title: Causes of sudden death in patients with obstructive sleep apnea.
abstract: There are few autopsy studies of patients dying suddenly with obstructive sleep apnea (OSA). Twenty-five forensic autopsies of unexpected sudden death in individuals with OSA were reviewed. The causes of death were as follows: cardiomyopathy (n = 11); sudden unexpected death without morphologic findings (SUDNA, n = 6); and other cardiovascular diseases not related to OSA (n = 8). The cardiomyopathy group comprised five hearts with concentric left ventricular hypertrophy without dilatation and six with left ventricular diameter >4 cm (dilated cardiomyopathy). Four of six hearts in the SUDNA group showed right ventricular dilatation compared with seven of 11 showed cardiomyopathy and one of eight miscellaneous. The degree of obesity was greatest in the dilated cardiomyopathy group (10 of 11 obese) followed by the SUDNA group (four of six obese). The cardiac findings in patients dying suddenly and unexpectedly with OSA include nonspecific cardiomyopathy, other cardiac conditions, and hearts without a morphologic cause of death, which show frequent right ventricular dilatation as the only finding.
authors.affiliation: Department of Forensic Medicine, Shanghai Medical College, Fudan University, Shanghai, China.|University of Maryland Medical System, 22 S. Greene St., Baltimore 21201, MD.
authors.forename: MingChang
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Forensic Medicine, Shanghai Medical College, Fudan University, Shanghai, China.|University of Maryland Medical System, 22 S. Greene St., Baltimore 21201, MD.|Division of Forensic Medicine, Key Laboratory of Evidence Sciences, China University of Political Science and Law, 25 West Tucheng Road, Beijing 100088, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Forensic Medicine, Shanghai Medical College, Fudan University, Shanghai, China.|University of Maryland Medical System, 22 S. Greene St., Baltimore 21201, MD.|Division of Forensic Medicine, Key Laboratory of Evidence Sciences, China University of Political Science and Law, 25 West Tucheng Road, Beijing 100088, China.
authors.forename: David
authors.initials: D
authors.lastname: Fowler
authors.affiliation: Department of Forensic Medicine, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Ziqin
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: University of Maryland Medical System, 22 S. Greene St., Baltimore 21201, MD.|Ningbo University, 818 Fenhua Road, Ningbo 315211, Zhejiang, China.
authors.forename: Dengming
authors.initials: D
authors.lastname: Wei
authors.affiliation: University of Maryland Medical System, 22 S. Greene St., Baltimore 21201, MD.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Forensic Medicine, Shanghai Medical College, Fudan University, Shanghai, China.|University of Maryland Medical System, 22 S. Greene St., Baltimore 21201, MD.
authors.forename: Allen
authors.initials: A
authors.lastname: Burke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002311:Cardiomyopathy, Dilated / Q000401:mortality / Q000473:pathology; D002492:Central Nervous System Depressants / Q000032:analysis; D003645:Death, Sudden / Q000209:etiology*; D000431:Ethanol / Q000097:blood; D005260:Female; D049429:Forensic Pathology; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000401:mortality / Q000473:pathology; D017380:Hypertrophy, Right Ventricular / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D009294:Narcotics / Q000032:analysis; D018377:Neurotransmitter Agents / Q000032:analysis; D009765:Obesity / Q000473:pathology; D009929:Organ Size; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D002492:Central Nervous System Depressants; D009294:Narcotics; D018377:Neurotransmitter Agents; D000431:Ethanol
keywords: cause of death; forensic science; obesity; obstructive sleep apnea; sudden death