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Evaluation of postmortem measurement of NT-proBNP as a marker for cardiac function
Authors:Katarzyna Michaud  Marc Augsburger  Nicolas Donzé  Sara Sabatasso  Mohamed Faouzi  Marc Bollmann  Patrice Mangin
Affiliation:Centre Universitaire romand de Médecine Légale, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Bugnon 21, 1005, Lausanne, Switzerland, katarzyna.michaud@chuv.ch.
Abstract:
Clinical biomarkers of cardiac function could also be monitored postmortem. Among the natriuretic peptides, the aminoterminal portion of pro-brain natriuretic peptide (NT-proBNP) appears to be a more reliable postmortem tool than the BNP, owing to its longer half-life and greater stability. In living persons, NT-proBNP is considered to be a marker of heart failure, and its level rises after cardiac ischemia. The goal of this study was first to evaluate the postmortem stability of NT-proBNP, then to measure the NT-proBNP levels in postmortem cases of heart failure related to coronary ischemia. The goal of this study was also to evaluate the correlations between different specimens collected at autopsy (e.g. blood, serum, vitreous humor and pericardial fluid). The study included 96 cases, which were classified into 4 groups according to the autopsy and histological findings. The NT-proBNP levels were significantly higher in individuals who had suffered from chronic cardiac ischemia, with or without acute coronary events, than in either control cases or those who had suffered from acute thromboembolism or acute rupture of a plaque without chronic cardiac ischemia. The highest levels were registered in individuals who had suffered from acute coronary thromboembolism in association with chronic coronary ischemia. Good correlations in the NT-proBNP levels for the different specimens were observed between samples of femoral blood, serum, and pericardial fluid. Our data indicated that postmortem measurements of NT-proBNP are reliable and compatible with clinical findings.
Keywords:NT-proBNP  Natriuretic peptides  Heart failure  Coronary ischemia  Forensic autopsy
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