Early markers of myocardial ischemia: from the experimental model to forensic pathology cases of sudden cardiac death.

Details

Serval ID
serval:BIB_1270E7C7F034
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Early markers of myocardial ischemia: from the experimental model to forensic pathology cases of sudden cardiac death.
Journal
International journal of legal medicine
Author(s)
Sabatasso S., Moretti M., Mangin P., Fracasso T.
ISSN
1437-1596 (Electronic)
ISSN-L
0937-9827
Publication state
Published
Issued date
01/2018
Peer-reviewed
Oui
Volume
132
Number
1
Pages
197-203
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The goal of this study was to assess whether early markers of myocardial ischemia, identified in a previous experimental work, can be applied in forensic pathology cases of sudden, ischemic cardiac death. These markers include desphosphorylated connexin 43 (Cx43), JunB, TUNEL assay, myoglobin, and troponin T. Fourteen cases of sudden cardiac death with gross and/or histological signs of myocardial infarction and 14 cases of sudden cardiac death with signs of early ischemia at histology and positive immunoreactions for fibronectin and C5b-9 were investigated. The control group was represented by 15 hanging (global hypoxia) cases. Immunohistochemical reactions were classified into four degrees and compared among groups. Cx43 and JunB were significantly more expressed in hanging than in ischemia/infarction, but they showed a different distribution in the tissue (sub-endocardial in ischemia/infarction, diffuse in hanging) and a different intensity of the signal. TUNEL assay was significantly more expressed in the group of early ischemia than in myocardial infarction. Myoglobin and troponin T did not show any significantly different expression among the three groups. Depletion markers have a limited application in forensic cases, and this is mostly because positive (depleted) areas are difficult to distinguish from artifactually paler areas. Nuclear markers (JunB and TUNEL), on the other hand, require a well-trained eye and a high magnification in order to be distinguished. Cx43, JunB, and TUNEL assays were confirmed to be early, sensitive markers for myocardial ischemia. Nonetheless, they are not specific, as they are expressed in global hypoxia as well, but with a different tissular distribution.

Keywords
Early markers, Forensic pathology, Immunohistochemistry, Myocardial ischemia, Sudden cardiac death
Pubmed
Web of science
Create date
15/05/2017 13:59
Last modification date
20/08/2019 12:40
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