title: Hypostasis in the heart and great vessels of non-traumatic in-hospital death cases on postmortem computed tomography: relationship to antemortem blood tests.
abstract: OBJECTIVE
  The purpose of this study was to investigate hypostasis in the heart and great vessels (HHGV) by postmortem computed tomography (PMCT) in cases of non-traumatic in-hospital deaths and to analyze relationships between clarity of HHGV and antemortem blood markers.
  
  
  METHODS
  The study included 31 cadavers of patients who died while receiving treatment in our academic tertiary-care hospital between April and December 2009. Antemortem blood tests including both hematological and blood coagulation markers were performed within 48h before death, and PMCT and conventional autopsies were performed. The findings of HHGV were assessed in the following six locations: the superior vena cava, right atrium, right ventricle, thoracic aorta, left atrium, and left ventricle. The clarity of HHGV on PMCT was divided into two groups using attenuation of the left ventricular wall as a reference: no/obscure HHGV group and clear HHGV group. The relationships between clarity of HHGV and six blood markers [red blood cell (RBC) count, hemoglobin (Hb), hematocrit (Ht), prothrombin percentage activity (PT%), activated partial thromboplastin time (aPTT), and fibrinogen] were evaluated statistically.
  
  
  RESULTS
  We observed no/obscure HHGV in 14 patients (45%) and clear HHGV in 17 patients (55%). The level of fibrinogen in clear HHGV group was significantly higher than in no/obscure HHGV group (P=0.029). No relationships were found between clarity of HHGV and other five blood markers.
  
  
  CONCLUSIONS
  HHGV is a common PMCT finding. Clear HHGV on PMCT was related to higher level of fibrinogen in non-traumatic in-hospital death cases.
authors: Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan. masanoriishida@hotmail.com
authors: Masanori
authors: M
authors: Ishida
authors: Wataru
authors: W
authors: Gonoi
authors: Kazuchika
authors: K
authors: Hagiwara
authors: Yutaka
authors: Y
authors: Takazawa
authors: Masaaki
authors: M
authors: Akahane
authors: Masashi
authors: M
authors: Fukayama
authors: Kuni
authors: K
authors: Ohtomo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003331:Coronary Vessels; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006331:Heart Diseases / Q000097:blood / Q000175:diagnosis; D006403:Hematologic Tests; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011180:Postmortem Changes; D015898:Tomography Scanners, X-Ray Computed; D055815:Young Adult
chemical_list: D015415:Biomarkers