Patologìâ (Aug 2020)
Heart pathomorphological changes in the long-term alcohol consumption
Abstract
Alcohol is one of the leading causes of death worldwide, annually taking 3 million lives. Alcohol abuse to a greater degree negatively affects the functioning of the cardiovascular system. Aim. Studying the severity of pathomorphological changes in the heart of deceased patients with alcoholism. Materials and methods. The heart sections of 35 deceased alcoholic patients (38–60 years old) were taken for histo-morphometric analysis. As a comparison group, the material of deceased patients (n = 15), suffering from ischemic heart disease (IHD) and hypertension disease (HD) was studied. Results. In conditions of alcoholism in 100 % of cases myocardium showed marked microcirculatory disorders, increased vascular permeability. In all cases sclerotic changes similar in topography to the comparison group were noted, however, sclerosis of large arterioles was 1.9 times less pronounced than in IHD group. In the myocardium of alcoholics, edema, atrophy of cardiomyocytes bundles and areas of fatty stroma are common. In 20 % of cases, there were mosaic necrosis of individual cardiomyocytes and small focal necrosis of small groups of cells, fibrinoid necrosis of small branches of coronary arteries. Compared with IHD group the number of fatty degenerated cardiomyocytes increased by 1.23 times, fuchsinophilic cardiomyocytes – by 1.38 times with simultaneous reducing severity of sclerotic changes in vessels by 1.9 times. Sclerotic changes in stroma are significantly higher in relation to IHD and HD groups (by 1.88 and 6.94 times, respectively). Conclusions. The morphogenesis of heart damage during alcoholism consists of combination of dystrophic, necrotic, atrophic and sclerotic changes – morphological substrate of alcoholic cardiomyopathy. These signs, based on quantitative analysis, are important criteria necessary for the thanatogenetic analysis in cases of death on the background of alcoholism.
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