Immuno-histochemistry in the detection of early myocardial infarction (a post-mortem study)

摘要

© 2011. Forensic Medicine Authority. Production and hosting by Elsevier B.V.Background: Immunohistochemical techniques have proven to be effective for use in forensic pathology, as they can be applied to tissue samples fixed in formalin and embedded in paraffin. Histologic sections, including ischaemic and non-ischaemic myocardia, were studied via immunohistochemistry with three different antibodies to human cardiac troponin (cTnT), myoglobin (MB), and caspase 3, using a standard avidin-biotin-peroxidase system. Results: All antibodies detected cTnT or MB in the normal myocardium as well as its loss from the necrotic myocardium, in some cases before histologic evidence of necrosis was present. Loss was non-uniform and greater at the periphery of the infarcts than at their central regions. Usually, loss of cTnT appeared to be better than loss of MB; however, MB was more sensitive, and caspase 3 was the most sensitive. Caspase 3 was detected in areas with established ischaemia and in cases with coronary occlusion where there was no histologic evidence of necrosis, as well as in cases with latent infarction. Conclusions: Immunohistochemical staining using antibodies to human cTnT, MB, and caspase 3 can be used to visualize myocardial infarctions in histologic sections of the myocardium during forensic autopsy. Loss of cTnT and MB, as well as positive staining for caspase 3, occurs very early following ischaemic injury and may precede histologic evidence of necrosis. Immunohistochemical staining of hearts for cTnT, MB, and caspase 3 can assist in the recognition of myocardial necrosis at autopsy in patients suspected of dying from acute myocardial ischaemia.