Dobutamine stress magnetocardiography for the detection of significant coronary artery stenoses – A prospective study in comparison with simultaneous 12-lead electrocardiography

摘要

Abstract. Background: Exercise electrocardiography is an imperfect test for the detection of coronary artery disease (CAD).nMagnetocardiography detects cardiac electrical disturbances associated with myocardial ischemia. We prospectively investigatednthe accuracy of high-dose dobutamine stress magnetocardiography (DS-MCG) and simultaneous electrocardiographyn(DS-ECG) for the detection of significant CAD.nMethods: 100 patients with an intermediate pre-test probability for CAD underwent DS-MCG using a multichannel magnetometernprior to invasive coronary angiography. Patients were examined at rest and during a standard dobutamine–atropinenscheme. Significant reduction of epicardial current strength/density during stress, reconstructed from the magnetic field mapnand superposed on a virtual heart model indicates myocardial ischemia. A 12-lead DS-ECG was recorded simultaneously.nSignificant coronary artery stenosis was defined as u000270% of lumen reduction.nResults:Without β-blocker all 100 patients reached the targeted heart rate. The image quality of DS-MCG and DS-ECG wasnsufficient for analysis in all patients. In 19 patients CAD was ruled out angiographically. Thirty two or seven patients revealedncoronary artery stenoses of 30–49% or of 50–69%, respectively. In 42 patients we found significant stenoses of u000270%. In 41 ofnthese patients DS-MCG revealed myocardial ischemia. The sensitivity of DS-MCG and DS-ECG for the detection of significantncoronary artery stenosis was 97.6% and 26.2%, the specificity of DS-MCG and DS-ECG 82.8% and 82.8%, respectively.nConclusions: DS-MCG can be performed with a standard dobutamine/atropine stress protocol. DS-MCG yields a significantlynhigher accuracy for the detection of significant coronary artery stenosis than DS-ECG.