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Post-Mortem Cardiac Magnetic Resonance in Explanted Heart of Patients with Sudden Death

Author

Listed:
  • Giovanni Donato Aquaro

    (Academic Radiology, University of Pisa, 56126 Pisa, Italy)

  • Benedetta Guidi

    (ASL Toscana Nord-Ovest, 55100 Lucca, Italy)

  • Michele Emdin

    (Fondazione Toscana G. Monasterio, 56124 Pisa, Italy
    Scuola Superiore Sant’Anna, 56127 Pisa, Italy)

  • Angela Pucci

    (Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy)

  • Enrica Chiti

    (Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy)

  • Alessandro Santurro

    (Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana, University of Salerno, 84084 Fisciano, Italy)

  • Matteo Scopetti

    (Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy)

  • Federico Biondi

    (Cardiology Department, University of Trieste, 34127 Trieste, Italy)

  • Aniello Maiese

    (UO Medicina Legale, University of Pisa, 56126 Pisa, Italy)

  • Emanuela Turillazzi

    (UO Medicina Legale, University of Pisa, 56126 Pisa, Italy)

  • Giovanni Camastra

    (Cardiac Department, Vannini Hospital Rome, 00177 Roma, Italy)

  • Lorenzo Faggioni

    (Academic Radiology, University of Pisa, 56126 Pisa, Italy)

  • Dania Cioni

    (Academic Radiology, University of Pisa, 56126 Pisa, Italy)

  • Vittorio Fineschi

    (Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Rome, Italy)

  • Emanuele Neri

    (Academic Radiology, University of Pisa, 56126 Pisa, Italy)

  • Marco Di Paolo

    (UO Medicina Legale, University of Pisa, 56126 Pisa, Italy)

Abstract

Background: We sought to evaluate the diagnostic accuracy of post-mortem cardiac magnetic resonance (PMCMR) of explanted hearts to detect the cardiac causes of sudden death. Methods: PMCMR was performed in formalin-fixed explanted hearts of 115 cases of sudden death. Histological sampling of myocardium was performed using two different approaches: (1) guideline-based sampling; (2) guideline-based plus PMCMR-driven sampling. Results: Forensic diagnosis of cardiac cause of death was ascertained in 72 (63%) patients. When the guideline-driven histological sampling was used, the PMCMR interpretation matched with final forensic diagnosis in 93 out of 115 cases (81%) with sensitivity of 88% (79–95%), specificity of 65% (47–80%), PPV of 84% (78–90%), NPV of 73% (58–84%), accuracy of 81% (72–88%), and AUC of 0.77 (0.68–0.84). When a PMCMR-driven approach was added to the guideline-based one, the matching increased to 102 (89%) cases with a PMCMR sensitivity of 89% (80–94%), a specificity of 86% (67–96%), PPV of 95% (89–98%), NPV of 73% (59–83%), accuracy of 89% (81–93%), and AUC of 0.88 (0.80–0.93). Conclusions: PMCMR has high accuracy to identify the cardiac cause of sudden death and may be considered a valid auxilium for forensic diagnosis. PMCMR could improve histological diagnosis in conditions with focal myocardial involvement or demonstrating signs of myocardial ischemia.

Suggested Citation

  • Giovanni Donato Aquaro & Benedetta Guidi & Michele Emdin & Angela Pucci & Enrica Chiti & Alessandro Santurro & Matteo Scopetti & Federico Biondi & Aniello Maiese & Emanuela Turillazzi & Giovanni Camas, 2022. "Post-Mortem Cardiac Magnetic Resonance in Explanted Heart of Patients with Sudden Death," IJERPH, MDPI, vol. 19(20), pages 1-15, October.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:20:p:13395-:d:944861
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