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应用无创伤性磁心电图描记术对急性胸痛患者进行早期冠心病诊断。

Non-invasive magnetocardiography for the early diagnosis of coronary artery disease in patients presenting with acute chest pain.

机构信息

Center for Brain and Cognitive Science Research, Korea Research Institute of Standards and Science, Daejeon, Korea.

出版信息

Circ J. 2010 Jul;74(7):1424-30. doi: 10.1253/circj.cj-09-0975. Epub 2010 May 27.

Abstract

BACKGROUND

Accurate identification of patients with acute coronary syndrome (ACS) is often difficult especially when an electrocardiogram (ECG) does not show typical elevation of ST segment. The aim of the present study was therefore to evaluate the efficacy of magnetocardiography (MCG) for diagnosis of ACS in patients with acute chest pain presenting without ST segment elevation.

METHODS AND RESULTS

In the present retrospective study 364 patients with the suspected ACS without ST segment elevation were selected. Significant coronary artery disease (CAD) was defined as a stenosis > or =50% in at least one of 16 segments of the 3 major coronary arteries and their branches. The MCG recordings were obtained at resting state using a 64-channel MCG system in a magnetically shielded room. The patients were classified on the basis of the probability distribution. The presence of significant CAD was identified with a sensitivity of 84.0% and a specificity of 85.0%, compared to 44.7% and 89.8% on ECG. In the subgroup of patients without specific findings on ECG or biomarker test, MCG had a sensitivity of 73.5% and a specificity of 82.3%.

CONCLUSIONS

MCG was acceptably sensitive and specific in identifying patients with ACS even in the absence of specific findings on ECG and positive biomarker tests. Thus, MCG seems beneficial for the early triage of patients with acute chest pain.

摘要

背景

急性冠状动脉综合征(ACS)患者的准确识别通常很困难,尤其是当心电图(ECG)未显示典型的 ST 段抬高时。因此,本研究旨在评估磁心电图(MCG)在无 ST 段抬高的急性胸痛患者中诊断 ACS 的功效。

方法和结果

本回顾性研究中选择了 364 例疑似 ACS 且无 ST 段抬高的患者。显著冠状动脉疾病(CAD)定义为至少 16 个主要冠状动脉及其分支的 16 个节段中存在狭窄> = 50%。在磁屏蔽室内使用 64 通道 MCG 系统在静息状态下获取 MCG 记录。根据概率分布对患者进行分类。与 ECG 的敏感性为 44.7%和特异性为 89.8%相比,MCG 对存在显著 CAD 的患者的敏感性为 84.0%,特异性为 85.0%。在 ECG 或生物标志物检查无特异性发现的患者亚组中,MCG 的敏感性为 73.5%,特异性为 82.3%。

结论

即使在 ECG 和阳性生物标志物检查无特异性发现的情况下,MCG 在识别 ACS 患者方面的敏感性和特异性均可以接受。因此,MCG 似乎有益于急性胸痛患者的早期分诊。

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