Demonstration of myocardial infarction in decomposed myocardium with vascular endothelial growth factor immunohistochemistry: A tropical climate study

Abstract

Background : Tissue damage caused by decomposition contributes to difficulties faced by forensic pathologists in medico-legal autopsy. Various studies have utilized immunohistochemistry in decomposed forensic caseworks,
including myocardial infarction (MI). To date, only few markers have been studied in decomposed MI specimens. Moreover, there are no researches that performed in tropical climate areas. This study is the first study to
perform vascular endothelial growth factor (VEGF) immunohistochemistry in decomposed MI samples. This is also the first paper on performed immunohistochemistry in tropical climate areas.

Objective : To study whether VEGF immunohistochemistry can be used in decomposed MI specimens in tropical climate areas. Secondary objective is the longest decomposition period that it could be used if the primary objective is possible.

Methods : MI and non-MI specimens from medico-legal autopsy cases were sampled and stored for 0, 1, 2, 3, and 5 days. When the storage times for each specimen were reached, the tissues were then processed and stained
by haematoxylin and eosin (H&E) staining, myoglobin (only in fresh specimens), and VEGF immunohistochemistry.

Results : Comparing VEGF immunohistochemistry staining between MI and non-MI groups, there were statistically significant difference of staining between the groups from fresh specimen up to decomposition period of 2 days. Comparing stainability of VEGF among specimens at different decomposition periods with fresh specimens, there was no statistically difference between fresh specimens and specimens with decomposition periods of 1 and 2 days.

Conclusion : In tropical climate, VEGF immunohistochemistry can detect MI until decomposition periods of 2 days. However, in early MI specimens, VEGF may still detect MI at decomposition period of 5 days.