Repolarization Heterogeneity of Magnetocardiography Predicts Long-Term Prognosis in Patients with Acute Myocardial Infarction.
OBJECTIVE
Magnetocardiography (MCG) has been proposed as a noninvasive, diagnostic tool for risk-stratifying patients with acute myocardial infarction (AMI). This study evaluated whether MCG predicts long-term prognosis in AMI.


METHODS
In 124 AMI patients (95 males, mean age 60±11 years), including 39 with ST-elevation myocardial infarction, a 64-channel MCG was performed within 2 days after AMI. During a mean follow-up period of 6.1 years, major adverse cardiac events (MACE) were evaluated.


RESULTS
MACE occurred in 31 (25%) patients, including 20 revascularizations, 8 deaths, and 3 re-infarctions. Non-dipole patterns were observed at the end of the T wave in every patients. However, they were observed at T-peak in 77% (24/31) and 54% (50/93) of patients with and without MACE, respectively (p=0.03). Maximum current, field map angles, and distance dynamics were not different between groups. In the multivariate analysis, patients with non-dipole patterns at T-peak had increased age- and gender-adjusted hazard ratios for MACE (hazard ratio 2.89, 95% confidence interval 1.20-6.97, p=0.02) and lower cumulative MACE-free survival than those with dipole patterns (p=0.02).


CONCLUSIONS
Non-dipole patterns at T-peak were more frequently observed in patients with MACE and were related to poor long-term prognosis. Thus, repolarization heterogeneity measured by MCG may be a useful predictor for AMI prognosis.
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Department of Cardiology, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea.
Woo Dae
WD
Bang
Bio-Signal Research Center, Korea Research Institute of Standards and Science, Daejeon, Korea.
Kiwoong
K
Kim
Bio-Signal Research Center, Korea Research Institute of Standards and Science, Daejeon, Korea.
Yong Ho
YH
Lee
Bio-Signal Research Center, Korea Research Institute of Standards and Science, Daejeon, Korea.
Hyukchan
H
Kwon
Bio-Signal Research Center, Korea Research Institute of Standards and Science, Daejeon, Korea.
Yongki
Y
Park
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Hui Nam
HN
Pak
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Young Guk
YG
Ko
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Moonhyoung
M
Lee
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. cby6908@yuhs.ac.
Boyoung
B
Joung
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053798:Magnetocardiography; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012680:Sensitivity and Specificity
Acute myocardial infarction; magnetocardiography; prognosis