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The relevance of the detection of troponins to the forensic diagnosis of cardiac contusion
Authors:Jan Peter, Andreas Kirchner, Eberhard Kuhlisch, Mario Menschikowski, Bernhard Neef,Jan Dreß  ler,
Affiliation:aDepartment of Legal Medicine, Technical University Medical School, Carl Gustav Carus, Inst. fur Rechtsmedizin, Fetscherstrasse 74, D-01307 Dresden, Germany
Abstract:The forensic diagnosis of cardiac contusion has hitherto been based mainly on anamnesis, concomitant thoracic injuries and the detection of macroscopic changes to the heart. Parallel histological and serological investigations of the heart-specific troponins have been conducted with varying results. This paper aims to show whether heart-specific troponins are suitable as a means of securing the diagnosis in proven cases of cardiac contusion and of determining which of the three heart-specific troponins cTnT, cTnI and cTnC are most significant in serology and histology for postmortem diagnosis.In the study, 25 cases of known cardiac contusion and 11 controls without vital myocardial trauma taken from autopsy material were prospectively investigated. Investigation of the venous serum revealed significant differences in the concentrations of the case and control groups for troponin T (mean value 5.5056 versus 0.4982; p = 0.014), for troponin C (mean value 263.9280 versus 68.5640; p = 0.001) and for troponin I (mean value 1404.0560 versus 36.1650; p = 0.003). In histology there are also significantly different depletions between the groups investigated (cTnT: p = 0.002; cTnC: p = 0.003; cTnI: p < 0.001) taking into account the autolysis time.
Keywords:Contusio cordis   Immunohistochemistry   ELISA Troponine T, I, C
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