Year: 2025
Type: article
Study design: Observational Study
Abstract: Alcohol is the most well-known toxic substance, the negative impact of which on human health and lifestyle is proven. Chronic alcoholism is a pathological condition that occurs after excessive alcohol consumption and can be observed in young and middle-aged men. The aim of the study is to determine the characteristics of the age-sex distribution and pathomorphological changes of the heart and vessels in forensic cases of alcoholic cardiomyopathy (ACMP). Material and methods. In our study, changes in the left ventricular myocardium due to alcohol consumption were investigated in 70 bodies of those who died at home under suspicious circumstances and were sent to the State Specialized Institution "Main Bureau of Forensic Medical Examination of the Ministry of Health of Ukraine" to determine the cause of death. Bioethics. The study was conducted in accordance with the ethical principles set forth in the Declaration of Helsinki (1964) and subsequent amendments thereto. Ethical approval was obtained from the Committee on Ethics of Scientific Research, Experimental Developments and Scientific Works of the Danylo Halytskyi Lviv National Medical University (excerpt from protocol No. 14 dated December 20, 2023). All data were anonymized and processed in strict confidentiality to preserve the privacy of the deceased and their families. Scientific research. "A study of pathogenetic mechanisms and pathomorphological features of endocrine, cardiovascular, respiratory, nervous, digestive, urinary, and reproductive systems and perinatal period diseases with the aim of improvement of their morphological diagnostics." Topic code: IN.07.00.0001.18. State registration number: 0122U201668 Results. The studied group with ACMP comprised 70 deceased people aged 16 to 40. Of these, 49 (70%) were aged 31 to 40. Of these, 51 (72.8%) were men, and 19 (27.2%) were women. Among the concomitant pathologies, chronic alcoholic hepatitis and hepatosis, as well as left-sided lower lobe bronchopneumonia, were detected in a third of cases. Additionally, in 8 (11.4%) cases, pulmonary embolism was found, associated with the presence of parietal thrombi. The final cause of death of the deceased was acute cardiac and cardiorespiratory failure, which arose as a result of heart damage. In 64.3% of people, a high level of ethyl glucuronide was found in the blood, which indicates alcohol consumption 96 hours before death. Heart lesions were represented by dilated cardiomyopathy and myocardial fibrosis. Conclusion. Histological features of ACMP include parenchymal remodeling with dystrophic changes, uneven hypertrophy of cardiomyocytes against the background of stromal, perivascular, and subendocardial fibrosis; intimal “cushion-like” protrusions and sclerosis of intramural arteries; microcirculatory disorders with sludge phenomenon; and focal-diffuse lipomatosis of the wall of the left and right ventricles to the subendocardial sections. Myocardial fibrosis was focal or diffuse, developed mainly in the interstitial spaces around blood vessels, and was accompanied by the proliferation of connective tissue cells of fibroblasts, simultaneously with a decrease in the number of myocytes.
Source: Sudovo-medična ekspertiza
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4412997803