Cardiac biomarkers in blood, and pericardial and cerebrospinal fluids of forensic autopsy cases: A reassessment with special regard to postmortem interval

Chen, Jian-Hua; Inamori-Kawamoto, Osamu; Michiue, Tomomi; Ikeda, Sayuko; Ishikawa, Takaki; Maeda, Hitoshi

doi:10.1016/j.legalmed.2015.03.007

Cited by 55 publications

(30 citation statements)

References 28 publications

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“…Chen et al [19] investigated comprehensively the cardiac markers from different samples taken from the body in a number of 1932 cases and showed that the level of each marker was higher in the blood collected from the bilateral heart chambers and in pericardial fluid than in blood from the iliac veins and it was even lower in the cerebrospinal fluid. Zhu et al [20] also determined the level of cTnT in cardiac cavities blood, peripheral blood and pericardial fluid, and from the total of 405 cases, 57 were diagnosed as acute myocardial infarction.…”

Section: Resultsmentioning

confidence: 99%

Biochemical Markers of Sudden Cardiac Death

2020

Rev.Chim.

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The possible use of biochemical markers in the postmortem diagnosis of sudden cardiac deaths is well known in the forensic setting, though several issues have limited its widespread adoption. The aim of the present study was to describe the discovery of cardiac troponin I (cTnI), myoglobin (MYO) and creatinine kinase MB (CK-MB) in femoral whole blood (FWB), pericardial fluid (PF) and vitreous humor (VH) samples, that were collected post-mortem, in various cases of death related to ischemic heart disease, using the rapid diagnostic test 'Cardiac Markers Combo Rapid Test Device'. The authors conducted a prospective study in which they analyzed a total of 100 autopsies performed at the Legal Medicine Clinical Service of Galați County. The results of the present study showed that cardiac markers can be determined using rapid diagnostic tests for blood from the femoral vein and pericardial fluid, but not for the vitreous humor. Using postmortem biochemical markers of myocardial ischaemia requires caution and flexibility, so that the forensic pathologist has to take into consideration, when interpreting the results, both the postmortem interval, and the type of biological sample. Keywords: sudden death, cardiac, markers, troponin, forensic pathology

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Section: Resultsmentioning

confidence: 99%

Biochemical Markers of Sudden Cardiac Death

2020

Rev.Chim.

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“…Three studies showed that cardiac Troponin T and I in cisternal CSF were slightly correlated with PMI up to 48 h post-mortem [47][48][49].…”

Section: Accepted Manuscript E Cardiac Troponinsmentioning

confidence: 99%

“… PMI should be inferred from the actual time of death. Instead, time of death is sometimes estimated based on autopsy findings or data obtained from police investigation[31,[47][48][49]53], leading to biased estimates of PMI. Factors known to influence post-mortem changes are inconsistently considered.Discrepancies in the results might, for instance, arise from body refrigeration before CSF sampling, as cooling slows autolytic and metabolic processes (e.g. glycolysis).…”

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confidence: 99%

Biochemical markers of time since death in cerebrospinal fluid: A first step towards“Forensomics”

Peyron

Lehmann

Delaby

et al. 2019

Critical Reviews in Clinical Laboratory Sciences

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Biochemical markers of time since death in cerebrospinal fluid: a first step towards "Forensomics" The accurate estimation of the time of death is a challenge in forensic medicine, as the methods routinely used to assess the post-mortem interval (PMI) are far from being precise. Over the past decades, biochemical methods have been implemented on post-mortem samples to improve the precision of PMI estimation. Studies have focussed on the biochemical profiles of closed compartment body fluids, as they are preserved longer than blood after death and are thus subject to confined post-mortem chemical changes. Cerebrospinal fluid (CSF) has been considered a suitable fluid to investigate these changes, as it is found in large amounts and is easy to sample. Moreover, the main molecules found in CSF have known reference values in living subjects, unlike most other body fluids. In this literature review, we focus on the panel of biomarkers that have been studied in CSF based on their potential of offering information on the time of death. The interest of these biomarkers in casework and the research perspectives in this field are discussed. Integrating data from different methods, including biochemistry, for better estimation of the time of death would represent a step forward in the forensic field, paving the way for an innovative approach that we suggest to call "Forensomics".

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“…Because cardiac troponin (cTn) has nearly absolute myocardial tissue specificity (Rallou et al, 2013), it is a recommended biomarker for the detection of myocardial necrosis (Thygesen et al, 2012), and has been recommended for the evaluation of the presence and extent of myocardial damage in various causes of death (Zhu et al, 2006). Antemortem biochemical estimation of cTn level in blood and pericardial fluid, as well as other cardiac muscle proteins, has been previously studied to identify myocardial ischemia as a cause of death The detection of the aforementioned protein markers to investigate myocardial injury in autopsy cases differs from that in clinical findings due to several influencing factors, as for example, the variation in sampling-site results (Chen et al, 2015). Immunohistochemical detection proved to be a better technique to forensic pathology to detect ischemic areas when assessing acute myocardial damage (Ribeiro-Silva et al 2002).…”

Section: Introduction Hementioning

confidence: 99%

Medicolegal Use of Troponin C Expression to Identify Different Causes of Cardiac Deaths at Different Postmortem Intervals

Ibrahim

2019

Zagazig Journal of Forensic Medicine

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Identification of the exact cause and time of death are important questions that have to be answered by the forensic pathologist. Traumatic cardiac injuries is a leading cause of death. This work aimed at using cardiac troponin C (cTnC) expression to differentiate between different types of cardiac injuries at different postmortem intervals (PMI). This study was performed on 90 forensic autopsies selected in the Medicolegal Department of Ministry of Justice. The cases were divided equally into 5 groups of different causes of death i.e. non-cardiac causes of death (control group), blunt cardiac injury (BCI), civilian cardiac firearm injury, civilian stab injury and sudden cardiac death (SCD). Brown Immunohistochemical expression of TnC was observed in all groups, where the non-cardiac death, blunt injury and firearm injury groups showed less immunohistochemical staining than stab injury and SCD. The density of the cTnC immunohistochemical staining increased by the increase in the PMI. Quantitative morphometric measurement of cTnC immunohistochemical expression was measured. Significant increases in the mean surface area of cTnC immunohistochemical expression were detected in the groups of only stab injury and SCD compared to the other studied groups (p<0.001), while non-significant differences were detected between non-cardiac, BCI and civilian cardiac firearm injury groups. Besides, the mean surface area of cTnC immunohistochemical expression increased significantly by the increase in the postmortem interval. These findings suggest that the mean surface area of cTnC immunohistochemical expression can differentiate between cardiac and noncardiac deaths, and between the different types of cardiac deaths.

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Cardiac biomarkers in blood, and pericardial and cerebrospinal fluids of forensic autopsy cases: A reassessment with special regard to postmortem interval

Cited by 55 publications

References 28 publications

Biochemical Markers of Sudden Cardiac Death

Biochemical Markers of Sudden Cardiac Death

Biochemical markers of time since death in cerebrospinal fluid: A first step towards“Forensomics”

Medicolegal Use of Troponin C Expression to Identify Different Causes of Cardiac Deaths at Different Postmortem Intervals

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