Non-invasive resting magnetocardiographic imaging for the rapid detection of ischemia in subjects presenting with chest pain.
BACKGROUND
Early diagnosis of ischemia is complicated by the poor sensitivity of standard tests and contraindication for stress testing in unstable angina patients. Magnetocardiography (MCG) imaging can be used for the rapid, non-invasive detection of ischemia at rest.


METHODS
We studied 125 patients with presumed ischemic chest pain. All were chest pain free at the time of scanning. A 6-minute resting MCG scan (CardioMag Imaging, Inc., New York, 9-channel system) was performed. Following the MCG scan, automated software data analysis was performed, and quantitative scores were automatically calculated for each subject. The presence of ischemia was determined after testing with serial troponins, stress testing, and/or coronary angiography.


RESULTS
The mean age was 59.4 +/- 13.6 years. Most patients (86.4%) had non-ischemic 12-lead ECG and normal troponin (86.2%). Fifty-five patients (44.0%) were determined to be ischemic. The MCG sensitivity, specificity, positive and negative predictive value was 76.4, 74.3, 70.0 and 80.0%, respectively, for the detection of ischemia (p < 0.0001).


CONCLUSIONS
MCG is a new rapid, non-invasive imaging tool able to detect repolarization abnormalities at rest consistent with ischemia in patients presenting with chest pain syndrome and normal or non-specific 12-lead ECG and normal troponin.
Tolstrup
Kirsten
K
Cedars-Sinai Medical Center, Division of Cardiology, Los Angeles, Calif. 90048, USA. tolstrupk@cshs.org
Madsen
Bo E
BE
Ruiz
Jose A
JA
Greenwood
Stephen D
SD
Camacho
Judeen
J
Siegel
Robert J
RJ
Gertzen
H Caroline
HC
Park
Jai-Wun
JW
Smars
Peter A
PA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000175:diagnosis*; D002637:Chest Pain / Q000175:diagnosis*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D053798:Magnetocardiography / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012146:Rest; D012680:Sensitivity and Specificity; D013997:Time Factors; D014336:Troponin / Q000097:blood
D014336:Troponin