Postmortem cardiac troponin T levels in the blood and pericardial fluid. Part 2 : Analysis for application in the diagnosis of sudden cardiac death with regard to pathology

Abstract Although previous forensic pathological studies have suggested the possible application of cardiac troponins in the diagnosis of myocardial infarction, there appears to be insufficient data with regard to its cardiac pathology. The present study analyzed the heart blood, peripheral blood and pericardial fluid levels of cardiac troponin T (cTnT) in sudden cardiac deaths ( n =96) within 48h postmortem in relation to pathological findings of acute myocardial infarction (AMI, n =34), recurrent myocardial infarction (RMI, n =23), ischemic heart disease without any pathological evidence of infarction (IHD, n =24) and other heart diseases (OHD, n =15). Control groups ( n =75, survival time n =35), drowning ( n =27) and cerebrovascular diseases ( n =13). There was a marked correlation in the cTnT levels between right and left heart blood samples. The pericardial level was usually higher than either heart blood level, and the external iliac venous blood level was the lowest. Although postmortem time-dependent increases in heart and pericardial blood cTnT levels were observed in most groups, they were most evident for AMI and asphyxiation. In the early postmortem period (