The Role of Molecular Autopsy in Concealed Cardiomyopathies.


Por: Campuzano O, Tirón C, Martínez-Barrios E, Greco A, Cruzalegui JC, Chipa F, César-Díaz S, Merchan EF, Coll M, Fernández-Falgueras A, Brugada R, Ortega M, Molina N, Barberia E, Toro R, Oliva A, Grassi S and Sarquella-Brugada G

Publicada: 28 oct 2025 Ahead of Print: 28 oct 2025
Resumen:
A conclusive and early diagnosis of cardiomyopathy is essential for implementing preventive therapeutic measures and, therefore, reducing the risk of malignant arrhythmias and even sudden cardiac death. Occasionally, this lethal event can be the first manifestation of cardiomyopathy, with or without a clear structural defect. In cases of sudden death, especially in young patients, the autopsy may be ambiguous and therefore lack a definitive diagnosis of cardiomyopathy, although it can sometimes identify signs that lead us to suspect it. This is one of the current challenges of forensic science, where occult cardiomyopathies often remain unidentified without additional testing that is not routinely included in current forensic protocols. In this protocol, it is crucial to perform a molecular autopsy but also to include additional data, especially family history, that will help conclude or at least suspect this entity. Obtaining this diagnosis or suspicion of concealed cardiomyopathy not only provides an answer to the unexpected death but also helps the relatives determine the cause of death. In addition, physicians should initiate a family assessment to identify other family members who may be at risk early and adopt personalized preventive measures.

Filiaciones:
:
 Medical Science Department, School of Medicine, University of Girona, 17003 Girona, Spain

 Institut Investigacions Biomèdiques de Girona, IDIBGI, 17190 Girona, Spain

 Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares, 28029 Madrid, Spain

Tirón C:
 Institut Investigacions Biomèdiques de Girona, IDIBGI, 17190 Girona, Spain

 Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares, 28029 Madrid, Spain

 Unitat de Genòmica i Medicina Personalitzada, Laboratori Clínic Territorial, Institut Català de la Salut, 17003 Girona, Spain

 Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitari Dr Josep Trueta, 17007 Girona, Spain

Martínez-Barrios E:
 Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Cardiology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 Arrítmies Pediàtriques, Cardiologia Genètica i Mort Sobtada, Malalties Cardiovasculars en el Desenvolupament, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), 1105 AZ Amsterdam, The Netherlands

Greco A:
 Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Cardiology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 Arrítmies Pediàtriques, Cardiologia Genètica i Mort Sobtada, Malalties Cardiovasculars en el Desenvolupament, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), 1105 AZ Amsterdam, The Netherlands

 Pediatrics Department, School of Medicine, University of Barcelona, 08036 Barcelona, Spain

Cruzalegui JC:
 Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Cardiology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 Arrítmies Pediàtriques, Cardiologia Genètica i Mort Sobtada, Malalties Cardiovasculars en el Desenvolupament, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), 1105 AZ Amsterdam, The Netherlands

 Pediatrics Department, School of Medicine, University of Barcelona, 08036 Barcelona, Spain

:
 Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Cardiology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 Arrítmies Pediàtriques, Cardiologia Genètica i Mort Sobtada, Malalties Cardiovasculars en el Desenvolupament, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), 1105 AZ Amsterdam, The Netherlands

César-Díaz S:
 Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Cardiology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 Arrítmies Pediàtriques, Cardiologia Genètica i Mort Sobtada, Malalties Cardiovasculars en el Desenvolupament, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), 1105 AZ Amsterdam, The Netherlands

:
 Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Cardiology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 Arrítmies Pediàtriques, Cardiologia Genètica i Mort Sobtada, Malalties Cardiovasculars en el Desenvolupament, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), 1105 AZ Amsterdam, The Netherlands

Coll M:
 Institut Investigacions Biomèdiques de Girona, IDIBGI, 17190 Girona, Spain

 Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares, 28029 Madrid, Spain

 Unitat de Genòmica i Medicina Personalitzada, Laboratori Clínic Territorial, Institut Català de la Salut, 17003 Girona, Spain

Fernández-Falgueras A:
 Institut Investigacions Biomèdiques de Girona, IDIBGI, 17190 Girona, Spain

 Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares, 28029 Madrid, Spain

 Unitat de Genòmica i Medicina Personalitzada, Laboratori Clínic Territorial, Institut Català de la Salut, 17003 Girona, Spain

Brugada R:
 Institut Investigacions Biomèdiques de Girona, IDIBGI, 17190 Girona, Spain

 Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares, 28029 Madrid, Spain

 Unitat de Genòmica i Medicina Personalitzada, Laboratori Clínic Territorial, Institut Català de la Salut, 17003 Girona, Spain

 Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitari Dr Josep Trueta, 17007 Girona, Spain

Ortega M:
 Forensic Pathology Service, Institut de Medicina Legal i Ciències Forenses de Catalunya, 08075 Barcelona, Spain

 Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain

Molina N:
 Forensic Pathology Service, Institut de Medicina Legal i Ciències Forenses de Catalunya, 08075 Barcelona, Spain

 Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain

Barberia E:
 Forensic Pathology Service, Institut de Medicina Legal i Ciències Forenses de Catalunya, 08075 Barcelona, Spain

 Faculty of Medicine and Health Sciences, University of Rovira and Virgili, 43201 Reus, Spain

Toro R:
 Medicine Department, School of Medicine, University of Cadiz, 11003 Cadiz, Spain

Oliva A:
 Area of Pathology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy

Grassi S:
 Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, 50134 Florence, Italy

Sarquella-Brugada G:
 Medical Science Department, School of Medicine, University of Girona, 17003 Girona, Spain

 Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Cardiology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 Arrítmies Pediàtriques, Cardiologia Genètica i Mort Sobtada, Malalties Cardiovasculars en el Desenvolupament, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain

 European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), 1105 AZ Amsterdam, The Netherlands

 Pediatrics Department, School of Medicine, University of Barcelona, 08036 Barcelona, Spain
ISSN: 20734425





Genes
Editorial
MDPI, MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND, Suiza
Tipo de documento: Article
Volumen: 16 Número: 11
Páginas:
WOS Id: 001623850300001
ID de PubMed: 41300724
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