Magnetic source imaging for detection of ischemic heart disease

Aim: To evaluate, sensitivity(S), specificity(Sp), PPV, NPV and predictive accuracy(PA) of Magnetic Source imaging (MSI), a radiation-free non-invasive imaging method of ischemic heart disease (IHD). Method: 53 pts with stable angina (StA) and 52 controls (C). Scan time 90 seconds. IHD confirmed with coronary angiography (CAng)(44) and/or stress-SPECT(40). Automated MSI analysis based on the dynamicity of the T-wave effective magnetic vector (EMV). Results: rest ECG abnormal in only 57.1% IHD pts. MSI detection of IHD pts under treatment: 54%S, 96%Sp, 93.5%PPV, 67.5%NPV and 75%PA. In 21 untreated pts: 62%S, 96%Sp, 87%PPV, 86%NPV and 86%PA. One highly-trained, 57 years old "healthy" subject, had normal effort-ECG, and normal EMV in 2005 and 2006, In 2007, maximal effort-ECG was still normal, while MSI evidenced and abnormal EMV. One months later, chest pain while running. ECG and enzyme were normal, but within 24h ACS required stenting of three critical LDA stenosis. Conclusions: MSI T-wave EMV detects IHD when ECG is still normal. PA is higher in untreated pts. Abnormal MSI in acute chest pain pts might predict ACS and address pts for CAng.