The application of selected histochemical and immunohistochemical markers and procedures to the diagnosis of early myocardial damage

• Published in: International journal of legal medicine Vol. 106; no. 3; p. 135
• Main Authors: Brinkmann, B, Sepulchre, M A, Fechner, G
• Format: Journal Article
• Language: English
• Published: Germany 01.05.1993
• Subjects: Adult; Aged; Aged, 80 and over; Autolysis; Case-Control Studies; Coronary Artery Disease - diagnosis; Coronary Artery Disease - metabolism; Coronary Thrombosis - diagnosis; Coronary Thrombosis - metabolism; Female; Forensic Medicine - methods; Histocytochemistry - methods; Humans; Immunohistochemistry - methods; Male; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - metabolism; Necrosis; Organ Size; Sensitivity and Specificity; Time Factors
• ISSN: 0937-9827
• DOI: 10.1007/bf01225234

Histochemical (= HIS) methods (haematoxylin-eosin, luxol fast blue, chromotrope aniline blue) and various immunohistochemical (= IH) markers (myoglobin, desmin, fibrinogen, complement C5b-9) were applied in parallel to test the efficiency, specificity and sensitivity for the recognition of early ischemic myocardial damage. The whole series was subgrouped into cardiac deaths (N = 35) and controls (N = 13). Cardiac deaths were sub-divided into 3 groups: 1. infarction visible in gross examination (N = 15), 2. coronary thrombosis without infarction (N = 11), 3. stenosing coronary atherosclerosis without infarction (N = 9). The control group (group 4) consisted of unnatural deaths with presumed short agonal periods (N = 13). Group 1 cases usually exhibited extended coagulation necrosis of the diffuse type and the contraction type in combination (1 exception). Group 2 showed mainly a patchy type of coagulation necrosis and contained 1 cases where all methods failed to react and 3 more cases where only the HIS methods failed to react. Group 3 and 4 were associated with a disseminated type of single and/or grouped fibre necrosis. In addition, the average reaction strengths showed a decrease from group 1 to group 4 which was more pronounced in the HIS reactions compared with the IH reactions. One case in group 1 showing negative IH reactions cannot be explained. Positive IH reactions observed in a few cases in group 2 contrasting with negative HIS reactions would indicate a greater sensitivity of this methodology and this interpretation also applies to groups 3 and 4. From pathophysiological considerations, the positive cases in groups 3 and 4 can be well explained.