title: Potential use of pericardial cTnI, Mg2+and Ca2+in the forensic investigation of seawater drowning in Greece: An initial assessment.
abstract: The investigation of drowning constitutes one of the biggest problems in forensic practice. Elevated cardiac troponin I (cTnI) levels in biological fluids have been associated with myocardial damage, whereas increased Mg2+and Ca2+levels were found in cases of seawater drowning. The aim of this study was to examine the diagnostic utility of postmortem determination of cTnI, Mg2+and Ca2+in the pericardial fluid, in differentiating between cases of seawater drowning related to myocardial injury and those brought about by other causes. This study included 76 cases selected during a 2-year period from medicolegal autopsies. The cases were divided into three groups, according to the cause of death established based on macroscopic and microscopic evidence. The groups were: 1) seawater drowning (n=23), 2) seawater drowning with histological evidence of myocardial infarction (n=28), and 3) myocardial infarction unrelated to drowning (n=25). cTnI was determined with an enzyme immunoassay; Mg2+and Ca2+with standard colorimetric assays. Pericardial cTnI levels were significantly lower in group 1 compared to groups 2 and 3. In contrast, pericardial Mg2+and Ca2+levels were both significantly higher in groups 1 and 2 compared to group 3. Our results suggest that the postmortem determination of pericardial cTnI levels may be useful in detecting previous myocardial damage as a contributory factor in death from seawater drowning and provide independent confirmation of the usefulness of pericardial Mg2+and Ca2+levels for differentiating between seawater drowning and fatal acute myocardial injury unrelated to the former.
authors.affiliation: Department of Forensic Medicine & Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece.
authors.forename: Aspasia
authors.initials: A
authors.lastname: Deliligka
authors.affiliation: Department of Forensic Medicine & Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Raikos
authors.affiliation: Department of Forensic Medicine & Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece.
authors.forename: Fotios
authors.initials: F
authors.lastname: Chatzinikolaou
authors.affiliation: Department of Pathology, Hippokration General Hospital, Thessaloniki 54642, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Venizelos
authors.affiliation: Department of Pathology, Hippokration General Hospital, Thessaloniki 54642, Greece.
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Chatzopoulos
authors.affiliation: 1st Laboratory of Pharmacology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece. Electronic address: goulas@med.auth.gr.
authors.forename: Antonis
authors.initials: A
authors.lastname: Goulas
mesh_terms: D000368:Aged; D002118:Calcium / Q000097:blood*; D004332:Drowning / Q000473:pathology*; D005260:Female; D049429:Forensic Pathology; D006115:Greece; D006801:Humans; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000378:metabolism*; D011180:Postmortem Changes; D012623:Seawater; D019210:Troponin I / Q000097:blood*
chemical_list: D019210:Troponin I; D008274:Magnesium; D002118:Calcium
keywords: Ca(2+); Cardiac troponin I; Mg(2+); Myocardial infarction; Pericardial fluid; Seawater drowning