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Immunohistochemical study of fibronectin for postmortem diagnosis of early myocardial infarction
1Department of Forensic Pathology, Sun Yat-sen University of Medical Sciences, Guangzhou, China.
Insights
Forensic diagnosis of early myocardial infarction is challenging. Fibronectin (FN) staining in cardiomyocytes is a reliable new marker for detecting acute myocardial infarction, even in autopsied hearts fixed for years.
Area of Science:
- Forensic Pathology
- Cardiovascular Pathology
- Immunohistochemistry
Background:
- Diagnosing early myocardial infarction postmortem presents significant forensic challenges.
- Current methods may lack sensitivity or be affected by postmortem changes.
- A reliable biomarker for early detection is crucial in forensic practice.
Purpose of the Study:
- To evaluate fibronectin (FN) immunohistochemistry as a novel method for diagnosing early myocardial infarction in autopsy cases.
- To determine the reliability of FN staining in cardiomyocytes for postmortem identification of acute myocardial infarction.
Main Methods:
- An immunohistochemical study using the streptavidin/biotin/peroxidase technique was performed on 34 autopsy hearts.
- Fibronectin (FN) staining was assessed in cardiomyocytes of cases with confirmed myocardial infarction, suspected early infarction, and controls.
- Cases included those autopsied between 8 hours and 4 days postmortem, with some fixed in formalin for over 10 years.
Main Results:
- Positive FN staining in cardiomyocytes was observed in all 5 definite myocardial infarction cases.
- 15 out of 18 suspected early myocardial infarction cases showed positive FN staining.
- No positive FN staining was detected in 11 non-cardiac death control cases.
- Satisfactory FN staining results were obtained even in cases fixed for over 10 years, indicating resistance to autolysis and formalin fixation.
Conclusions:
- Positive fibronectin (FN) staining in cardiomyocytes is a reliable and sensitive marker for the postmortem diagnosis of acute myocardial infarction.
- FN immunohistochemistry offers a valuable new method for routine forensic practice, particularly for retrospective analysis.
- Fibronectin's stability against postmortem autolysis and formalin fixation makes it suitable for long-term archival cases.
Abstract:
The postmortem diagnosis of early myocardial infarction has been a puzzling problem in forensic practice. In the present study, an immunohistochemical study of fibronectin (FN) was performed for the first time on 34 autopsy hearts to determine early myocardial infarction with streptavidin/biotin/peroxidase technique. Five cases of definite myocardial infarction showed positive FN staining of cardiomyocytes; of 18 cases where early myocardial infarction was suspected, positive FN staining of cardiomyocytes was found in 15 cases, but no such staining was seen in 11 non-cardiac death controls. The results led to the conclusion that positive FN staining in cardiomyocytes is a reliable marker of acute myocardial infarction and could be used as a new, sensitive method for the postmortem diagnosis of early myocardial infarction. It is worth noting that all cases in this study were autopsied between 8 h and 4 days after death and 5 cases had been fixed in 10% formalin for over 10 years. FN immunohistochemistry still gave satisfactory results in those cases. It seemed that FN was not affected by postmortem autolysis and formalin-fixation and could be used in routine forensic practice, especially for retrospective analysis of cases.