Early atherosclerotic lesions of the cardiac conduction system arteries in infants.
BACKGROUND
Although several studies have described initial atherosclerotic lesions of the coronary arteries, already detectable in infancy and even during the intrauterine life, little, if any, attention has been given to the possible involvement of the cardiac conduction system arteries. In particular, to the best of our knowledge, none has considered the lesions of the cardiac conduction arteries as an initial stage of atherosclerosis.


METHODS
The cardiac conduction system of 70 infants dying suddenly and unexpectedly was removed in two blocks for paraffin embedding and serially cut.


RESULTS
The histological study of the cardiac conduction arteries of the 70 cases examined showed a normal structure in 55 cases (78.57%). In 15 cases (21.43%), there was a thickening of the sinoatrial node and/or atrioventricular artery associated with a thickening of varying severity in coronary artery walls. The lesions were marked by thickening and deposits of amorphous material and mainly lipids in the intima, as well as fragmentation of the elastic fiber system. A significant correlation was evident between early atherosclerotic lesions and both formula feeding and parental cigarette smoking (P<.05, chi(2) test).


CONCLUSIONS
The combination of both the considered risk factors seems to increase the early atherogenic effect of each noxa because the coronary lesions were more diffused in formula-fed infants whose parents both smoked.
Matturri
Luigi
L
Institute of Pathology, University of Milan, Via della Commenda 19, 20122 Milan, Italy. luigi.matturri@unimi.it
Ottaviani
Giulia
G
Lavezzi
Anna M
AM
Rossi
Lino
L
D001283:Atrioventricular Node / Q000378:metabolism / Q000473:pathology*; D015415:Biomarkers / Q000032:analysis; D003324:Coronary Artery Disease / Q000209:etiology* / Q000378:metabolism / Q000473:pathology*; D003331:Coronary Vessels / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012849:Sinoatrial Node / Q000378:metabolism / Q000473:pathology*; D013398:Sudden Infant Death / Q000473:pathology
D015415:Biomarkers