Brain natriuretic peptide (BNP) is a major marker for evaluating cardiac function and has been widely used in clinical practice. Recent researches show that BNP is also useful for identification of sudden cardiac death in forensic pathology. This article reviews the molecular structure and biological characteristics of the BNP and its application as a functional indicate in forensic medicine. It shows that the expression of BNP in cardiac muscles, together with the expression of BNP in blood and pericardium liquid can be used to evaluate the pathological physiology changes and dysfunction degrees of the heart during the cardiac sudden death.
Amino Acid Sequence ; Animals ; Autopsy ; Biomarkers ; Death, Sudden, Cardiac ; Forensic Pathology ; Heart Diseases/physiopathology* ; Heart Failure/physiopathology* ; Humans ; Immunohistochemistry ; Molecular Sequence Data ; Myocardium/pathology* ; Natriuretic Peptide, Brain/metabolism* ; Peptide Fragments/metabolism* ; Pericardium/metabolism* ; Postmortem Changes ; RNA, Messenger/metabolism*

Increased epicardial adipose tissue (EAT) may be closely associated with the development of metabolic abnormalities. We investigated whether EAT predicts the incident metabolic syndrome in a community-based, middle-aged population. The study subjects were comprised of 354 adults (134 men and 220 women) aged 40 to 70 yr without metabolic syndrome. Baseline EAT thickness, measured by echocardiography, was compared between subjects who developed new-onset metabolic syndrome at follow-up survey and those who did not. After an average of 2.2 yr of follow-up, 32 men (23.9%) and 37 women (16.8%) developed metabolic syndrome. Median EAT thickness at baseline was significantly higher in male subjects who developed metabolic syndrome than those who did not (1.52 mm vs 2.37 mm, P<0.001). The highest quartile of EAT thickness (> or =2.55 mm) was associated with increased risk of progression to metabolic syndrome (Odds ratio [OR], 3.09; 95% confidence interval [CI], 1.11-8.66) after adjustment for age, smoking, alcohol intake, regular exercise, total energy intake, high sensitive C-reactive protein and homeostasis model assessment of insulin resistance in men. A significant association of EAT with incident metabolic syndrome was not seen in women (OR, 1.25; 95% CI, 0.54-2.90). In conclusion, increased EAT thickness is an independent predictor for incident metabolic syndrome in men.
Adipose Tissue/*physiopathology ; Adult ; Aged ; Blood Pressure ; Body Mass Index ; C-Reactive Protein/analysis ; Echocardiography ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Metabolic Syndrome X/*epidemiology ; Middle Aged ; Odds Ratio ; Pericardium/*pathology/physiopathology ; Prospective Studies ; Risk Factors ; Sex Factors ; Waist Circumference