The value of magnetocardiography in patients with and without relevant stenoses of the coronary arteries using an unshielded system.

摘要

BACKGROUND: The diagnostic management of patients with chest pain remains a clinical challenge. Magnetocardiography (MCG) is a noninvasive method for the recording of cardiac electromagnetic signals at multiple sites above the chest cage. Contrary to electrocardiogram (ECG) the magnetic field is unaltered by surrounding tissues. The present study aimed to analyze the diagnostic value of an unshielded four-channel MCG for the detection of coronary artery disease (CAD) in patients with chest pain. METHODS: The study included 417 subjects: 177 patients with angiographically documented CAD (stenoses > or =50%), 123 symptomatic patients without hemodynamically relevant stenosis (nCAD) and 117 healthy subjects. Twelve-lead ECG was obtained in all subjects. The magnetocardiography recordings were taken from 36 positions at rest. From these current density vector maps were generated during the ST-T interval. Each map was classified using a classification system with a scale from 0 (normal) to 4 (grossly abnormal). RESULTS: While the ECG was normal in all subjects the MCG revealed typical differences. In normals most maps were classified as category 0, 1 or 2, in nCAD and more so in CAD patients the categories 3 and 4 prevailed. Using a cut-off value of 39.2% for the discrimination between normals and CAD patients sensitivity was 73.3%, specificity 70.1%. CONCLUSION: Contrary to ECG, unshielded MCG reveals significant differences between normals and symptomatic patients with and without relevant stenoses using current density reconstruction during repolarization at rest. This method might be a suitable noninvasive tool for the management of patients with chest pain.