Postmortem pericardial natriuretic peptides as markers of cardiac function in medico-legal autopsies.
Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in the blood are clinical markers for the diagnosis of cardiac failure. This study was a comprehensive analysis of the postmortem pericardial levels of the natriuretic peptides in serial medico-legal autopsy cases (n=263, within 72 h postmortem) to assess their validity in investigating cardiac function. There was no significant relationship of pericardial ANP or BNP levels with postmortem time or the age of the subjects. The ANP and BNP levels showed negative correlations with the pericardial cardiac troponin T level. The ANP level was significantly elevated in drowning cases. Pericardial BNP and the BNP/ANP ratio were significantly higher for chronic congestive heart disease. However, asphyxiation, sharp instrument injury, hyperthermia, and fatal MA poisoning cases showed lower levels for both markers. These observations suggest that elevations in the postmortem pericardial ANP and BNP may mainly depend on acute atrial overload and subacute or chronic cardiac failure, respectively, and may be reduced by advanced myocardial damage.
Zhu
Bao-Li
BL
Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka, 545-8585, Japan. baolizhu@med.osaka-cu.ac.jp
Ishikawa
Takaki
T
Michiue
Tomomi
T
Li
Dong-Ri
DR
Zhao
Dong
D
Tanaka
Sayaka
S
Kamikodai
Yasunobu
Y
Tsuda
Kohei
K
Okazaki
Shuji
S
Maeda
Hitoshi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000032:analysis*; D001344:Autopsy / Q000379:methods*; D015415:Biomarkers / Q000032:analysis; D002423:Cause of Death; D005260:Female; D006331:Heart Diseases / Q000378:metabolism*; D006333:Heart Failure / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000032:analysis*; D010496:Pericardium / Q000378:metabolism*; D012372:ROC Curve; D011863:Radioimmunoassay; D012680:Sensitivity and Specificity; D020107:Troponin T / Q000378:metabolism
D015415:Biomarkers; D020107:Troponin T; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor