Aortic and coronary atherosclerosis in a hamburg autopsy series

Summary

Morphometrical examinations were carried out on 116 male and 117 female cadavers in order to quantify arteriosclerotic lesions of the aorta and coronary arteries. None of these cases died of natural causes. The age range was between 5 and 64 years. Two defined segments of the descending thoracic aorta and the abdominal aorta were examined from every cadaver, the coronary arteries were dissected out and divided into 3 defined segments. After the vessels had been stained with Sudan IV the point-counting-method was used to evaluate the following arteriosclerotic lesions: fatty streaks, fibrous plaques and complicated lesions. The raised lesions are considered to be the sum of the fibrous plaques and complicated lesions. The frequency of the various lesions as well as their absolute and relative surface areas were evaluated. — The following were also taken into account: relative body weight, absolute and relative heart weight, absolute vessel surface area. The characteristics were correlated statistically and variance analyses were carried out. The most important results are:

• 1. The absolute increase in surface area of all vessels shows an age-dependent rise in both sexes.

• 2. The relative heart weights are constant in all age groups; the absolute heart weights increase over all age groups.

• 3. Fatty streaks occur in all age groups, with increasing frequency up to the third decade. The absolute increase in streak surface area increases in almost all vessels and during all decades, however the relative increase in streak surface area is not influenced uniformly by age. The absolute and relative extent of the fatty streaks correlates significantly with the relative body weight.

• 4. Complicated lesions are first observed in the 4th decade and have a relatively small area of spread, with the exception of the abdominal aorta. Fibrous plaques are first observed in the 2nd decade. The frequency and extent of these lesions increases over all decades. Males regularly show more pronounced lesions than females.

• 5. The comparison with three non-German autopsy studies of European origin, as well as with a comprehensive study of the international Arteriosclerosis-Project shows: fatty streaks are quantitatively less pronounced in the male coronary arteries than in most of the so-far examined random groups. The difference in occurence and in the spread of fatty streaks is not very large in the other vessels or in the female group. Raised lesions are quantitatively substantially more strongly pronounced in the male coronary arteries than in all other previously examined random groups. The differences are less pronounced in the other vessels and in females.