title: Diagnosis of myocardial ischemia combining multiphase postmortem CT-angiography, histology, and postmortem biochemistry.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Service d'Anatomie Pathologique et Médecine Légale, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Jessica
authors.initials: J
authors.lastname: Vanhaebost
authors.affiliation: CURML, University Center of Legal Medicine, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland.
authors.forename: Kewin
authors.initials: K
authors.lastname: Ducrot
authors.affiliation: CURML, University Center of Legal Medicine, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland.
authors.forename: Sébastien
authors.initials: S
authors.lastname: de Froidmont
authors.affiliation: 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.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Scarpelli
authors.affiliation: CURML, University Center of Legal Medicine, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland.
authors.forename: Coraline
authors.initials: C
authors.lastname: Egger
authors.affiliation: CURML, University Center of Legal Medicine, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland.
authors.forename: Pia
authors.initials: P
authors.lastname: Baumann
authors.affiliation: Service d'Anatomie Pathologique et Médecine Légale, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Gregory
authors.initials: G
authors.lastname: Schmit
authors.affiliation: CURML, University Center of Legal Medicine, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland.
authors.forename: Silke
authors.initials: S
authors.lastname: Grabherr
authors.affiliation: CURML, University Center of Legal Medicine, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland. cristian.palmiere@chuv.ch.
authors.forename: Cristian
authors.identifier: http://orcid.org/0000-0002-5799-9893
authors.initials: C
authors.lastname: Palmiere
mesh_terms: D001344:Autopsy / Q000379:methods; D015415:Biomarkers / Q000097:blood; D000072226:Computed Tomography Angiography; D049429:Forensic Pathology; D006801:Humans; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T
keywords: Forensic autopsy; Myocardial ischemia; Pathological myocardial enhancement; Postmortem angiography; Postmortem biochemistry; Troponin