title: Elevation of NT-proBNP and cardiac troponins in sepsis-related deaths: a forensic perspective.
abstract: In the present study, the levels of NT-proBNP, troponin T, and troponin I were measured in postmortem serum from femoral blood in a series of sepsis-related fatalities that had undergone forensic autopsies. We aimed to assess whether a possible increase in the concentrations of these biomarkers was correlated to macroscopic or microscopic observations that suggest myocardial damage or cardiac dysfunction. Two study groups were retrospectively formed, a sepsis-related fatalities group and a control group. Both groups consisted of 16 forensic autopsy cases. Unenhanced computed tomography scan, autopsy, histological, toxicological, microbiological, and biochemical analyses were performed for all cases in both groups. Levels of procalcitonin, C-reactive protein, NT-proBNP, troponin T, and troponin I were systematically measured in postmortem serum from femoral blood. The preliminary results suggest that the postmortem serum troponin I, troponin T, and NT-proBNP levels are increased in sepsis-related deaths in the absence of any relevant coronary artery disease, myocardial ischemia, or signs of heart failure. These findings corroborate clinical data from previous studies pertaining to the usefulness of troponins and natriuretic peptides as indicators of toxic and inflammatory damage to the heart in cases of severe sepsis and septic shock without concomitant underlying coronary syndromes.
authors.affiliation: Departmental Section of Forensic and Legal Medicine and School of Specialisation in Legal Medicine, University of Genova, Via de Toni 12, 16132, Genova, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Tettamanti
authors.affiliation: University Center of Legal Medicine, Lausanne University Hospital, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland.
authors.forename: Tania
authors.initials: T
authors.lastname: Hervet
authors.affiliation: University Center of Legal Medicine, Lausanne University Hospital, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland.
authors.forename: Silke
authors.initials: S
authors.lastname: Grabherr
authors.affiliation: University Center of Legal Medicine, Lausanne University Hospital, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland. cristian.palmiere@chuv.ch.
authors.forename: Cristian
authors.initials: C
authors.lastname: Palmiere
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood*; D019210:Troponin I / Q000097:blood; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D019210:Troponin I; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002116:Calcitonin; D002097:C-Reactive Protein
keywords: Autopsy; Cardiac biomarkers; Postmortem biochemistry; Sepsis