Background Inflammatory cardiomyopathy is one of the most common causes of sudden cardiac death in young adults. Diagnosis of inflammatory cardiomyopathy remains challenging, and better monitoring tools are needed. We present magnetocardiography as a method to diagnose myocardial inflammation and monitor treatment response. Methods and Results A total of 233 patients were enrolled, with a mean age of 45 (±18) years, and 105 (45%) were women. The primary analysis included 209 adult subjects, of whom 66 (32%) were diagnosed with inflammatory cardiomyopathy, 17 (8%) were diagnosed with cardiac amyloidosis, and 35 (17%) were diagnosed with other types of nonischemic cardiomyopathy; 91 (44%) did not have cardiomyopathy. The second analysis included 13 patients with inflammatory cardiomyopathy who underwent immunosuppressive therapy after baseline magnetocardiography measurement. Finally, diagnostic accuracy of magnetocardiography was tested in 3 independent cohorts (total n=23) and 1 patient, who developed vaccine‐related myocarditis. First, we identified a magnetocardiography vector to differentiate between patients with cardiomyopathy versus patients without cardiomyopathy (vector of ≥0.051; sensitivity, 0.59; specificity, 0.95; positive predictive value, 93%; and negative predictive value, 64%). All patients with inflammatory cardiomyopathy, including a patient with mRNA vaccine‐related myocarditis, had a magnetocardiography vector ≥0.051. Second, we evaluated the ability of the magnetocardiography vector to reflect treatment response. We observed a decrease of the pathologic magnetocardiography vector toward normal in all 13 patients who were clinically improving under immunosuppressive therapy. Magnetocardiography detected treatment response as early as day 7, whereas echocardiographic detection of treatment response occurred after 1 month. The magnetocardiography vector decreased from 0.10 at baseline to 0.07 within 7 days ( P =0.010) and to 0.03 within 30 days ( P <0.001). After 30 days, left ventricular ejection fraction improved from 42.2% at baseline to 53.8% ( P <0.001). Conclusions Magnetocardiography has the potential to be used for diagnostic screening and to monitor early treatment response. The method is valuable in inflammatory cardiomyopathy, where there is a major unmet need for early diagnosis and monitoring response to immunosuppressive therapy.
Background Thousands of patients present themselves annually to the emergency department or private clinic with chest pain. Categorizing different types of angina is clinically important and is one of the cornerstones for pre-test-probability. In patients with angina pectoris, symptoms mostly occurred during physical exertion and usually lasted a short time. This paper examines Magnetocardiography (MCG) in patients with angina pectoris. Cardiac electromagnetic activity is recorded by MCG which is a non-invasive, non-contact, and radiation-free multichannel mapping technique. We present results focusing on resting- and stress-MCG in order to detect true coronary artery disease. Method We examined 131 patients (66±12 yrs., 94 male) with angina pectoris who were asymptomatic during the time in the emergency department. Troponin and ECG were in normal range. These patients had complex cardiovascular risk factors – arterial hypertension in 87%, hyperliproteinemia in 63%, nicotine consumption in 23%, diabetes mellitus in 14%. The cardiac magnetic field was registered over the anterior chest wall with a 64-channel gradiometer system in a magnetically shielded room (CS-MAG III, BMP GmbH). Rest- and Stress-MCG measurement were performed before patients received an invasive ischemia investigation. We calculated in total 9 MCG parameters that could serve as indicators in the diagnosis of ischemia and coronary artery disease (CAD): T-wave dispersion, T-wave vectors MCG (VMCG), T-Scores, ST-Fluc-Score and PLP-Score. Results All of the 131 patients received an invasive diagnostic. 43 patients exhibited a CAD. Resting MCG could identify 28/43 patients correctly (SENS of 65%, NPV of 66%). Stress-MCG was able to identify 42/43 correctly (SENS 98%, NPV 88%). Conclusions Stress-MCG seems to be a highly sensitive method in detecting CAD in patients with stable angina. In diagnostics, it should be complemented by other indicators such as troponin to improve its specificity.
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