ArticleIs Immunohistochemistry a Useful Tool in the Postmortem Recognition of Myocardial Hypoxia in Human Tissue with No Morphological Evidence of Necrosis?Ribeiro-Silva, Alfredo M.D.; S. Martin, Carmen C. M.D., Ph.D.; Rossi, Marcos A. M.D., Ph.D.Author Information From the Department of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. Manuscript received April 24, 2001; accepted September 8, 2001. Address correspondence and reprint requests to Marcos A. Rossi at Department of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, 14049–900, Ribeirão Preto, São Paulo, Brazil. E-mail: firstname.lastname@example.org Supported by a grant from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP: 99/05188–9). Professor Rossi is Senior Investigator (1A) of the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq-Processo 301109/79–6). The American Journal of Forensic Medicine and Pathology: March 2002 - Volume 23 - Issue 1 - p 72-77 Buy Abstract Myocytes in the border zone of myocardial infarction are under severe hypoxia without characteristic morphology of necrosis, and show ultrastructural features similar to those seen within the first hours after coronary occlusion. This study was carried out to evaluate the possibility that immunohistochemical methods could be used for the early diagnosis of myocardial infarction by detecting areas of hypoxia. Nineteen human sections of formalin-fixed paraffin-embedded myocardial samples showing a necrotic area and its border were submitted to immunohistochemical staining with the markers antimuscle actin, antimyoglobin, antitroponin T, antifibronectin, and anticomplement component C9. Sections were also subjected to azan trichrome and hematoxylin-basic fuchsin-picric (HBFP) staining techniques. Immunohistochemistry and azan trichrome showed that in the border zone there was a pattern of reaction intermediate between the infarcted area and the normal myocardium. The HBFP failed to distinguish these two areas. In conclusion, immunohistochemistry and azan trichrome can recognize myocardial hypoxia. Because hypoxia is an invariable condition in infarction, these techniques can be used to confirm suspected cases of myocardial infarction in which necrosis is not yet evident. However, considering that agonal states may be associated with generalized hypoxia, further studies are needed to confirm the reliability of this procedure in the earlier phases of myocardial infarction. © 2002 Lippincott Williams & Wilkins, Inc.