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Forensic Sciences Research 2019年第3期4卷 257-266页

作者： benito morentin M.Paz Suárez-Mier Ana Monzó Pilar Molina Joaquín S.Lucena Section of Forensic Pathology Basque Institute of Legal MedicineBilbaoSpain Histopathology Service Department of MadridNational Institute of Toxicology and Forensic SciencesSpain Forensic Pathology Service Institute of Legal Medicine and Forensic SciencesValenciaSpain Forensic Pathology Service Institute of Legal Medicine and Forensic SciencesSevilleSpain

This is a multicentre forensic study that identifies all sports-related sudden deaths (SRSDs) in young people,due to myocardial diseases (MDs) that occurred in a large area of Spain.The aim of the study is to assess the epidemiology,causes of death,and sport activities associated with these fatalities.This is a retrospective study based on forensic autopsies performed in the provinces of Biscay,Seville,Valencia and in the jurisdiction covered by the National Institute of Toxicology and Forensic Sciences in Madrid (Spain).The retrospective study encompasses from 2010 to 2017.All sudden cardiac deaths (SCDs) in persons 1-35years old were selected.The total number of SCDs were divided into death occurred during exercise (SRSD) and death during rest,sleep or normal activities (non-SRSD).Each of these two groups was subdivided according to the cause of death into MD (primary cardiomyopathies and myocarditis) and non-MD.Clinic-pathological,toxicological and genetic characteristics of SRSD due to MD were analysed.Over the 8-year study period,we identified 645 cases of SCD in the young: 75 SRSD (11.6%) and 570 non-SRSD (88.4%).MD was diagnosed in 33 (44.0%) of the SRSD and in 112 (19.6%) of the non-SRSD cases.All cases of SRSD due to MD were males (mean age (24.0±7.6) years) practicing recreational sports (85%).SRSDs were more frequent in arrhythmogenic cardiomyopathy (ACM) (37%) and hypertrophic cardiomyopathy (HCM) (24%),followed by myocarditis (15%) and idiopathic left ventricular hypertrophy (ILVH) (9%).Only in five cases of SRSD the MD responsible of death (HCM) had been diagnosed in life.Cardiovascular symptoms related to the disease were present in other seven patients (six of them with ACM).Postmortem genetic studies were performed in 15/28 (54%) primary cardiomyopathies with positive results in 12 (80%) cases.The most frequent sports disciplines were football (49%) followed by gymnastics (15%) and running (12%).In Spain,SRSD in young people due to MDs occurs in males who perform a recreational activity.Compared

关键词： Forensic sciences forensic pathology sudden cardiac death sports myocardial diseases autopsy young

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