Rigor mortis at the myocardium investigated by post-mortem magnetic resonance imaging
Jérôme Bonzon1, Corinna A Schön1, Nicole Schwendener1
1Center for Forensic Imaging Bern, Institute of Forensic Medicine, University of Bern, Bühlstr. 20, CH-3012 Bern, Switzerland.
Introduction:
Post-mortem cardiac MR exams present with different contraction appearances of the left ventricle in cardiac short axis images. It was hypothesized that the grade of post-mortem contraction may be related to the post-mortem interval (PMI) or cause of death and a phenomenon caused by internal rigor mortis that may give further insights in the circumstances of death.
Method And Materials:
The cardiac contraction grade was investigated in 71 post-mortem cardiac MR exams (mean age at death 52 y, range 12-89 y; 48 males, 23 females). In cardiac short axis images the left ventricular lumen volume as well as the left ventricular myocardial volume were assessed by manual segmentation. The quotient of both (LVQ) represents the grade of myocardial contraction. LVQ was correlated to the PMI, sex, age, cardiac weight, body mass and height, cause of death and pericardial tamponade when present. In cardiac causes of death a separate correlation was investigated for acute myocardial infarction cases and arrhythmic deaths.
Results:
LVQ values ranged from 1.99 (maximum dilatation) to 42.91 (maximum contraction) with a mean of 15.13. LVQ decreased slightly with increasing PMI, however without significant correlation. Pericardial tamponade positively correlated with higher LVQ values. Variables such as sex, age, body mass and height, cardiac weight and cause of death did not correlate with LVQ values. There was no difference in LVQ values for myocardial infarction without tamponade and arrhythmic deaths.
Conclusion:
Based on the observation in our investigated cases, the phenomenon of post-mortem myocardial contraction cannot be explained by the influence of the investigated variables, except for pericardial tamponade cases. Further research addressing post-mortem myocardial contraction has to focus on other, less obvious factors, which may influence the early post-mortem phase too.
Insights
Post-mortem cardiac MRI shows left ventricular contraction varies. Pericardial tamponade, not PMI or cause of death, influences this contraction, suggesting other factors are involved.
Area of Science:
- Forensic pathology
- Cardiovascular imaging
- Medical physics
Background:
- Post-mortem cardiac MRI reveals varying left ventricular contraction patterns.
- The study explores if contraction relates to post-mortem interval (PMI), cause of death, or internal rigor mortis.
Purpose of the Study:
- To investigate the factors influencing post-mortem myocardial contraction.
- To determine the relationship between left ventricular quotient (LVQ) and PMI, demographics, and cause of death.
Main Methods:
- Analyzed 71 post-mortem cardiac MR exams, assessing left ventricular lumen and myocardial volumes.
- Calculated LVQ as the quotient of lumen and myocardial volumes to quantify contraction.
- Correlated LVQ with PMI, sex, age, cardiac weight, body mass, height, cause of death, and pericardial tamponade.
Main Results:
- LVQ values ranged from 1.99 to 42.91 (mean 15.13).
- Pericardial tamponade positively correlated with higher LVQ (greater contraction).
- No significant correlation found between LVQ and PMI, sex, age, body metrics, or cause of death.
Conclusions:
- Post-mortem myocardial contraction is not explained by PMI, cause of death, or demographics, except in cases of pericardial tamponade.
- Further research should explore other factors influencing early post-mortem myocardial contraction.
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