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. 2023 Jul-Sep;64(3):399-410.
doi: 10.47162/RJME.64.3.11.

Assessment of the aortic tunica media histological changes in relation with the cause of death

Doru Adrian Şeicaru  1 , Mircea Liţescu, Florentina Gherghiceanu, Mircea Sebastian Şerbănescu, Valentin Titus Grigorean, Răzvan Mihail Pleşea
Affiliations

Assessment of the aortic tunica media histological changes in relation with the cause of death

Doru Adrian Şeicaru et al. Rom J Morphol Embryol. 2023 Jul-Sep.

Abstract

Aim: The authors set out to evaluate the correlations between three of the main morphological aortic parameters (elastic fibers - FE, collagen fibers - FCOL, and smooth muscle fibers - FM) and the cause of death.

Materials and methods: Study groups included 25 cases died of a vascular disease (V_P), 37 cases died of a non-vascular disease (NV_P) and 28 cases died of a violent/suspect non-pathological cause of death (V_Dth), the latter group representing also the control group. Four aortic cross-sections (base, arch, thoracic, and abdominal regions) were collected during autopsy from the selected cases, fixed in 10% buffered formalin and first of all photographed together with a calibrating ruler. Then, they were embedded in paraffin, sectioned off at 4 μm and stained with Hematoxylin-Eosin (HE) and Orcein. The obtained histological slides were transformed into virtual slides. Fibrillary components amounts were using a custom-made software, developed in MATLAB (MathWorks, USA). Statistical tools used were Pearson's correlation test, t-test (two-sample assuming equal variances) and one-way analysis of variance (ANOVA) test.

Results and discussions: The amounts of the three fibrillary components of the aortic tunica media had a synchronous variation in all aortic regions in each of the three groups, excepting FCOL in the group of patients died from vascular pathology, which presented only a trend of synchronous variation along the aorta. FE had their lowest values and FCOL had their highest values in patients died from vascular pathology. FCOL had always higher levels than FE in people died from any pathological condition, vascular or non-vascular. FM had always at least two times lower level than that of the other types of fibers, regardless of whether the person died due to a pathological condition or not.

Conclusions: The different pathological conditions causing death are influencing the fibrillary composition of aortic tunica media. Further studies are required to reveal other changes in the morphology of aortic wall in particular and vascular wall in general that could be related with different pathological conditions affecting the entire organism.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

Figure 1
Figure 1
Windows of Aperio ImageScope program: (a) Selection of areas for measurement of different fibrillary components of aortic wall: HE (up), Orcein (middle) and Goldner’s trichrome (bottom) staining, ×0.6; (b) Detail – areas selected for elastic fibers measurement (left) stained with Orcein and smooth muscle fibers and collagen fibers stained with Goldner’s trichrome (right), ×20. HE: Hematoxylin–Eosin
Figure 2
Figure 2
Behavior of fibrillary components along the aorta in V_P group. FCOL: Collagen fibers; FE: Elastic fibers; FM: Smooth muscle fibers; V_P: Vascular pathology
Figure 3
Figure 3
Behavior of all types of fibers (FE, FCOL and FM) along the aortic length in V_P group. FCOL: Collagen fibers; FE: Elastic fibers; FM: Smooth muscle fibers; V_P: Vascular pathology.
Figure 4
Figure 4
Behavior of fibrillary components along the aorta in NV_P group. FCOL: Collagen fibers; FE: Elastic fibers; FM: Smooth muscle fibers; NV_P: Non-vascular pathology
Figure 5
Figure 5
Behavior of all types of fibers (FE, FCOL and FM) along the aortic length in NV_P group. FCOL: Collagen fibers; FE: Elastic fibers; FM: Smooth muscle fibers; NV_P: Non-vascular pathology
Figure 6
Figure 6
Behavior of fibrillary components along the aorta in V_Dth group. FCOL: Collagen fibers; FE: Elastic fibers; FM: Smooth muscle fibers; V_Dth: Violent death
Figure 7
Figure 7
Behavior of all types of fibers (FE, FCOL and FM) along the aortic length in V_Dth group. FCOL: Collagen fibers; FE: Elastic fibers; FM: Smooth muscle fibers; V_Dth: Violent death
Figure 8
Figure 8
Comparison with literature of causes of death. CD: Communicable diseases; I: Injuries; NCD: Noncommunicable diseases; NV_P: Non-vascular pathological cause of death; OS: Our study; RO: Romania; V_P: Vascular pathological cause of death; V_Dth: Violent/suspicious cause of death
Figure 9
Figure 9
Evolution of FE amount along the aorta in the three groups. FE: Elastic fibers; NV_P: Non-vascular pathology; V_Dth: Violent death; V_P: Vascular pathology
Figure 10
Figure 10
Evolution of FCOL amount along the aorta in the three groups. FCOL: Collagen fibers; NV_P: Non-vascular pathology; V_Dth: Violent death; V_P: Vascular pathology
Figure 11
Figure 11
Evolution of FM amount along the aorta in the three groups. FM: Smooth muscle fibers; NV_P: Non-vascular pathology; V_Dth: Violent death; V_P: Vascular pathology
Figure 12
Figure 12
Evolution of the three types of fibers’ amounts in the V_P group. FCOL: Collagen fibers; FE: Elastic fibers; FM: Smooth muscle fibers; V_P: Vascular pathology
Figure 13
Figure 13
Evolution of the three types of fibers’ amounts in the NV_P group. FCOL: Collagen fibers; FE: Elastic fibers; FM: Smooth muscle fibers; NV_P: Non-vascular pathology
Figure 14
Figure 14
Evolution of the three types of fibers’ amounts in the V_Dth group (control group). FCOL: Collagen fibers; FE: Elastic fibers; FM: Smooth muscle fibers; V_Dth: Violent death
See this image and copyright information in PMC

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