The Immunohistochemical Study Of Bcl-2,Bax And Myoglobin In The Autopsied Hearts Of Sudden Coronary Death And Acute Myocardium Infarction

Objective:The patients with sudden coronary death(SCD)often died of fetal arrhythmia induced by ischemia/reperfusion(I/R)within one hour after the onset of disease. However the routine pathological method can not detect the definite morphological changes until four to six hours after the myocardium ischemia injury. Recent study suggests that myocardium apoptosis can occur on the early stage of I/R before necrosis and both contribute to the myocardium injury. We intend to detect the expression of apoptosis related proteins Bcl-2, Bax and myoglobin in the autopsied hearts of sudden coronary death and acute myocardium infarction(AMI) in order to find some sensitive, reliable markers for the forensic diagnosis of SCD and early AMI.Methods: The immunohistochemical method (SP) was used to detect the expressions of apoptosis related proteins Bcl-2, Bax and myoglobin in the autopsied hearts of sudden coronary death, AMI and non-cardiac death in 20 cases respectively. And the positive areas of Bcl-2 and Bax and the depletion areas of Mb were measured by computer image analysis.Results: There were positive expressions of Bcl-2 in the myocardium plasma of 16 cases of SCD and 18 cases of AMI while that of Bax were 14 in SCD and 16 in AMI in contrast with no expression in the cases of non-cardiac death. The positive areas percent of Bcl-2 per 100x high field were 25.446(8.463 and 32.143 ( 9.234 respectively while that of Bax were 20.354(9.354 and 28.478 ( 8.973 respectively. There was positive correlation between Bcl-2 and Bax. The correlation ratio was 0.986. Besides there was positive area depletion of Mb in the myocardium of 18 cases of SCD and 19 cases of AMI while no depletion in the non-cardiac death. The depletion area percent of Mb per 100x high field were 48.361(4.432 and 63.154(3.165 respectively. There was no significant difference between SCD and AMI groups,but there was while compared with the non-cardiac death group with all three markers.(P(0.01)Conclusions:1. The expressions of Bcl-2 and Bax in the myocardium of SCD and AMI indicate the involvement of apoptosis which contributes to the myocardium injury. They are also the early signs of myocardium ischemia/reperfusion injury. Bcl-2, Bax might become the sensitive, reliable markers for the forensic diagnosis of SCD and early AMI.2. The depletion of Mb in the cases of SCD and AMI suggests the occurrence of myocardium ischemia/reperfusion injury. Mb can become the sensitive, reliable markers for the forensic diagnosis of SCD and early AMI.