Left ventricular volume on immediate postmortem computed tomography (CT) (<1 hour) as an indicator of cardiac death:
1Department of Forensic Medicine, Graduate School of Medicine, Fukui University, Fukui, Japan; Department of Radiological Technology, Shin-Takeo Hospital, Saga, Japan.
Aim:
Although postmortem computed tomography (PMCT) is widely performed, its applications in the diagnosis of cardiac death (CD) remain limited. This study aimed to evaluate whether the left ventricular volume (LVV) measured on early PMCT could serve as an indicator of CD.
Materials And Methods:
We retrospectively analysed 71 subjects (33 with clinically adjudicated CD (CACD) and 38 classified as non-CACD) with cardiopulmonary arrest who underwent PMCT within one hour after death. LVV was quantified from the 3D reconstruction of the PMCT data. Intergroup differences were assessed using the Mann-Whitney U-test, and the diagnostic performance of the LVV and LVV indexed to body surface area (LVV/BSA) was evaluated using receiver operating characteristic (ROC) analysis.
Results:
The CACD group demonstrated a significantly greater LVV than the non-CACD group (median: 35.4 mL vs 11.0 mL, P < 0.001). Similarly, the LVV/BSA ratio was significantly higher in the CACD group (median: 22.9 mL/m2 vs 8.0 mL/m2, P < 0.001). ROC curve analysis yielded an area under the curve of 0.768 for LVV and 0.752 for LVV/BSA, indicating fair diagnostic performance.
Conclusion:
This study shows that LVV measured on PMCT within the first hour after death reflects reduced antemortem cardiac contractility, suggesting that the LVV may be a useful marker for estimating CD and could facilitate objective and standardised postmortem investigations.
