Expression Of Sex Hormone Receptors In Coronary Artery And Cardiomyocytes With Sudden Death Caused By Coronary Atherosclerotic Heart Disease

Background In the practice of forensic pathology, it is the most common to the cases ofsudden death caused by coronary atherosclerotic heart disease (CAD). Most of them aremales. Although more men seem to be involved in the crime and disputes compared withwomen, the truth is that there are significant gender differences in the incidence of CADaccording to the epidemiologic investigation. CAD is mostly happened in the older over40years old especially in men. However, the incidence rises sharply in the postmenopausalwomen and gets close to the men of the same age. Therefore, it is widely considered thatestrogen has favorable effects on the cardiovascular system. In recent years, there is adifferent understanding of the role of androgen playing in the cardiovascular system. Justlike estrogen, androgen can also induce coronary vasodilatation and suppression ofinflammatory factors. In a certain concentration, androgen may have protective effects onthe cardiovascular system. Since androgen can be changed into estrogen by aromatase, andthey have antagonistic action to each other, it is of great significance that how estrogen andandrogen and their relationship affect the development of CAD and acute coronarysyndrome. In fact, the objects of clinical study are living people, and the objects of forensicpathology almost the corpses. So it is difficult for medicolegal study to detect the bloodconcentration of sex hormone directly. But we can study the expression of the sexhormones receptors in the coronary arteries and myocardial tissues of autopsy cases whichmakes more sense to reflect the exposure to sex hormones of tissues during its lifetime indirectly as they play their biological effects mainly through their receptors. Nowadays,immunohistochemical techniques become very mature and the samples of forensicautopsied cases are suitable to do some research work with this technique. Currently, noresearch work had been reported on the association among sex hormones and therelationship of sex hormones and the sudden deaths caused by CAD byimmunohistochemistry.Objectives To study the expression of ER and AR in coronary arteries and myocardialtissues in the cases of sudden coronary death and control groups and explore therelationship between sex hormones and sudden death caused by CAD and the mechanismof the development of coronary atherosclerosis, and provide references for the preventionand treatment of CAD and the medicolegal identification of sudden coronary death.Material and Methods Fifty-three cases and heart samples were selected from the autopsiedcases in our department in2011and divided into3groups, of which there were18case ofsudden death caused by CAD in the experimental group,18cases with CAD but died ofother causes in the control group Ⅰ, and17cases without CAD and also died of othercauses in the control group Ⅱ. The samples were cutted in coronary arteries andmyocardial tissues of each case and stained with HE and immunohistochemistry (SPmethod) to observe the expression of ER and AR in coronary arteries and cardiomyocytes,and detected there average optical density (AOD) of positive signal in each vision by usingImage-Pro Plus6.0software. All data and the difference among three groups were analyzedby GraphPad Prism5Demo statistical software.Results While the expression of ER and AR in control group Ⅱ was strongly positive, itwas weak in control group Ⅰ and became weaker in experimental group. The results ofimage and statistical analysis:①The expression of ER and AR in coronary arteries andcardiomyocytes had no significant statistical difference between experimental group andcontrol group Ⅰ (P＞0.05);②Compare with control group Ⅱ, the expression of ER andAR in coronary arteries and cardiomyocytes were much lower in experimental group (P＜ 0.05);③The expression of ER and AR in coronary arteries were lower in control group Ⅰthan that in control group Ⅱ (P＜0.05);④The rate of ER/AR had no significantstatistical difference among three groups （P＞0.05).Conclusion The expression of sex hormone receptor, ER and AR, in coronary was reducedin CAD patients, suggested that both estrogen and androgen may have favorable effects onthe cardiovascular system. The significance of rate of ER/AR expression need furtherinvestigation.