Myocardial contraction bands. Definition, quantification and significance in forensic pathology

• Published in: International journal of legal medicine Vol. 115; no. 3; pp. 142 - 151
• Main Authors: Baroldi, G, Mittleman, R E, Parolini, M, Silver, M D, Fineschi, V
• Format: Journal Article
• Language: English
• Published: Germany Springer Nature B.V 01-12-2001
• Subjects: Accidental deaths; Acquired Immunodeficiency Syndrome - pathology; Adult; Chagas Disease - pathology; Coronary Disease - pathology; Female; Forensic Medicine; Forensic pathology; Heart Failure - pathology; Humans; Intracranial Hemorrhages - pathology; Male; Middle Aged; Myocardial Contraction; Myocardium - pathology; Necrosis; Staining and Labeling
• ISSN: 0937-9827; 1437-1596
• DOI: 10.1007/s004140100229

Pathological contraction bands affecting myocardial cells are observed in many different human conditions and in different experimental models. Their morphology was defined long ago but we need to understand the pathogenesis and functional meaning. A distinction between different histological forms of contraction bands and their quantification in a large spectrum of human diseases (262 cases) and a normal population sample where death was due to various types of accidental death (170 cases) produced the following conclusions: 1) The term "contraction band necrosis", as used presently, is ambiguous and should be reserved for a specific morpho-functional entity induced experimentally by intravenous catecholamine infusion and seen in equivalent human cases with pheochromocytoma. 2) In human pathology it may represent a sign of adrenergic stress linked with malignant arrhythmia/ventricular fibrillation. 3) Beyond a histological threshold of 37+/-7 foci and 322+/-99 myocells/100 mm2, the lesion may indicate sympathetic overdrive in the natural history of a disease and associated arrhythmogenic supersensitivity. 4) The detection of few pathological contraction bands in normal subjects in some types of accidental death correlates with the survival time, suggesting an agonal adrenergic stimulation to promote the cardiac pump.