Validation of magnetocardiography versus fractional flow reserve for detection of coronary artery disease

心磁图 医学 部分流量储备 冠状动脉疾病 心脏病学 接收机工作特性 内科学 曲线下面积 冠状动脉造影 计算机辅助设计 诊断准确性 缺血 ST段 放射科 心肌梗塞 工程制图 工程类
作者
Jai‐Wun Park,Eun‐Seok Shin,Soe Hee Ann,Martin Gödde,Lea Song-I Park,Johannes Brachmann,Silvia Vidal-Lopez,Jan Wierzbinski,Yat‐Yin Lam,F. Jung
出处
期刊:Clinical Hemorheology and Microcirculation [IOS Press]
卷期号:59 (3): 267-281 被引量:22
标识
DOI:10.3233/ch-141912
摘要

Although magnetocardiography (MCG) has been proposed as a non-invasive technique with high accuracy for functional diagnosis of myocardial injury, the validation of MCG against fractional flow reserve FFR in diagnosing coronary artery disease (CAD) has not yet been established. The goal of the study was to determine the diagnostic accuracy of MCG versus invasively determined FFR in patients with suspected or known CAD.Forty seven patients with suspected CAD (35 men; mean age 69 years) who underwent coronary angiography and FFR measurement were enrolled. FFR ≤ 0.8 was considered to indicate significant myocardial ischemia. The change of ST-segment fluctuation score from rest to stress was calculated from the MCG. In addition, two blinded cardiologists assessed MCG images that were visualized by post-processing method, bull's-eye mapping.The best cut-off value of the percent change of ST-segment fluctuation score was -39.0% with sensitivity of 86.7% and specificity of 73.9%. Sensitivity, specificity, diagnostic accuracy, and the area under the receiver-operator characteristics curve of bull's-eye mapping for the detection of significant CAD were 90.5%, 92.3%, 91.5%, and 0.914 on a patient basis and 90.0%, 93.8%, 92.3%, and 0.919 by coronary territory, respectively.MCG accurately detects functionally significant CAD as defined by using FFR, provides an assessment of ischemic status in agreement with the change of ST-segment fluctuation score, and accurately localizes the ischemic territory in bull's eye mapping. Therefore, MCG may provide an incremental value for prediction of myocardial ischemia non-invasively and safely in clinical practice with fast examination time.
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