![handle is hein.journals/injlegame110 and id is 1 raw text is: Int J Legal Med (1997) 110:1-4
V. Ramos - A. Valenzuela - E. Villanueva
M. T. Miranda
Antioxidant-related enzymes in myocardial zones
and human pericardial fluid in relation to the cause of death
Received: 6 July 1995 / Received in revised form: 1 July 1996
Abstract The aim of this work was to shed light on hy-
poxic and ischemic processes in the heart that may lead to
irreversible or lethal myocardial injury. We determined
malondialdehyde (MDA) and glutathione peroxidase
(GSH-Px) and superoxide dismutase (SOD) activities in
human cardiac tissues from 45 medico-legal autopsies of
persons who died from different causes. Samples were
taken from three different areas of myocardium: the ante-
rior and posterior walls of the left ventricle, and the inter-
ventricular septum. We used light microscopy to examine
the heart sections (hematoxylin-eosin and Masson's
trichromic stains), and studied the K+/Na+ ratio and peri-
cardial fluid. A decrease in GSH-Px activity was found in
cases with severe atherosclerosis of the coronary artery in
comparison with the group with slight or moderate athero-
sclerosis. Postmortem activities of GSH-Px and SOD were
significantly different in the three myocaridal zones stud-
ied. An increase in GSH-Px activity in the interventricular
septum was noted in cases of cardiac deaths. Antioxidant-
related enzymes such as GSH-Px and SOD can therefore
be regarded as new biochemical markers indicative of
myocardial hypoxia. The possible applications to the post-
mortem diagnosis of the cause of death are discussed.
Key words Postmortem changes Malondialdehyde-
Antioxidant-related exzymes Cause of death
Introduction
The precise cause of death can sometimes be difficult to
establish in forensic practice. There have been many at-
tempts from different perspectives to find reliable markers
Preliminary results of this work were presented at the XVIth Con-
gress of the International Academy of Legal Medicine and Social
Medicine, Strasbourg (France), 1994
V. Ramos A. Valenzuela (®) - E. Villanueva - M. T. Miranda
Department of Forensic Medicine, University of Granada,
E-18071 Granada, Spain
of hypoxic/ischemic myocardial damage. Many morpho-
logical, histochemical, enzyme-histochemical, and bio-
chemical methods have been used in attempts to diagnose
myocardial damage and especially for the exact diagnosis
in cases of early myocardial infarction [5, 16]. The useful-
ness of conventional histology is limited because myocar-
dial damage is usually manifested after 5-8 h. The results
of enzyme-histochemical techniques are difficult to inter-
pret because of artifacts caused by autolysis. Most avail-
able methods are nonspecific, or the changes induced by
ischemia occur too late [14]. Biochemical methods in-
clude analysis of the pericardial fluid [19, 23] as a useful
source of information on the state of the myocardium,
while other researchers have used cardiac tissue itself
[19]. Although no definitive solutions have been found to
this problem, biochemical methods have nevertheless
shown themselves to be particularly useful for demon-
strating myocardial damage at earlier stages than is possi-
ble with histological methods.
There is currently evidence that several clinical situa-
tions which result in tissue injury do so by generating
toxic metabolites of oxygen in amounts exceeding the ca-
pacity of tissue to protect itself [13, 26]. Included in these
pathological conditions are myocardial infarction, cardiac
arrhythmias, alcoholic myocardiopathy, and coronary
artery disease [6, 28]. Free radicals can injure cells and
tissues [15] producing, among other effects, lipid peroxi-
dation of membranes including the production of malon-
dialdehyde. In mammals, glutathione peroxidase (GSH-
Px; EC 1.11.1.9) and superoxide dismutase (SOD; EC
1.15.1.1) are primarily involved in protecting cellular
structures against peroxides and free radicals [10, 22, 36].
Imbalances caused by the excessive production of radicals
or a decrease in defense systems result in varying degrees
of cellular injury and may even cause cell death. Although
much research has been devoted to free radicals in human
pathology, studies that can be applied to cardiac forensic
pathology are lacking. We have attempted to determine
the usefulness of the postmortem analysis of two cellular
antioxidant enzymatic systems (GSH-Px and SOD) in
caridac tissue and pericardial fluid in cases of death re-
© Springer-Verlag 1997](ViewImageLocal?handle=hein.journals/injlegame110&div=1&collection=&method=preview&ext=.png&size=3)
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