title: Correlation between coronary plaque burden and heart weight.
abstract: It is unclear if the extent of coronary atherosclerosis is associated with increase in heart muscle mass. We retrospectively reviewed autopsy reports of sudden coronary deaths occurring in a statewide medical examiner system over a one-year period. Cardiomegaly was assessed by height, and given a score of 0-4 based on amount above the upper limit of normal range. Coronary disease was quantitated as number of epicardial arteries with ≥75% cross sectional luminal narrowing. There were 100 hearts with one-vessel disease, 77 with two-vessel disease, and 59 with three- or four-vessel diseases. The extent of disease was less in women than men (P=0.002). Healed infarcts were present in 21% of women and 36% of men. Cardiomegaly was present in 50% of women and 69% of men. By univariate analysis, in patients without hypertension, cardiomegaly score in the three- or four-vessel disease group was significantly greater than in the one-vessel disease group (P=0.005), as well as the frequency of cardiomegaly (P=0.001). Hearts with myocardial scar had a more frequent cardiomegaly (P=0.0004) and higher cardiomegaly score (P=0.004) than without myocardial scar. Moreover, by multivariate analysis, body mass index (P<0.0001), extent of coronary disease (P=0.02) and healed infarct (P=0.04) were positively associated with cardiomegaly. We conclude that there is a significant correlation between the extent of coronary atherosclerosis and cardiac hypertrophy independent of age and body mass index in sudden coronary deaths as well as healed infarct. These data support a causative association between chronic ischemia and cardiomegaly.
authors.affiliation: Department of Forensic Medicine, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Mingchang
authors.initials: M
authors.lastname: Zhang
authors.forename: Julia
authors.initials: J
authors.lastname: Shields
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhang
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.forename: David
authors.initials: D
authors.lastname: Fowler
authors.forename: Ziqin
authors.initials: Z
authors.lastname: Zhao
authors.forename: Allen
authors.initials: A
authors.lastname: Burke
mesh_terms: D000328:Adult; D000368:Aged; D001344:Autopsy; D006332:Cardiomegaly / Q000401:mortality / Q000473:pathology*; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000401:mortality / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D016757:Death, Sudden, Cardiac / Q000473:pathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000473:pathology; D016018:Least-Squares Analysis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000473:pathology; D009206:Myocardium / Q000473:pathology*; D009929:Organ Size; D058226:Plaque, Atherosclerotic; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index