Is fibrosis a marker for angiotensin pathway involvement in sudden cardiac death?

Pulmonary pathology is the third most requent cause of sudden death in young adults, usually associated with asthma, thrombembolism, infectious respiratory disorders, or rheumatoid disorders. Many cardiovascular pathologies leading to sudden cardiac death are known to be associated with unspecific pulmonary changes. In this study we aimed to analyze the morphologic appearance of the lungs in cases of sudden death with a blank autopsy. Material and method: 89 sudden death cases with blank autopsies were selected from the National Institute of Legal Medicine database; from each a total number of 59 parameters were selected and analyzed. Results: Significant correlations were found between pulmonary fibrosis and renal glomerular fibrosis, pulmonary edema and renal interstitial fibrosis, pulmonary stasis and myocardial lipomatosis, and pulmonary fibrosis and hypoxic cardiomyocytes. Very significant correlations new identified between pulmonary and renal stasis, pulmonary edema and renal glomerular sclerosis, pulmonary fibrosis and renal interstitial fibrosis, myocardial stasis and myocardial hemorrhages. Conclusion: unspecific fibrotic pulmonary changes were found and were positively correlated with renal fibrosis. This may suggest a possible role of angiotensin pathway in some sudden deaths where the autopsy is blank or unspecific. Further studies must be conducted in this area in order to confirm this hypothesis.