Vibrational spectroscopic techniques as a tool in diagnosis of sudden cardiac death: a systematic review

Background In the practice of forensic pathology, sudden cardiac death (SCD) takes place among leading causes of death. Despite the advancing postmortem diagnostic methods and pathological examinations, SCD presents significant postmortem diagnostic challenges. As emerging techniques in forensic investigations and medical diagnostics, vibrational spectroscopy, including Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy, rise as promising tools. Therefore, this paper evaluates the potential and effectiveness of vibrational spectroscopic methods in the diagnosis of SCD. Main body A systematic review was conducted through literature search in Scopus, PubMed, and Web of Science databases using predefined keywords. Studies utilizing FTIR and Raman spectroscopy for diagnosis of SCD were included in the scope of the study. The risk of bias was assessed using the PROBAST tool. Ten research papers met the inclusion criteria. FTIR and Raman spectroscopy demonstrated distinctive spectral differences in myocardial, pulmonary, arterial, and blood samples from SCD cases. Chemometric and machine learning models enhanced diagnostic accuracy, with some studies achieving over 95% specificity and sensitivity. However, a number of limitations such as small sample sizes, heterogeneous SCD classifications, not considering postmortem interval-related biochemical changes, comorbidities, and variability in spectral analysis methodologies limit the potential of applicability of studies. Conclusions Vibrational spectroscopic applications offer a promising, fast, non-destructive approach for postmortem diagnosis of SCD. However, further studies with standardized protocols, and involving larger series are needed to validate their applicability in routine for postmortem diagnosis.