[Sudden cardiac death in alcoholic cardiomyopathy]. / Vnezapnaia serdechnaia smert' pri alkogol'noi kardiomiopatii.

A composite morpho-histo-biochemical and ultrastructural investigation of the myocardium of 50 subjects dying suddenly in the presence of alcoholic cardiomyopathy (ACMP) was carried out. The dynamics of changes in the myocardium in the development of ACMP is shown indicating that the main feature of the heart in such cases is diffuse uneven atrophy of cardiomyocytes with their replacement by fatty tissue. There are large foci of lesions in the heart stained by Regot's method and the activity of succinate dehydrogenase is changed reflecting metabolic disorders. The ultrastructural changes included vacuolation of sarcoplasmic reticulum, increased amounts of lipids and lysosomes, and intracrystal inclusions in the mitochondria. Examinations of adrenergic heart innervation revealed focal deficiency of noradrenalin in atrial and ventricular plexuses. There was a hypothalamic edema with severe disorders in ACMP. The set of the above lesions appears to explain the sudden death as each of these lesions alone cannot cause sudden death.