Infection-associated intimal thickening in the coronary arteries of children

Objectives: based on autopsy material from children this study investigated the possible relationship of clinically evident infection prior to death w ith intimal thickening of the coronary arteries. Background: viral infectio ns are suggested to be associated with intimal thickening in the coronary a rteries both in animals and man. Methods: the coronary arteries were examin ed in 175 autopsied children 0-15 years of age (median 7 days). Semi-serial cross sections of the coronary arteries were screened for maximal intimal thickening at 0.2 mm intervals. The length of the internal elastic lamina, the areas of arterial media and intima were measured from cross-sections. I rregular linings of the arteries were mathematically transformed to circles . The percentage of intimal and musculoelastic layer area to luminal area e ncircled by arterial media was calculated. Results: intimal thickening incr eased with age but was also associated with the presence of infectious dise ase at death. Already in the newborn children, who died shortly after the b irth, the percentage of intimal and musculoelastic layer area to luminal ar ea encircled by arterial media was big, maximally 55%. In the left coronary artery the mean percentages were 32 and 21% in the groups with viral and b acterial infections, respectively as compared to 16% in the group with no e vidence of infection. Conclusion: infections in general and viral infection s in particular, seem to be associated with intimal thickening, which may p redispose coronary arteries to atherosclerosis, Atherogenesis might have a rapid dynamic component. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.