Morphologic and morphometric analysis of atherosclerotic coronary arteries in medicolegal autopsies

Objective: Present study was aimed at evaluating the degree of severity of atherosclerosis by morphologic and morphometric indices. Study was also undertaken to correlate morphological grades with morphometric parameters. Materials and Methods: Present study comprised of 80 heart specimens from consecutive medicolegal autopsy cases. Detailed gross examination of heart and four coronary arteries viz right coronary, left coronary, left anterior descending and left circumflex artery was done for evidence of infarction and atherosclerosis respectively. All the four arteries were assessed morphologically for 6 numerical grades as per the American Heart Association criteria. Thickness of intima, thickness of media, diameter of lumen and diameter internal to the media was measured under 400X using MICAPS software. Two morphometric parameters viz percentage of luminal narrowing and intima to media thickness ratio (IMTR) were evaluated for severity of atherosclerosis. Result: Atherosclerosis was present in 81.87 % of cases. Females outnumbered males. Eccentric atheromas were seen in 67.81% of arteries. Left anterior descending artery had severe degree of atherosclerosis. Both parameters were directly proportional to the grades of atherosclerosis in all the four coronary arteries. Myocardial infarction was predominantly observed in grade VI atherosclerosis. Conclusion: Comprehensive analysis of both morphologic and morphometric evaluation of arteries is a reliable tool to assess the severity of atherosclerosis.