were mathematically transformed to circles. The percentage of intimal and musculoelastic layer area to luminal area encircled by arterial media was calculated.


RESULTS
intimal thickening increased with age but was also associated with the presence of infectious disease at death. Already in the newborn children, who died shortly after the birth, the percentage of intimal and musculoelastic layer area to luminal area encircled by arterial media was big, maximally 55%. In the left coronary artery the mean percentages were 32 and 21% in the groups with viral and bacterial infections, respectively as compared to 16% in the group with no evidence of infection.


CONCLUSIONS
infections in general and viral infections in particular, seem to be associated with intimal thickening, which may predispose coronary arteries to atherosclerosis. Atherogenesis might have a rapid dynamic component.
Department of Pediatrics, Lund University Hospital, Sweden.
E
E
Pesonen
I
I
Paakkari
J
J
Rapola
D000293:Adolescent; D001424:Bacterial Infections / Q000150:complications*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000473:pathology; D002423:Cause of Death; D002455:Cell Division; D002648:Child; D002675:Child, Preschool; D003331:Coronary Vessels / Q000473:pathology*; D004730:Endothelium, Vascular / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009131:Muscle, Smooth, Vascular / Q000473:pathology; D012189:Retrospective Studies; D017539:Tunica Intima / Q000473:pathology*; D014777:Virus Diseases / Q000150:complications*