Rapid Biochemical Analysis of Postmortem Serum and Myocardial Homogenates-An Exploratory Study
Niki Sarri1, Henrik Druid1,2, Ali-Reza Rezaie1
1Swedish National Board of Forensic Medicine, 17165 Solna, Sweden.
Biomolecules
|October 29, 2025
Summary
Analyzing cardiac biomarkers in myocardial tissue homogenates, not serum, aids in diagnosing sudden cardiac death (SCD). This method, using readily available analyzers, helps pathologists identify early ischemic changes postmortem.
Area of Science:
- Forensic Pathology
- Clinical Chemistry
- Biomarker Analysis
Background:
- Postmortem diagnosis of sudden cardiac death (SCD) is challenging due to the lack of definitive markers like thrombi.
- Traditional methods struggle with the slow development of postmortem structural and immunohistochemical changes.
- Clinical chemistry biomarkers in myocardial tissue and serum are explored for improved diagnostic accuracy.
Purpose of the Study:
- To investigate the utility of clinical chemistry biomarkers in myocardial homogenates and serum for postmortem SCD diagnosis.
- To compare different extraction buffers for biomarker analysis in myocardial samples.
- To evaluate the diagnostic potential of tissue-based biomarkers versus serum-based biomarkers in differentiating SCD from controls.
Main Methods:
- Analysis of myocardial samples (n=113) and serum using various extraction buffers (distilled water, T-PER, 2 M urea).
- Assay of biomarkers including AST, ALT, CK-MB, LDH, orosomucoid, total protein, cardiac Troponin T, myoglobin, and NT-proBNP.
- Utilized IndikoPlus and Roche Cobas 8000 c701 analyzers for biomarker quantification and proteomic profiling.
Main Results:
- Distilled water extraction was effective for most analytes, comparable to T-PER and 2 M urea.
- Biomarker levels were consistently higher in myocardial homogenates than in serum.
- Significant loss of several biomarkers was observed in myocardial samples from SCD cases compared to controls, unlike serum levels.
Conclusions:
- Analysis of myocardial tissue homogenates is superior to serum analysis for detecting early postmortem ischemia.
- Selected biomarkers in tissue homogenates can aid in differentiating sudden cardiac death cases from controls.
- In-house benchtop multi-analyzers offer rapid results to support pathological decision-making during autopsy.
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