{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T20:53:54Z","timestamp":1783630434391,"version":"3.55.0"},"reference-count":16,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T00:00:00Z","timestamp":1665964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["IJERPH"],"abstract":"<jats:p>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\u201395%), specificity of 65% (47\u201380%), PPV of 84% (78\u201390%), NPV of 73% (58\u201384%), accuracy of 81% (72\u201388%), and AUC of 0.77 (0.68\u20130.84). 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\u201394%), a specificity of 86% (67\u201396%), PPV of 95% (89\u201398%), NPV of 73% (59\u201383%), accuracy of 89% (81\u201393%), and AUC of 0.88 (0.80\u20130.93). 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.<\/jats:p>","DOI":"10.3390\/ijerph192013395","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T21:11:51Z","timestamp":1666041111000},"page":"13395","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Post-Mortem Cardiac Magnetic Resonance in Explanted Heart of Patients with Sudden Death"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0915-915X","authenticated-orcid":false,"given":"Giovanni","family":"Aquaro","sequence":"first","affiliation":[{"name":"Academic Radiology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Guidi","sequence":"additional","affiliation":[{"name":"ASL Toscana Nord-Ovest, 55100 Lucca, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Emdin","sequence":"additional","affiliation":[{"name":"Fondazione Toscana G. Monasterio, 56124 Pisa, Italy"},{"name":"Scuola Superiore Sant\u2019Anna, 56127 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8110-4458","authenticated-orcid":false,"given":"Angela","family":"Pucci","sequence":"additional","affiliation":[{"name":"Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1053-5661","authenticated-orcid":false,"given":"Enrica","family":"Chiti","sequence":"additional","affiliation":[{"name":"Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5491-3719","authenticated-orcid":false,"given":"Alessandro","family":"Santurro","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana, University of Salerno, 84084 Fisciano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7259-3090","authenticated-orcid":false,"given":"Matteo","family":"Scopetti","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Biondi","sequence":"additional","affiliation":[{"name":"Cardiology Department, University of Trieste, 34127 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniello","family":"Maiese","sequence":"additional","affiliation":[{"name":"UO Medicina Legale, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Turillazzi","sequence":"additional","affiliation":[{"name":"UO Medicina Legale, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4865-0454","authenticated-orcid":false,"given":"Giovanni","family":"Camastra","sequence":"additional","affiliation":[{"name":"Cardiac Department, Vannini Hospital Rome, 00177 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5262-4489","authenticated-orcid":false,"given":"Lorenzo","family":"Faggioni","sequence":"additional","affiliation":[{"name":"Academic Radiology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5120-886X","authenticated-orcid":false,"given":"Dania","family":"Cioni","sequence":"additional","affiliation":[{"name":"Academic Radiology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1686-3236","authenticated-orcid":false,"given":"Vittorio","family":"Fineschi","sequence":"additional","affiliation":[{"name":"Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7950-4559","authenticated-orcid":false,"given":"Emanuele","family":"Neri","sequence":"additional","affiliation":[{"name":"Academic Radiology, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Di Paolo","sequence":"additional","affiliation":[{"name":"UO Medicina Legale, University of Pisa, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1161\/CIRCRESAHA.116.304521","article-title":"The spectrum of Epidemiology Underlying Sudden Cardiac Death","volume":"116","author":"Hayashi","year":"2015","journal-title":"Circ. 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