Dobutamine stress magnetocardiography for the detection of significant coronary artery stenoses – A prospective study in comparison with simultaneous 12-lead electrocardiography

Issue title: Selected Proceedings of the 14th European Conference for Clinical Hemorheology and Microcirculation, Dresden, Germany, June 27–30, 2007

Article type: Research Article

Authors: Park, J.-W.^; | Leithäuser, B. | Vršansky, M. | Jung, F.

Affiliations: Cardiology/Angiology Division, Hoyerswerda Hospital, Hoyerswerda, Germany | Institute for Heart and Circulation Research, Hoyerswerda, Germany | Berlin–Brandenburg Centre for Regenerative Therapies, Charité, Campus Virchow–Klinikum, Berlin, Germany

Note: [] Corresponding author: Jai-Wun Park, MD, PhD, Cardiology/Angiology Division, Hoyerswerda Hospital, Maria-Grollmuss-Strasse 10, 02977 Hoyerswerda, Germany. Tel.: +49 3571 443238; Fax: +49 3571 443434; E-mail: jai-wunpark@t-online.de.

Abstract: Background: Exercise electrocardiography is an imperfect test for the detection of coronary artery disease (CAD). Magnetocardiography detects cardiac electrical disturbances associated with myocardial ischemia. We prospectively investigated the accuracy of high-dose dobutamine stress magnetocardiography (DS-MCG) and simultaneous electrocardiography (DS-ECG) for the detection of significant CAD. Methods: 100 patients with an intermediate pre-test probability for CAD underwent DS-MCG using a multichannel magnetometer prior to invasive coronary angiography. Patients were examined at rest and during a standard dobutamine–atropine scheme. Significant reduction of epicardial current strength/density during stress, reconstructed from the magnetic field map and superposed on a virtual heart model indicates myocardial ischemia. A 12-lead DS-ECG was recorded simultaneously. Significant coronary artery stenosis was defined as ≥70% of lumen reduction. Results: Without β-blocker all 100 patients reached the targeted heart rate. The image quality of DS-MCG and DS-ECG was sufficient for analysis in all patients. In 19 patients CAD was ruled out angiographically. Thirty two or seven patients revealed coronary artery stenoses of 30–49% or of 50–69%, respectively. In 42 patients we found significant stenoses of ≥70%. In 41 of these patients DS-MCG revealed myocardial ischemia. The sensitivity of DS-MCG and DS-ECG for the detection of significant coronary artery stenosis was 97.6% and 26.2%, the specificity of DS-MCG and DS-ECG 82.8% and 82.8%, respectively. Conclusions: DS-MCG can be performed with a standard dobutamine/atropine stress protocol. DS-MCG yields a significantly higher accuracy for the detection of significant coronary artery stenosis than DS-ECG.

Keywords: Magnetocardiography, electrocardiography, coronary artery disease, dobutamine stress test

DOI: 10.3233/CH-2008-1064

Journal: Clinical Hemorheology and Microcirculation, vol. 39, no. 1-4, pp. 21-32, 2008