Pathological Investigation of Sudden Cardiac Death
Dr Mary Sheppard, Principal Investigator
As a national referral centre we receive a significant number of cases making it feasible to undertake such a large scale project. We are the largest referral centre for sudden cardiac death in UK and internationally.
To study the histological changes seen in the heart in cases of sudden cardiac death, I classify these according to established histological criteria and record the proportions of various causes and identify any other changes not recognised. Sudden cardiac death due to cardiac causes is an important cause of death. The research emphasises the importance of identifying underlying genetic causes which has important implications for the next of kin.
We have found that nearly half of the cases of sudden cardiac death show a morphologically normal heart, which may represent what are known as channelopathies – inherited defects in ion channels affecting cardiac electrical conduction. These along with cardiomyopathies are the most common causes of sudden cardiac death and are diseases with an underlying genetic predisposition which is important to recognise so that screening of relatives can be undertaken.
Cardiac Pathology is a specialist field and requires detailed examination of the heart.
This study is particularly important for relatives of the deceased as the cause of death can have a significant bearing for surviving relatives. Through our research relatives can be advised and sent for specialist screening to help prevent further cases of sudden cardiac death.
Current Research Collaboration
- Sinus of valvular aneurysms. Raphael Alonso and Dr Wei Li, working on both clinical and pathological cases
- Wolff-Parkinson White disease and sudden death. Amanda Vernava, Billy Iqbal, St Marys, Paddington – Evidence of cardiac hypertrophy linked to WPW in sudden death
- Congenital Heart Disease and sudden death. Prof Gatzoulis, Dr Yen Ho and Matina Prapa – A study funded for 3 year to investigate SCD in CHD
- Inflammatory pathology of aorta. Dr Van der Wal, Netherlands – Characterization of inflammatory cells in the adventitia of the ascending aorta
- Identification of Genetic mutations in unexplained sudden death. Elijah Behr, St Georges – a retrospective analysis
- Stress cardiomyopathy, catecholamine toxicity and the heart. Alexander Lyon, NHLI – an animal study
- Maternal death. Keiko Ogo. Collaboration with Japan, funding application to the Great Britain Sasakawa Foundation