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Diagnosis of myocardial ischemia combining multiphase postmortem CT-angiography, histology, and postmortem biochemistry

  • CARDIAC RADIOLOGY
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Abstract

Purpose

The aim of this study was to assess whether the identification of pathological myocardial enhancement at multiphase postmortem computed tomography angiography was correlated with increased levels of troponin T and I in postmortem serum from femoral blood as well as morphological findings of myocardial ischemia. We further aimed to investigate whether autopsy cases characterized by increased troponin T and I concentrations as well as morphological findings of myocardial ischemia were also characterized by pathological myocardial enhancement at multiphase postmortem computed tomography angiography.

Materials and methods

Two different approaches were used. In one, 40 forensic autopsy cases that had pathological enhancement of the myocardium (mean Hounsfield units ≥95) observed at postmortem angiography were retrospectively selected. In the second approach, 40 forensic autopsy cases that had a cause of death attributed to acute myocardial ischemia were retrospectively selected.

Results

The preliminary results seem to indicate that the identification of a pathological enhancement of the myocardium at postmortem angiography is associated with the presence of increased levels of cardiac troponins in postmortem serum and morphological findings of ischemia. Analogously, a pathological enhancement of the myocardium at postmortem angiography can be retrospectively found in the great majority of autopsy cases characterized by increased cardiac troponin levels in postmortem serum and morphological findings of myocardial ischemia.

Conclusions

Multiphase postmortem computed tomography angiography is a useful tool in the postmortem setting for investigating ischemically damaged myocardium.

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Author information

Authors and Affiliations

  1. Service d’Anatomie Pathologique et Médecine Légale, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium

    Jessica Vanhaebost & Gregory Schmit

  2. CURML, University Center of Legal Medicine, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland

    Kewin Ducrot, Sébastien de Froidmont, Coraline Egger, Pia Baumann, Silke Grabherr & Cristian Palmiere

  3. Dipartimento di Sanità Pubblica e Medicina di Comunità, Università degli Studi di Verona, Policlinico G.B. Rossi, P.le L.A. Scuro 10, 37134, Verona, Italy

    Maria Pia Scarpelli

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  1. Jessica Vanhaebost
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  2. Kewin Ducrot
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  3. Sébastien de Froidmont
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  4. Maria Pia Scarpelli
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  5. Coraline Egger
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  7. Gregory Schmit
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  8. Silke Grabherr
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  9. Cristian Palmiere
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Correspondence to Cristian Palmiere.

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Vanhaebost, J., Ducrot, K., de Froidmont, S. et al. Diagnosis of myocardial ischemia combining multiphase postmortem CT-angiography, histology, and postmortem biochemistry. Radiol med 122, 95–105 (2017). https://doi.org/10.1007/s11547-016-0698-2

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  • DOI: https://doi.org/10.1007/s11547-016-0698-2

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