Key result
Portable magnetometer identifies ischemic heart disease with ~98% negative predictive value.
Why the study?
Distinguishing ischemic heart disease from non-ischemic chest pain in patients presenting with chest pain remains challenging and current diagnostics are time-consuming and imperfect.
Does a portable prototype magnetometer improve the discrimination of ischemic heart disease from non-ischemic chest pain compared with standard evaluation?
Cross-Sectional (n=176)
No
Does a portable prototype magnetometer improve the discrimination of ischemic heart disease from non-ischemic chest pain compared with standard evaluation?
Effect estimate: AUC 0.78, Specificity 35.0%, Sensitivity 95.4%, NPV 97.8%
A portable prototype magnetometer evaluating cardiac magnetic fields demonstrates high sensitivity and negative predictive value, suggesting potential utility as a non-invasive triage tool to rule out ischemic heart disease in patients with chest pain.
May support noninvasive IHD rule-out in chest pain; hypothesis-generating and requires prospective validation versus standard evaluation.
BACKGROUND: Magnetocardiography (MCG) is a non-invasive technique used to measure and map cardiac magnetic fields. We describe the predictive performance of a portable prototype magnetometer designed for use in acute and routine clinical settings. We assessed the predictive ability of the measurements derived from the magnetometer for the ruling-out of healthy subjects and patients whose chest pain has a non-ischemic origin from those with ischemic heart disease (IHD). METHODS: MCG data were analyzed from a technical performance study, a pilot clinical study, and a young healthy reference group. Participants were grouped to enable differentiation of those with IHD versus non-IHD versus controls: Group A (70 IHD patients); Group B (69 controls); Group C (37 young healthy volunteers). Scans were recorded in an unshielded room. Between-group differences were explored using analysis of variance. The ability of 10 candidate MCG predictors to predict normal/abnormal cases was analyzed using logistic regression. Predictive performance was internally validated using repeated five-fold cross-validation. RESULTS: Three MCG predictors showed a significant difference between patients and age-matched controls (P<0.001); eight predictors showed a significant difference between patients and young healthy volunteers (P<0.001). Logistic regression comparing patients with controls yielded a specificity of 35.0%, sensitivity of 95.4%, and negative predictive value for the ruling-out of IHD of 97.8% (area under the curve 0.78). CONCLUSION: This analysis represents a preliminary indication that the portable magnetometer can help rule-out healthy subjects and patients whose chest pain has a non-ischemic origin from those with IHD.
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Ghasemi-Roudsari et al. (2018) conducted a cross-sectional in Ischemic heart disease / Chest pain (n=176). Magnetocardiography (MCG) via portable prototype magnetometer vs. Clinical and functional reference standard was evaluated on Discrimination of ischemic heart disease from controls (logistic regression Model 1 cross-validated) (AUC 0.78, Specificity 35.0%, Sensitivity 95.4%, NPV 97.8%). A portable prototype magnetometer differentiated ischemic heart disease from controls with an AUC of 0.78, sensitivity of 95.4%, and a negative predictive value of 97.8%.
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