title: Coronary fat embolism following subarachnoid hemorrhage: an experimental study.
abstract: BACKGROUND
  Subarachnoid hemorrhage (SAH) can lead to neurogenic pulmonary edema (NPE), and chylomicron metabolism may be altered unfavorably in acute lung injury. This study aimed to investigate the possible effect of NPE on the development of coronary fat embolism.
  
  
  METHODS
  This study was conducted on 27 rabbits, 5 of which were used as the control (n=5). Experimental SAH was induced in 15 of the animals by injecting homologous blood into the cisterna magna, and the remaining 7 animals were administered only isotonic saline solution (Sham, n=7) in the same manner under general anesthesia. After 21 days, all the animals were euthanized, and their hearts, lungs, and brains underwent histopathological examination.
  
  
  RESULTS
  Six animals died of SAH during the experiment, and foamy hemorrhagic parenchymal lesions and intra-alveolar hemorrhage were observed in their lungs. The histopathologic findings revealed minimal changes in the lungs, heart, and brains of the surviving animals; however, an abundant amount of fat globules was found in the coronary arteries of the six nonsurviving animals. There was a meaningful difference between the number of occluded coronary arteries with fatty globules in the surviving and nonsurviving animals (P<.001). However, the difference between the survivors and the isotonic-saline-injected group was not meaningful (P>.05). Coronary fat embolism was an important mortality factor following SAH (P<.005).
  
  
  CONCLUSIONS
  In SAH-induced NPE, the leakage of chylomicrons into the systemic circulation may lead to coronary fat embolism, which has not yet been reported in the literature.
authors.affiliation: Ataturk University Faculty of Medicine, Department of Cardiology, Erzurum, Turkey.
authors.forename: Ednan
authors.initials: E
authors.lastname: Bayram
authors.affiliation: Ataturk University Faculty of Medicine, Department of Anesthesiology and Reanimation, Erzurum, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Atalay
authors.affiliation: Palandoken State Hospital, Department of Cardiology, Erzurum, Turkey.
authors.forename: Ender
authors.initials: E
authors.lastname: Altaş
authors.affiliation: Ataturk University Faculty of Medicine, Department of Cardiology, Erzurum, Turkey. Electronic address: yavuzerkoza@hotmail.com.
authors.forename: Yavuzer
authors.initials: Y
authors.lastname: Koza
authors.affiliation: Erzurum Education and Research Hospital, Department of Pathology, Erzurum, Turkey.
authors.forename: Eşref
authors.initials: E
authors.lastname: Kabalar
authors.affiliation: Ataturk University Faculty of Medicine, Department of Cardiology, Erzurum, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Açıkel
authors.affiliation: Ataturk University Faculty of Medicine, Department of Neurosurgery, Erzurum, Turkey.
authors.forename: Mehmet Dumlu
authors.initials: MD
authors.lastname: Aydın
mesh_terms: D000818:Animals; D002914:Chylomicrons / Q000097:blood; D054059:Coronary Occlusion / Q000097:blood / Q000209:etiology* / Q000473:pathology; D003331:Coronary Vessels / Q000378:metabolism / Q000473:pathology*; D004195:Disease Models, Animal; D004620:Embolism, Fat / Q000097:blood / Q000209:etiology* / Q000473:pathology; D008297:Male; D011654:Pulmonary Edema / Q000097:blood / Q000209:etiology* / Q000473:pathology; D011817:Rabbits; D013345:Subarachnoid Hemorrhage / Q000097:blood / Q000150:complications* / Q000473:pathology
chemical_list: D002914:Chylomicrons
keywords: Coronary fat embolism; Neurogenic pulmonary edema; Subarachnoid hemorrhage