Abstract
Objective: The electrophysiological properties of the myocardium are extremely heterogeneous. Verification of new magnetocardiography (MCG) signs appears an important aspect for severity assessment of ischemic myocardium damage, ischemic heart disease (IHD) course prognosis, determining of indications for preventive “aggressive” therapy and estimation of its efficacy in patients with IHD. The objective of this research was the investigation of magnetocardiography (MCG) capabilities in diagnosis of ischemic and inflammatory myocardial injuries using new MCG markers of the spatiotemporal organization of myocardium excitation. Methods and results: There were 128 patients examined in three groups. Group 1 contained 34 healthy volunteers. Group 2 contained 62 patients with IHD diagnosis. Group 3 included 32 comparatively young patients with acute myocarditis diagnosis. MCG-mapping of patients was performed at rest on the 7-channel MCG-scanners “Cardiomagscan” V 3.1 (Company KMG, Ukraine) in non-shielded MCG laboratory. 11 MCG markers were determined for selected time intervals of the cardiac cycle. Obtained data provided evidences about significant differences in values of proposed MCG markers for various groups. In patients with AMI, rate of parameters change is higher than without AMI (Sub-groups 2.1 and 2.2 differ by 8 MCG markers). Patients of 2nd and 3rd groups are different from healthy patients by 8 of 11 markers. Analysis of the obtained data has demonstrated good capabilities of MCG in differential diagnostics. Application of discriminatory analysis allowed us to get classification functions, which could be used (with 82% accuracy) to qualify the just examined patient to the investigated categories. Conclusion: Based on the new methodological approach during the studies, the most informative MCG-criteria of space-temporal organization of myocardium excitation in patients with IHD has been proposed. The method is able to distinguish healthy subjects and myocarditis patients and patients with IHD without previous MI with high sensitivity and specificity.
Highlights
Nowadays routine clinic-functional diagnostic methods of ischemic heart disease (IHD) are mostly based on clinical signs of disease and ECG ST segment shift in rest and during functional tests
Verification of new magnetocardiography (MCG) signs appears an important aspect for severity assessment of ischemic myocardium damage, ischemic heart disease (IHD) course prognosis, determining of indications for preventive “aggressive” therapy and estimation of its efficacy in patients with IHD
In our investigation, the most effective MCG markers where ones calculated on JT interval, namely Delta 80, D1 and D2, which characterize abnormal angular displacement of current density vectors (CDV) at the beginning of the “ischemia window” and position changes of ST-segment, which is in agreement with results of foreign authors [21]
Summary
Nowadays routine clinic-functional diagnostic methods of ischemic heart disease (IHD) are mostly based on clinical signs of disease and ECG ST segment shift in rest and during functional tests. CAG is usually used for patients with IHD symptoms and with positive or controversial results of screening tests (stress ECG, stress echocardiography) in order to confirm availability and expansion of vascular injuries, for estimation of revascularization feasibility and adequacy, coronary atherosclerosis progression or regression. During investigations of limitations of the IHD diagnosis at rest, it was determined that MCG exceeds ECG with diagnosis accuracy 60% - 90% for different examined populations [6,7,8,9,10]. Non-coronary myocardial diseases, myocarditis, are often accompanied by expressed pain syndrome, but clinically available practical methods of differential diagnostics are insufficiently informative. Objective of this research was to investigate MCG capabilities in diagnosis of ischemic and inflammatory myocardial injuries using new MCG markers of the spatiotemporal organization of myocardium excitation
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