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УЖМБС 2021, 6(6): 183–187
https://doi.org/10.26693/jmbs06.06.183
Forensic Medicine

Use of Troponin I as a Biochemical Marker for Diagnostics of Asphictic State in Mechanical Asphyxia

Volobuiev O. E.
Abstract

The purpose of the study was to determine the quantitative content of the biochemical marker of myocardial damage (subunits of the troponin complex: Troponin I) in the blood as a diagnostic criterion for asphyxia in mechanical asphyxia. Materials and methods. To determine the presence of asphyxia, the quantitative content of Troponin I in the blood of 12 dead people was studied and analyzed, among which violent death was observed in 7 cases and non-violent – in 5 cases. The study for biochemical detection of Troponin I used a method based on enzyme-linked immunosorbent assay followed by statistical processing of the results using the MedStat package. Results and discussion. Among the biochemical markers for the diagnosis of asphyxia in hanging and aspiration asphyxia, the most indicative is the determination of the quantitative content of Troponin I in the blood, which is also used in clinical practice to substantiate the diagnosis of cardiac pathology. Therefore, it is important to conduct a differential diagnosis of changes in quantitative indicators of biochemical markers depending on the cause and genesis of death. During the study of the quantitative content of Troponin I in the blood of those who died of mechanical asphyxia (hanging, aspiration asphyxia), it was found that the content of troponin I is from 140 ng/ml to 170 ng/ml. The quantitative content of Troponin I in the blood of those who died of acute and chronic coronary heart disease (control group) is from 10.1 ng/ml to 120 ng/ml. The average value of the quantitative content of Troponin I in two samples was found: in the blood of those who died of mechanical asphyxia – 156 ng/ml±4.4 ng/ml; in the blood of those who died of acute and chronic coronary heart disease – 45.62 ng/ml±22.4 ng/ml. The study revealed a difference in quantitative indicators of biochemical markers depending on the cause and genesis of death, found that the quantitative content of Troponin I in the blood of the dead from mechanical asphyxia (hanging, aspiration asphyxia) compared with the quantitative content of Troponin I in the blood of the dead with chronic coronary heart disease is higher, at the level of significance p=0.008. Conclusion. Thus, in the course of research, the feasibility of using changes in quantitative indicators of the biochemical marker Troponin I to determine the asphyxiation in violent death (mechanical asphyxia) and differential diagnosis in cases of non-violent death (acute and chronic coronary heart disease) was proved, which significantly increases efficiency and reliability of forensic medical examinations

Keywords: mechanical asphyxia, diagnosis, biochemical markers, Troponin I

Full text: PDF (Ukr) 279K

References
  1. Sayit II, Abdukakhkhor ZhU, Asatulayev AF, Obidzhon EM. Struktura smerti po materialam sudebno-meditsinskoy ekspertizy [Structure of death on materials of forensic medical examination]. Respublika Uzbekistan. 2019. [Russian]. Available from: https://journals.indexcopernicus.com/api/file/viewByFileId/1078798/
  2. Simović AM, Kosutić JLj, Prijić SM, Knezević JB, Vujić AJ, Stojanović ND. The role of biochemical markers as early indicators of cardiac damage and prognostic parameters of perinatal asphyxia. Vojnosanit Pregl. 2014;71:149–155. PMid:24665572. https://doi.org/10.2298/VSP1402149S
  3. Zhou WJ, Yu F, Shi J, Yang H, Zou SJ, Jiang YM. Serum levels of cardiac troponin I in asphyxiated neonates predict mortality. Clin Lab. 2016;62:1427–1434. https://doi.org/10.7754/Clin.Lab.2016.151130
  4. Montaldo P, Rosso R, Chello G, Giliberti P. Cardiac troponin I concentrations as a marker of neurodevelopmental outcome at 18 months in newborns with perinatal asphyxia. J Perinatol. 2014;34:292–295. https://www.ncbi.nlm.nih.gov/pubmed/24480903. https://doi.org/10.1038/jp.2014.1
  5. Rahimi R, Dahili ND, Anuar Zainun K, Mohd Kasim NA, Noor S. Post mortem troponin t analysis in sudden death: Is it useful? Malays J Pathol. 2018;40:143–148.
  6. Batalis NI, Marcus BJ, Papadea CN, Collins KA. The role of postmortem cardiac markers in the diagnosis of acute myocardial infarction. J Forensic Sci. 2010;55:1088–1091. https://www.ncbi.nlm.nih.gov/pubmed/20345772. https://doi.org/10.1111/j.1556-4029.2010.01368.x
  7. Sapouna R, Gourgiotis D, Athanaselis S, Papadodima S, Spiliopoulou C. Diagnostic value of cardiac troponin i in postmortem diagnosis of myocardial infarction. Am J Forensic Med Pathol. 2013;34:139–141. https://www.ncbi.nlm.nih.gov/pubmed/23574865. https://doi.org/10.1097/PAF.0b013e3182880aa1
  8. Carvajal-Zarrabal O, Hayward-Jones PM, Nolasco-Hipolito C, Barradas-Dermitz DM, Calderon-Garciduenas AL, Lopez-Amador N. Use of cardiac injury markers in the postmortem diagnosis of sudden cardiac death. J Forensic Sci. 2017;62:1332–1335. https://www.ncbi.nlm.nih.gov/pubmed/28111741. https://doi.org/10.1111/1556-4029.13397
  9. Beausire T, Faouzi M, Palmiere C, Fracasso T, Michaud K. High-sensitive cardiac troponin hs-tnt levels in sudden deaths related to atherosclerotic coronary artery disease. Forensic Sci Int. 2018;289:238–243. https://www.ncbi.nlm.nih.gov/pubmed/29908517. https://doi.org/10.1016/j.forsciint.2018.05.051
  10. Aissaoui A, Haj Salem N, Zaqout A, Boughattas M, Belhaj M, Mosrati MA, et al. Cardiac troponin i and the post-mortem diagnosis of myocardial damage. Ann Cardiol Angeiol. 2013;6:248-252. https://www.ncbi.nlm.nih.gov/pubmed/23561699. https://doi.org/10.1016/j.ancard.2013.02.007
  11. Zhu BL, Ishikawa T, Michiue T, Li DR, Zhao D, Kamikodai Y, et al. Postmortem cardiac troponin t levels in the blood and pericardial fluid. Part 2: Analysis for application in the diagnosis of sudden cardiac death with regard to pathology. Leg Med. 2006;8:94–101. https://www.ncbi.nlm.nih.gov/pubmed/16413814. https://doi.org/10.1016/j.legalmed.2005.10.003
  12. Cao Z, Jia Y, Zhu B. Bnp and nt-probnp as diagnostic biomarkers for cardiac dysfunction in both clinical and forensic medicine. Int J Mol Sci. 2019;20:1820. https://www.ncbi.nlm.nih.gov/pubmed/31013779. Https://www.ncbi.nlm.nih.gov/pmc/articles/6515513. https://doi.org/10.3390/ijms20081820
  13. Chen JH, Inamori-Kawamoto O, Michiue T, Ikeda S, Ishikawa T, Maeda H. Cardiac biomarkers in blood, and pericardial and cerebrospinal fluids of forensic autopsy cases: A reassessment with special regard to postmortem interval. Leg Med (Tokyo). 2015;17(5):343-350. https://www.ncbi.nlm.nih.gov/pubmed/26052007. https://doi.org/10.1016/j.legalmed.2015.03.007
  14. Instruktsiya iz zastosuvannya Troponin I – IFA–BEST [Instructions for use Troponin I - IFA-BEST]. [Ukrainian]. Available from: http:www.vector-best.ru
  15. Fathil MF, Md Arshad MK, Gopinath SC, Hashim U, Adzhri R, Ayub RM, et al. Diagnostics on acute myocardial infarction: Cardiac troponin biomarkers. Biosens Bioelectron. 2015;70:209–220. https://www.ncbi.nlm.nih.gov/pubmed/25841117. https://doi.org/10.1016/j.bios.2015.03.037
  16. Kehl DW, Iqbal N, Fard A, Kipper BA, De La Parra Landa A, Maisel AS. Biomarkers in acute myocardial injury. Transl Res. 2012;159:252–264. https://www.ncbi.nlm.nih.gov/pubmed/22424429. https://doi.org/10.1016/j.trsl.2011.11.002
  17. Jarolim P. High sensitivity cardiac troponin assays in the clinical laboratories. Clin Chem Lab Med. 2015;53:635–652. https://www.ncbi.nlm.nih.gov/pubmed/25252753. https://doi.org/10.1515/cclm-2014-0565
  18. Maeda H, Ishikawa T, Michiue T. Forensic biochemistry for functional investigation of death: Concept and practical application. Leg Med (Tokyo). 2011;13:55–67. https://www.ncbi.nlm.nih.gov/pubmed/21269863. https://doi.org/10.1016/j.legalmed.2010.12.005
  19. Jaffe AS, Ordonez-Llanos J. High sensitivity troponin in chest pain and acute coronary syndromes. A step forward? Rev Esp Cardiol. 2010;63:763–769. https://doi.org/10.1016/S1885-5857(10)70160-2
  20. Palmiere C, Tettamanti C, Bonsignore A, De Stefano F, Vanhaebost J, Rousseau G, et al. Cardiac troponins and nt-probnp in the forensic setting: Overview of sampling site, postmortem interval, cardiopulmonary resuscitation, and review of the literature. Forensic Sci Int. 2018;282:211–218. https://www.ncbi.nlm.nih.gov/pubmed/29227899. https://doi.org/10.1016/j.forsciint.2017.11.034