According to a study, researchers examined an autopsy is often an overlooked source of medical insight which may be hindering advances in cardiovascular medicine. The study was published in a special issue of the American Heart Association's journal Circulation.

An autopsy is a source of discovery that informs the way we think about disease systemically. Atherosclerosis, hypertension, diabetes and metabolic syndrome these are the diseases you study during an autopsy. These are the diseases that are killing hundreds of thousands of people and autopsy is important to help understand how these diseases develop and progress.

Autopsy information provided the first image of the human coronary system. Their findings provided insight into the basic processes underlying chest pain and heart attack; identified collateral heart circulation; defined the anatomy of the diseased heart and the vascular changes of congestive heart failure and cardiogenic shock.

Autopsy Issue

A special autopsy issue, three studies offer insight into how autopsy contributes to answers about the causes of sudden cardiac death, gathering information from implantable devices about time and cause of death as well as ways to improve heart function, and identifying the original cause of atherosclerosis fatty deposits that can clog arteries and lead to heart attack and stroke.

The first study suggests that molecular autopsy may provide answers regarding sudden unexplained death in the young and whether surviving family members are also at risk. They studied autopsy subjects with cardiac implantable electronic devices (CIEDs). These devices often store valuable downloadable information which is used to determine cause, mechanism and time of death more precisely than autopsy alone.

Cardiac Implanted Electronic Devices

The researchers collected and analyzed data from 151 cardiac implanted electronic devices 109 pacemakers, 35 defibrillators and seven implantable loop recorders—removed during 5,368 autopsies conducted from February 2012 to April 2017. Device and data analysis determined the time of death in 70% of these cases and clarified the cause of death in 60.8%. Also, device analysis in an important tool to detect potential CIED-related safety issues.

They took tissue samples harvested from 100 autopsies of young adults and used mass-spectrometry to identify early signs of "re-wiring" at a cellular level that appear to be the earliest sign of atherosclerosis.

Tests of the tissue samples detected changes in a handful of mitochondrial proteins considered the building blocks of tissue. Importantly all the changes occurred in protein networks believed to be markers for atherosclerosis.

A role of an autopsy can play in the American Heart Association's One Brave Idea initiative, which is intended as a multipronged campaign to identify the cause of heart disease and identify strategies to prevent it.