PDF(Pubmed)
Abstract：
UNASSIGNED: In patients with angina and non-obstructive coronary artery disease (ANOCA), diagnosis of coronary microvascular dysfunction (CMD) remains an unmet need. Magnetocardiography (MCG), is a rest-based, non-invasive scan that can detect weak electrophysiological changes that occur at the early phase of ischemia.
UNASSIGNED: This study assessed the ability of MCG to detect CMD in ANOCA patients as compared to reference standard, invasive coronary flow reserve (CFR).
UNASSIGNED: Patients with ANOCA and invasive coronary physiologic assessment using intracoronary flow measurements with Doppler and thermodilution methods were enrolled. CMD was defined dichotomously as an invasive CFR < 2.0 by Doppler or thermodilution assessment. Noninvasive 36-channel 90-s MCG scan was performed and quantitative assessment of four distinct MCG features was completed. We evaluated the diagnostic performance of 2 or more abnormal MCG features to detect CMD in the overall cohort and performed a subgroup analysis in the subset of patients with Doppler CFR assessment.
UNASSIGNED: Among 79 ANOCA patients, 25 were CMD positive and 54 patients were CMD negative by CFR. Using invasive CFR as reference, MCG had an ROC AUC of 0.66 with a sensitivity of 68 % and specificity of 65 % for the detection of CMD. In the subgroup with Doppler CFR assessment, MCG had an ROC AUC of 0.76 with a sensitivity of 75 % and specificity of 77 %.
UNASSIGNED: In ANOCA patients, MCG demonstrates the ability to detect CMD using a 90-second non-invasive scan without the need for an intravenous stressor or ionizing radiation. Further investigations are needed to validate an MCG-based diagnostic pathway for CMD.
UNASSIGNED: This study assessed the ability of MCG to detect CMD in ANOCA patients as compared to reference standard, invasive coronary flow reserve (CFR).
UNASSIGNED: Patients with ANOCA and invasive coronary physiologic assessment using intracoronary flow measurements with Doppler and thermodilution methods were enrolled. CMD was defined dichotomously as an invasive CFR < 2.0 by Doppler or thermodilution assessment. Noninvasive 36-channel 90-s MCG scan was performed and quantitative assessment of four distinct MCG features was completed. We evaluated the diagnostic performance of 2 or more abnormal MCG features to detect CMD in the overall cohort and performed a subgroup analysis in the subset of patients with Doppler CFR assessment.
UNASSIGNED: Among 79 ANOCA patients, 25 were CMD positive and 54 patients were CMD negative by CFR. Using invasive CFR as reference, MCG had an ROC AUC of 0.66 with a sensitivity of 68 % and specificity of 65 % for the detection of CMD. In the subgroup with Doppler CFR assessment, MCG had an ROC AUC of 0.76 with a sensitivity of 75 % and specificity of 77 %.
UNASSIGNED: In ANOCA patients, MCG demonstrates the ability to detect CMD using a 90-second non-invasive scan without the need for an intravenous stressor or ionizing radiation. Further investigations are needed to validate an MCG-based diagnostic pathway for CMD.
摘要：
■在心绞痛和非阻塞性冠状动脉疾病（ANOCA）患者中，冠状动脉微血管功能障碍（CMD）的诊断仍未满足需求。心磁图(MCG),是基于休息的，非侵入性扫描，可以检测在缺血早期发生的微弱电生理变化。
■这项研究评估了MCG与参考标准相比在ANOCA患者中检测CMD的能力，有创冠状动脉血流储备（CFR）。
■纳入使用多普勒和热稀释方法的冠状动脉内血流测量进行ANOCA和侵入性冠状动脉生理评估的患者。通过多普勒或热稀释评估，将CMD二分定义为侵入性CFR<2.0。进行非侵入性36通道90sMCG扫描，并完成了对四个不同MCG特征的定量评估。我们评估了2个或更多异常MCG特征的诊断性能，以在整个队列中检测CMD，并在多普勒CFR评估的患者亚组中进行了亚组分析。
■在79名ANOCA患者中，CFR显示CMD阳性25例，CMD阴性54例。使用侵入性CFR作为参考，MCG具有0.66的ROCAUC,对于CMD的检测具有68%的灵敏度和65%的特异性。在多普勒CFR评估的亚组中，MCG的ROCAUC为0.76，灵敏度为75％，特异性为77％。
■在ANOCA患者中，MCG证明了使用90秒非侵入性扫描检测CMD的能力，而无需静脉内应激源或电离辐射。需要进一步的研究来验证基于MCG的CMD诊断途径。
■这项研究评估了MCG与参考标准相比在ANOCA患者中检测CMD的能力，有创冠状动脉血流储备（CFR）。
■纳入使用多普勒和热稀释方法的冠状动脉内血流测量进行ANOCA和侵入性冠状动脉生理评估的患者。通过多普勒或热稀释评估，将CMD二分定义为侵入性CFR<2.0。进行非侵入性36通道90sMCG扫描，并完成了对四个不同MCG特征的定量评估。我们评估了2个或更多异常MCG特征的诊断性能，以在整个队列中检测CMD，并在多普勒CFR评估的患者亚组中进行了亚组分析。
■在79名ANOCA患者中，CFR显示CMD阳性25例，CMD阴性54例。使用侵入性CFR作为参考，MCG具有0.66的ROCAUC,对于CMD的检测具有68%的灵敏度和65%的特异性。在多普勒CFR评估的亚组中，MCG的ROCAUC为0.76，灵敏度为75％，特异性为77％。
■在ANOCA患者中，MCG证明了使用90秒非侵入性扫描检测CMD的能力，而无需静脉内应激源或电离辐射。需要进一步的研究来验证基于MCG的CMD诊断途径。
