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Diagnosis of the acute ischaemic heart by ion elution from myocardium
Insights
Diagnosing post-mortem myocardial ischemia is challenging. This study found that a low potassium (K) to sodium (Na) ratio in heart tissue can indicate ischemia, even without visible changes, aiding diagnosis.
Area of Science:
- Cardiovascular Pathology
- Biochemistry
- Forensic Medicine
Background:
- Post-mortem diagnosis of acute myocardial ischemia can be difficult without clear morphological evidence.
- Ischemic cell injury causes potassium (K) efflux and sodium (Na) influx, altering tissue ion ratios.
- The K:Na ratio in circulating blood and tissue decreases with ischemia.
Purpose of the Study:
- To evaluate the utility of the myocardial K:Na ratio as a biomarker for post-mortem diagnosis of acute myocardial ischemia.
- To establish a simple method for measuring the K:Na ratio in myocardial tissue.
Main Methods:
- Myocardial tissue samples were analyzed for potassium (K) and sodium (Na) ion content.
- Ions were eluted from tissue samples and the eluate was assayed.
- The K:Na ratio was mapped onto horizontal slices of the heart.
- Results were compared to morphological evidence of ischemia and a previous homogenization method.
Main Results:
- The K:Na ratio measurement method showed comparable results to tissue homogenization.
- A low K:Na ratio in myocardial tissue correlated with areas of morphological ischemia.
- The low K:Na ratio extended beyond areas with visible ischemic changes, suggesting greater sensitivity.
Conclusions:
- The myocardial K:Na ratio is a simple and potentially valuable tool for the post-mortem diagnosis of acute myocardial ischemia.
- This method can detect ischemia even in the absence of definitive morphological changes or recent coronary thrombosis.
- The technique may be suitable for routine application in forensic and pathological practice.
Abstract:
The post-mortem diagnosis of acute myocardial ischaemia may be difficult to establish in the absence of morphological changes in the myocardium or recent coronary thrombosis. Ischaemic cell injury leads to potassium (K) efflux and sodium (Na) influx and, if the blood is still circulating, the K:Na ratio of the tissue falls. In this study, the K:Na ratio was measured by eluting the ions from samples of myocardium and assaying the eluate. The method yields similar results to those obtained by a previous method, in which myocardial samples were homogenized. The K:Na ratios on samples of horizontal slices through the heart were plotted on maps of the slices. A low K:Na ratio corresponded to, but extended beyond, areas where there was morphological evidence of ischaemia. The method is simple and may be of use in routine practice.