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sudden cardiac death Due to Long QT Syndrome

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Journal of Forensic Science and Medicine 2022年第4期8卷 190-193页

作者： Jiayi Wu Wei Tang Kai Zhang Kai Li Jianwen Wang Youjia Yu Feng Chen Department of Forensic Medicine Nanjing Medical UniversityNanjingChina Department of Forensic Medicine Forensic Expertise Institute of Nanjing Medical UniversityNanjingChina Key Laboratory of Targeted Intervention of Cardiovascular Disease Collaborative Innovation Center for Cardiovascular Disease Translational MedicineNanjing Medical UniversityNanjingChina

Identification of sudden cardiac death(SCD)with a structurally normal heart remains an important challenge in forensic *** QT syndrome(LQTS)is known as an inherited or acquired channelopathy,which is characterized with prolonged QT interval,and is likely to cause SCD in young *** this circumstance,no specific pathological change in the heart can be found anatomically or histologically in the LQTS ***,postmortem LQTS diagnosis is mainly based on clinical manifestations and genetic ***,we reported a 26‑year‑old woman who was found dead at home with a history of unexplained *** clinical records and an electrocardiograph(ECG)obtained 3 months before her death showed a QTc interval of 539 ms which implicates the diagnosis of *** the autopsy and pathological examination findings lacked specificity,we noticed enhanced lipofuscin accumulation in cardiomyocytes,which might be related to *** excluding potential diseases and injuries,we made the postmortem diagnosis as LQTS according to ECG,clinical history,and forensic postmortem *** conclusion,we provided clinical and pathological features of an SCD case due to LQTS,which might enrich the understanding of forensic postmortem SCD diagnosis with nonstructural cardiac diseases.

关键词： Electrocardiograph long QT syndrome QT interval sudden cardiac death

Regulatory variation within 3’UTR of STAT5A correlates with sudden cardiac death in Chinese populations

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Forensic Sciences Research 2022年第4期7卷 726-735页

作者： Huan Yu Yadong Guo Zhenzhen Yang Qing Zhang Jiabin Xu Qi Yang Yiling Qu Rui Tan Lijuan Li Yan He Chengtao Li Suhua Zhang Bin Luo Yuzhen Gao Department of Forensic Medicine Medical College of Soochow UniversitySuzhouChina Department of Forensic Science School of Basic Medical SciencesCentral South UniversityChangshaChina Public Security Bureau of Taixing TaizhouChina Department of Epidemiology Medical College of Soochow UniversitySuzhouChina Shanghai Key Laboratory of Forensic Medicine Academy of Forensic ScienceShanghaiChina Faculty of Forensic Medicine Zhongshan School of MedicineSun Yat-sen UniversityGuangzhouChina

Definitive diagnosis to sudden cardiac death(SCD)is often challenging since the postmortem examination on SCD victims could hardly demonstrate an adequate cause of *** is therefore important to uncover the inherited risk component to *** transducer and activators of transcription 5 A(STAT5A)is a member of the STAT family and a transcription factor that is activated by many cell ligands and associated with various cardiovascular *** this study,we performed a systematic variant screening on the STAT5A to filter potential functional genetic *** on the screening results,an insertion/deletion polymorphism(rs3833144)in 3’UTR of STAT5A was selected as the candidate variant.A total of 159 SCD cases and 668 SCD matched healthy controls was enrolled to perform a case-control study and evaluate the association between rs3833144 and SCD susceptibility in Chinese *** regression analysis showed that the deletion allele of rs3833144 had significantly increased the SCD risk(odds ratio(OR)=1.54;95%confidence interval(CI)=1.18-2.01;P=0.000955).Further genotype-expression eQTL analysis showed that samples with deletion allele appeared to lower expression of STAT5A,and in silico prediction suggested the local 3 D structure changes of STAT5A mRNA caused by the *** the other hand,the bioinformatic analysis presented that promoters of RARA and PTGES3L-AARSD1 could interact with rs3833144,and eQTL analysis showed the higher expression of both genes in samples with deletion ***-luciferase activity assays also suggested the significant regulatory role of rs3833144 in gene *** current data thus suggested a possible involvement of rs3833144 to SCD predisposition in Chinese populations and rs3833144 with potential function roles may become a candidate marker for SCD diagnosis and prevention.

关键词： Forensic sciences forensic genetics STAT5A 3’UTR rs3833144 sudden cardiac death indel polymorphism

Analyses of N‑Terminal Pro‑Brain Natriuretic Peptide,cardiac Troponin T,and Creatine Kinase MB in Pericardial Fluid in sudden cardiac death Caused by Ischemic Heart Disease

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Journal of Forensic Science and Medicine 2022年第4期8卷 135-141页

作者： Zhipeng Cao Tianqi Wang Shao‑Huang Wu Zihan Liao Baoli Zhu Rui Zhao Department of Forensic Pathology School of Forensic MedicineChina Medical UniversityShenyangChina2Liaoning Province Key Laboratory of Forensic Bio‑Evidence SciencesShenyangChina3Center of Forensic InvestigationChina Medical UniversityShenyangChina

Background:Biochemical analyses of N‑terminal pro‑brain natriuretic peptide(NT‑proBNP),cardiac troponin T(cTnT),and creatine kinase MB(CK‑MB)have been reported to be valuable for the auxiliary diagnosis of sudden cardiac death(SCD)in previous forensic *** and Objectives:The present study aimed to evaluate the diagnostic efficiency of combined analyses of NT‑proBNP,cTnT and CK‑MB in the pericardial fluid for forensic diagnosis of SCD caused by ischemic heart *** and Methods:Levels of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid of 132 medicolegal autopsy cases were obtained through electrochemiluminescence ***:NT‑proBNP,cTnT,and CK‑MB levels were significantly elevated in SCD cases(P<0.05).Receiver‑operating characteristics(ROC)analysis showed that NT‑proBNP,cTnT,and CK‑MB have diagnostic value for the diagnosis of SCD:NT‑proBNP,cutoff value of 2236 pg/ml;cTnT,cutoff value of 199.51 ng/ml;CK‑MB:cutoff value of 2742.5 ng/ml,and the combined analyses of these three biomarkers have better diagnostic efficiency than each single biomarker ***,the causes of SCD were sub‑divided into acute ischemic heart disease,acute myocardial infarction(AMI),and recurrent myocardial infarction subgroups for further analysis,which revealed that the ratio of cTnT/CK‑MB could be used to distinguish AMI with the cutoff value of 0.1085 estimated by ROC ***:These observations suggested that the postmortem biochemical analyses of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid may assist to diagnose SCD in forensic practice,and the combined analyses of multiple biomarkers have better diagnostic efficiency than each single biomarker *** the basis of the postmortem biochemical analyses of NT‑proBNP,cTnT and CK‑MB,combining the ratio of cTnT/CK‑MB could be used to distinguish AMI.

关键词： cardiac troponin T creatine kinase MB ischemic heart disease N‑terminal pro‑brain natriuretic peptide pericardial fluid postmortem biochemistry sudden cardiac death

Exosome Biomarkers in Cardiovascular Diseases and their Prospective Forensic Application in the Identification of sudden cardiac death

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Journal of Forensic Science and Medicine 2022年第4期8卷 170-178页

作者： Ye Wang Jie Wang Li Hu Shuainan Huang Yue Cao Youjia Yu Feng Chen Department of Forensic Medicine Nanjing Medical UniversityNanjingChina Key Laboratory of Targeted Intervention of Cardiovascular Disease Collaborative Innovation Center for Cardiovascular Disease Translational MedicineNanjing Medical UniversityNanjingChina

sudden cardiac death(SCD)is a common cause of death due to the high prevalence and mortality of cardiovascular disease(CVD).Currently,the forensic identification of SCD relies on traditional histomorphological examination,lacking stable biomarkers with high specificity and *** studies have shown that exosomes(Exos)are ideal vectors and the application of Exos provides novel insight as the diagnostic biomarkers and treatment of CVD,and is hot research filed in *** review briefly describes the biology of Exos,including the biogenesis of Exos and the mechanisms of *** research progresses on Exos multi‑omics,i.e.,genomics,proteomics and metabolomics,and their roles in the diagnosis of different types of CVD,especially coronary heart disease and cardiomyopathy,are *** addition,the current difficulties of applications of Exos in forensic identification of SCD and the prospective forensic applications in the future are *** aim of this review is to summarize the current advances of Exos in CVD in a disease‑oriented manner,and to provide a reference for future forensic pathological identification of SCD,as well as the early diagnosis of SCD in clinic.

关键词： Cardiovascular disease cause of death exosomes forensic pathology sudden cardiac death

A Pregnant Woman Died of sudden cardiac death:Should Esophageal Foreign Body Be Considered an Inductive Factor?A Case Report and Literature Review

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Journal of Forensic Science and Medicine 2022年第4期8卷 186-189页

作者： Chang Cao Mingming Li Zhanzhan Liu Shiyong Fang Gang Chen Guang Chen Tongjun Ma Xuyang Zhu Xiang Xu School of Forensic Medicine Wannan Medical CollegeWuhuAnhui ProvinceChina Wannan Medical College Wuhu Zhiwei Pathology Diagnosis CenterWuhuAnhui ProvinceChina

Here,we report a case of acute attack of coronary heart disease(CHD).A 47‑year‑old pregnant woman with gestational hypertension developed sudden‑onset chest tightness,palpitations,dyspnea,and cyanosis of the face and lips after *** blood pressure was 180/110 mmHg and her blood oxygen saturation was 45%at that *** cardiopulmonary resuscitation,a weak heartbeat was restored,but oxygen saturation did not increase ***,she was transferred to the intensive care unit;however,she died after 21 days of *** findings revealed that a foreign body was embedded in the esophagus near the right piriform,and her heart weighed 392 g;histopathological examination revealed CHD,thrombosis in the lumen of the right coronary artery,cardiomyocyte hypertrophy,vascular hyaline degeneration in arterioles,neutrophils in the bronchiole and *** the tested samples yielded negative toxicological *** status and autopsy findings were not compatible with a diagnosis of peripartum *** patient’s sudden death was attributed to CHD,and esophageal foreign‑body impaction was considered to be concomitant *** findings might help in increasing the awareness between esophageal foreign‑body impaction and sudden cardiac death and they can also help in clarifying that understanding the primary cause of death is the key to resolving an iatrogenic medical tangle.

关键词： Advanced maternal age coronary heart disease esophageal foreign body forensic pathology sudden cardiac death

sudden cardiac death in a case of Crohn's disease with COVID-19: A case report

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Journal of Acute Disease 2022年第3期11卷 123-126页

作者： Neeraj Kumar Subhajit Ghosh Abhyuday Kumar Sanjeev Kumar Prem Kumar Departments of Trauma&Emergency All India Institute of Medical SciencesPatnaIndia Departments of Anaesthesiology All India Institute of Medical SciencesPatnaIndia Departments of CTVS All India Institute of Medical SciencesPatnaIndia Departments of Radiology All India Institute of Medical SciencesPatnaIndia

Rationale:The mechanism of sudden cardiac death in COVID-19 can be *** hypersensitivity to 5-ASA therapy leading to myocarditis has been reported in some *** storm syndrome and idiosyncratic reaction with mesalazine use may lead to sudden cardiac death in *** of immunosuppressants in hospitalized COVID-19 patients should be continued with caution,especially in patients with inflammatory bowel ***’s concern:A 75-year-old man who was tested positive for SARS-CoV-2 was admitted with a history of shortness of breath for the last two *** was a known case of Crohn’s disease treated with ***:COVID-19 pneumonia with underlying Crohn’s disease leading to sudden cardiac ***:Remdesivir,antibiotics,steroids,low molecular weight heparin,tablet zinc,tab vitamin C,and other supportive treatment were *** of increased inflammatory markers,itolizumab was given to the patient on the 2nd ***:On the 5th day of the intensive care unit,the patient complained of sudden chest pain with respiratory distress leading to bradycardia and asystole and could not be ***:Causes for sudden cardiac death in COVID-19 pneumonia patients with Crohn’s disease is *** mesalazine may be a safe and effective drug in the management of inflammatory bowel disease,it can induce sytokine strom syndrome and idiosyncratic reactions that could be one of the reasons of sudden cardic ***,we should be aware of its serious and potentially life-threatening complications,especially in COVID-19 infected patients.

关键词： COVID-19 sudden cardiac death Chron’s disease

sudden cardiac death caused by myocarditis in persons aged 1-49 years:a nationwide study of 14 294 deaths in Denmark

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Forensic Sciences Research 2019年第3期4卷 247-256页

作者： Thomas Hadberg Lynge Trine Skov Nielsen Bo Gregers Winkel Jacob Tfelt-Hansen Jytte Banner Department of Cardiology RigshospitaletDenmarkSection of Forensic PathologyAarhus UniversityAarhusDenmark Department of Forensic Medicine Section of Forensic PathologyAarhus UniversityAarhusDenmark Department of Forensic Medicine Section of Forensic PathologyCopenhagen UniversityCopenhagenDenmark

Myocarditis is associated with an increased risk of sudden cardiac death (SCD) in the ***,Information on nationwide burden of SCD caused by myocarditis (SCD-myocarditis) is *** this study all deaths among persons in Denmark aged 1-35years in 2000-2009 and 36-49years in 2007-2009 (27.1 million person-years) were *** reports,death certificates,discharge summaries,and nationwide registries were used to identify all cases of *** the 10-year study period,there were 14294 deaths,of which we identified 1 363 (10%) *** autopsied SCD (n=753,55%),cause of death was myocarditis in 42 (6%) cases corresponding to an SCD-myocarditis incidence of 0.16 (95%CI: 0.11-0.21) per 100000 *** had significantly higher incidence rates of SCD-myocarditis compared to females with an incidence rate ratio of 2.2 (95%CI:1.1-4.1).Myocarditis was not registered as cause of death In any of the non-autopsied SCD (n=610,45%).In conclusion,after nationwide unselected Inclusion of 14294 deaths,we found that 6% of all autopsied SCD was caused by *** cases of SCD-myocarditis were reported in the non-autopsied SCD,which could reflect underdiagnosing of myocarditis in non-autopsied ***,our data suggest a female protection towards SCDmyocarditis.

关键词： Forensic sciences sudden cardiac death myocarditis autopsy epidemiology gender children young adults

sudden cardiac death in anabolic androgenic steroids abuse: case report and literature review

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Forensic Sciences Research 2019年第3期4卷 267-273页

作者： Ana Isabel Hernández-Guerra Javier Tapia Luis Manuel Menéndez-Quintanal Joaquín S.Lucena Histopathology Service National Institute of Toxicology and Forensic Sciences(NITFS)Canary Islands DepartmentTenerifeSpain Forensic Pathology Service Institute of Legal Medicine and Forensic Sciences(ILMFS)Las Palmas de Gran CanariaSpain Chemistry Service NITFSCanary Islands DepartmentTenerifeSpain Forensic Pathology Service ILMFSSevilleSpain

Anabolic androgenic steroids (AAS) have several adverse effects on the cardiovascular system that may lead to a sudden cardiac death (SCD).We herein report a case involving a 24-year-old male,AAS abuser with intramuscular delivery in the 6 months before,who suffered a cardiorespiratory arrest at home's bathtub when returning from New Year's party.A forensic autopsy was performed according to the guidelines of the Association for European Cardiovascular Pathology (AECVP).The body showed hypertrophy of skeletal musculature,with low amount of subcutaneous fat and no signs of injury (body mass index,BMh 26.8 kg/m^(2)).On internal examination,there were multiorgan congestion,acute pulmonary edema,and cardiomegaly (420 g) with severe coronary atherosclerosis and superimposed acute occlusive thrombosis at the left main trunk and left anterior *** of scarring were located at the intersection between the posterior wall and the posterior third of the septum (postero-septal).At histology,acute myocardial infarction at the anterior third of the septum and the anterior wall,and subacute myocardial infarction at apical septum and apical posterior wall were *** findings were small intramyocardial vessel disease and myocytes *** analysis in blood showed ethanol ((0.90 ±0.05) g/L),stanazolol (11.31 μg/L),nandrolone (2.05μg/L) and testosterone (sudden death in a young athlete we must pay attention to the physical phenotype that may suggest AAS abuse and perform a detailed examination of the *** analysis is a key to establish the relationship between SCD and AAS abuse.

关键词： Forensic sciences forensic pathology anabolic androgenic steroids(AAS) sudden cardiac death autopsy cardiac pathology toxicology

sudden cardiac death of Duchenne muscular dystrophy with NT-proBNP in pericardial fluid as a useful biomarker for diagnosis of the cause of death: a case report

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Forensic Sciences Research 2020年第2期5卷 165-169页

作者： Mengzhou Zhang Rui Zhao Tianshui Yu Jiaoyong Li Miao Zhang Shukun Jiang Linlin Wang Guohua Zhang Rubo Li Baoli Zhu Dawei Guan Department of Forensic Pathology China Medical University School of Forensic MedicineShenyangChina Remote Forensic Consultation Center Collaborative Innovation Center of Judicial CivilizationChina University of Political Science and LawBeijingChina

Duchenne muscular dystrophy(DMD)is one of the most common and severest muscular *** it can be a cause of death when associated with cardiac muscle and/or respiratory muscles,no cases of sudden deaths in the setting of undiagnosed DMD with cardiac involvement have been reported in the *** studies showed that N-terminal-proBNP(NT-proBNP)was a robust laboratory biomarker to diagnose and monitor cardiac failure in clinical situations,suggesting that it may be used as an auxiliary indicator for diagnosis on left ventricular dysfunction in sudden cardiac deaths in forensic ***,we reported a case of 29-year-old man who died *** revealed that muscles of the body were almost replaced by fatty and fibrotic *** heart was enlarged with disarray and degeneration of cardiomyocytes in cardiac *** absence of dystrophin was detected by immunohistochemical staining,which confirmed *** biochemical test of pericardial fluid revealed a high level of NT-proBNP,indicating dysfunction of the left ventricle before *** cause of death was certified as an early dilated cardiomyopathy(DCM)/dysfunction of the left ventricle secondary to DMD,suggesting that sudden cardiac death with cardiac dysfunction could be identified by immunohistochemical method in combination with pericardial fluid NT-proBNP determination after systemic autopsy.

关键词： Forensic sciences forensic medicine NT-proBNP sudden cardiac death Duchenne muscular dystrophy left ventricular dysfunction