«Саратовский научно-медицинский журнал» » Архив номеров » Volume 10, issue 1 » Публикация

Аннотация In order to establish the relationship between the timing of fetal obliteration of communication and expression remodeling of the heart chambers, as one of the possible causative factors of SIDS, the selected material has been based on macromorphometric study. Material included 43 hearts from infants who died of SIDS. The control group consisted of 48 hearts of children suddenly dead from aspiration of gastric contents and infectious disease. The methods composed a macroscopic examination of the heart by the method of separate weighing of the complex morphometric studies, histological examination (used the following stains: hematoxylin and eosin, picrofuchsin by Van Gieson, Nissl's stain), immunohistochemical method using markers of neurofilament. The results revealed that in children who died of SIDS, obliteration of the fetal communication occurs essentially in the late period —to the age of 8 months, and the mass of the left and right ventricles of the heart exceeds the age limit of normal due to the prevalence of ventricular muscle mass and hypertrophy of cardiomyocytes. In all parts of the heart subendocardial fibrosis in the ventricles — pronounced interstitial fibrosis has been observed. In the interatrial septum at the location at the oval window morphometric study resulted in significant predominance area percentage of connective tissue in relation to the muscle tissue. On histological sections elements of the nervous tissue — randomly arranged nerve ganglia with degenerative changes and nerve fibers were identified. Conclusion. Finally, it should be noted that the growth of cardiosclerosis in all parts of the heart in newborns and infants, who died suddenly from SIDS, extends the terms of obliteration of fetal communications, and degenerative changes in the nerve ganglia that lead to the disturbance of supply and distribution of nerve impulses that pass through them. These factors contribute to the development of hemodynamic disturbances and may be important in the development of sudden death in children.