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Forensic Science, Medicine and Pathology

, Volume 15, Issue 4, pp 528–535 | Cite as

Combined determination of B-type natriuretic peptide and high-sensitivity troponin I in the postmortem diagnosis of cardiac disease

  • Rafael Bañón
  • Diana Hernández-RomeroEmail author
  • Esperanza Navarro
  • María Dolores Pérez-Cárceles
  • José Antonio Noguera-Velasco
  • Eduardo Osuna
Original Article

Abstract

Cardiac disease is the most common cause of sudden death in Western countries. It is known that high-sensitivity troponin I (hs-cTnI), widely used for detection of myocardial injury, is a sensitive biochemical marker. B-type natriuretic peptide (BNP) is a reliable tool for diagnosing heart failure, and for establishing prognosis or disease severity. We aimed to evaluate the diagnostic efficacy of the postmortem determination of BNP in serum alone or in addition to other biomarkers, such as hs-cTnI and MB isoenzyme of creatine kinase (CK-MB), to ascertain whether its determination improves the post-mortem diagnosis of heart failure-associated causes of death. This study involved 133 cadavers with a mean age of 58.2 (± 17.6) years and a mean postmortem interval of 12.8 (±6.6) h. Cases were assigned into two diagnostic groups, according to the cause of death: cardiac deaths (N = 62) and control (N = 71). In the cardiac group, two categories were established according to morphological features of the heart: ‘ischemic deaths’ (N = 39), and ‘congestive heart’ (n = 23). Both hs-cTnI and BNP were useful in diagnosing cardiac deaths, whereas CK-MB did not have any diagnostic relevance. hs-cTnI is higher in cases which acute ischemia as the principal pathology, while the presence of high BNP values is significantly related with chronic cardiac situations with significant ventricular overload. Our findings show that postmortem determination of hs-cTnI and BNP provides valuable information; hs-cTnI is useful for diagnosis of cardiac deaths, mainly with ischemic implications, and BNP gave better results for the diagnosis of congestive heart failure.

Keywords

High-sensitivity cardiac troponin, ß-type natriuretic peptide Cardiac disease Postmortem diagnosis 

Notes

Funding

The authors do not declare external funding for the study.

Compliance with ethical standards

Conflict of interest

The authors has no conflicts of interest to report.

Ethical approval

The study was approved by the Ethics Committee of the Institute of Forensic Medicine and the Ethics Committee of the University of Murcia.

Informed consent

The article does not include participants that require their informed consent.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of Legal MedicineMurciaSpain
  2. 2.Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB-Arrixaca), Regional Campus of International Excellence ‘‘Campus Mare Nostrum”University of MurciaMurciaSpain
  3. 3.Institute of Legal MedicineAlicanteSpain
  4. 4.Department of BiochemistryUniversity Hospital “Virgen de la Arrixaca”MurciaSpain

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