title: Incremental diagnostic value of combined quantitative and qualitative parameters of magnetocardiography to detect coronary artery disease.
abstract: OBJECTIVE
  Magnetocardiography (MCG) has been proposed as a non-invasive and functional technique with high accuracy for diagnosis of myocardial ischemia. This study sought to investigate the incremental diagnostic value of combined quantitative and qualitative parameters of MCG to detect coronary artery disease (CAD).
  
  
  METHODS
  Ninety six patients with suspected CAD who underwent coronary angiography were enrolled in the analysis to test the diagnostic accuracy of 2 MCG parameters (a quantitative parameter of the percent change of ST-segment fluctuation score and a qualitative parameter of non-dipole phenomenon).
  
  
  RESULTS
  The best cut-off value for the percent change of ST-segment fluctuation score was -51.0%. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 78.1, 73.9, 82.0, 79.1, and 77.4, in the percent change of ST-segment fluctuation score and 86.5, 84.8, 88.0, 86.7, and 86.3 in non-dipole phenomenon. The area under the curve of receiver-operating characteristics was 0.79 for the percent change of ST-segment fluctuation score and 0.86 for non-dipole phenomenon (p<0.001). However, the incorporation of non-dipole phenomenon into a model with the percent change of ST-segment fluctuation score significantly improved C-statistics, indicating the enhancement of diagnostic performance in the detection of significant CAD (0.790 to 0.930; p<0.001).
  
  
  CONCLUSIONS
  Qualitative assessment of non-dipole phenomenon has a better diagnostic value than the quantitative parameter of percent change of ST-segment fluctuation score in the detection of significant CAD. Furthermore, this study found that the incorporation of non-dipole phenomenon into the percent change of ST-segment fluctuation score significantly improved the diagnostic performance of CAD detection.
authors.affiliation: Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Shin
authors.affiliation: Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong.
authors.forename: Yat-Yin
authors.initials: YY
authors.lastname: Lam
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea.
authors.forename: Ae-Young
authors.initials: AY
authors.lastname: Her
authors.affiliation: Coburg Hospital, 2nd Medical Department, Coburg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Brachmann
authors.affiliation: Institute of Biomaterial Science and Berlin-Brandenburg, Center for Regenerative Therapies (BCRT), Helmholtz Zentrum Geesthacht, Teltow, Germany.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Jung
authors.affiliation: Coburg Hospital, 2nd Medical Department, Coburg, Germany. Electronic address: jai-wunpark@t-online.de.
authors.forename: Jai-Wun
authors.initials: JW
authors.lastname: Park
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004562:Electrocardiography / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D005858:Germany; D006801:Humans; D053798:Magnetocardiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015588:Observer Variation; D011446:Prospective Studies; D036301:Qualitative Research; D012372:ROC Curve; D012042:Registries; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Coronary artery disease; Magnetocardiography; Myocardial ischemia; Non-dipole phenomenon; ST-segment fluctuation score