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Updated: Jul 24, 2025

3D Whole-heart Myocardial Tissue Analysis
Published on: April 12, 2017
Recent perspectives on the early expression immunohistochemical markers in post-mortem recognition of myocardial
Radu Moldovan1, Vlad Andrei Ichim2, Vladimir Beliș3
1Emergency County Hospital "Constantin Opris", Baia Mare, Department of Forensic Medicine, Street George Coșbuc 31, Baia Mare, Maramures, 430031, Romania.
Insights
Diagnosing early Acute Myocardial Infarction (AMI) post-mortem is challenging. Immunohistochemistry (IHC) offers a reliable method for detecting cellular changes, aiding in forensic pathology and early diagnosis of heart tissue death.
Area of Science:
- Forensic Pathology
- Cardiovascular Pathology
Background:
- Acute Myocardial Infarction (AMI) is a leading global cause of death, particularly in older adults.
- Early diagnosis of AMI during post-mortem examination presents significant challenges due to the absence of visible microscopic tissue alterations.
Approach:
- A systematic review of 10-15 years of publications was conducted to identify immunohistochemistry (IHC) markers for early AMI detection.
- Search terms included "Acute Myocardial Infarction," "Ischemia," "Hypoxia," "Forensic," "Immunohistochemistry," and "Autopsy," narrowing 160 articles to 50.
Key Points:
- Immunohistochemistry (IHC) is crucial for identifying subtle cellular changes in early AMI, offering a safer alternative to traditional methods.
- The review highlights established IHC markers considered gold standards for post-mortem AMI diagnosis.
- Emerging IHC markers with potential for earlier and more accurate detection of myocardial infarction are also discussed.
Conclusions:
- IHC plays a vital role in the post-mortem diagnosis of early Acute Myocardial Infarction.
- This review provides a comprehensive overview of current and novel IHC markers for forensic and clinical pathology applications in diagnosing myocardial infarction.
Abstract:
Acute Myocardial Infarction (AMI) refers to the death of heart tissue in the absence ofperfusion. It is one of the top causes of death globally, particularly in middle andhigher-age groups. However, for the pathologist, the post-mortem macroscopic andmicroscopic diagnosis of early AMI remains challenging. In the early acute stage ofAMI, no microscopic visible signs of tissue alterations like necrosis and neutrophilinfiltration can be seen. In such a scenario, immunohistochemistry (IHC) accounts forthe most suitable and safest alternative to study early diagnostic cases by selectivelydetecting changes in the cell population. This systematic review focuses on themultiple causes/changes that lead to the privation of blood flow as well as tissuechanges induced by the absence of perfusion.We performed a systematic review of the last 10-15 years' publications that focused ondetecting immunohistochemical changes that appear in the cell population in case ofacute myocardial infarction. We found around 160 articles on AMI, which we narroweddown to 50 with the use of specific filters such as: "Acute Myocardial Infarction," "Ischemia," "Hypoxia," "Forensic," "Immunohistochemistry, and "Autopsy." The presentreview comprehensively highlights the current knowledge of specific IHC markers usedas gold standards during post-mortem investigation of acute myocardial infarction. Thepresent review comprehensively highlights the current knowledge of specific IHCmarkers used as gold standards during post-mortem investigation of acute myocardialinfarction, and some new potential immunohistochemical markers that can be used inthe early detection of myocardial infarction.
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