Magnetocardiography detected myocardial inflammation in cardiac amyloidosis with 60% sensitivity and 88.2% specificity at a VMCG cut-off ≥0.078 (AUC 0.785).
Does magnetocardiography accurately detect myocardial inflammation in patients with cardiac amyloidosis compared to endomyocardial biopsy?
Magnetocardiography demonstrated significant diagnostic accuracy for non-invasively detecting myocardial inflammation in patients with cardiac amyloidosis.
Tasa de eventos absoluta: 0% vs 0%
Abstract Background Myocardial inflammation may be associated with adverse outcomes in both cardiac transthyretin amyloidosis (ATTR-CA) and cardiac immunoglobulin light chain amyloidosis (AL-CA), according to recent data. However, the number of patients diagnosed by endomyocardial biopsy - required to detect myocardial inflammation - is gradually decreasing due to a trend towards less invasive diagnostics. Therefore, alternative methods to detect myocardial inflammation need to be identified. Purpose This study sought to assess magnetocardiography (MCG), a technique measuring the cardiac electromagnetic field, as an alternative non-invasive method to detect myocardial inflammation in cardiac amyloidosis. Methods Patients with ATTR-CA or AL-CA who underwent MCG and endomyocardial biopsy as part of their diagnostic workup were identified retrospectively. MCG was performed using a CS MAG III system and the cardiac electromagnetic field was quantified by calculating the magnetocardiography vector (VMCG). Endomyocardial biopsies and immunohistopathological evaluation were part of routine diagnostic workup. Consistent with previous studies, elevated macrophage and lymphocyte cell counts were considered as myocardial inflammation. VMCG values are reported as median with interquartile range and compared between patients with and without myocardial inflammation using a Mann-Whitney-U test. Receiver operating characteristic analysis assessed diagnostic accuracy. The area under the curve is reported with 95% confidence interval (CI). The optimal VMCG cut-off to diagnose myocardial inflammation was derived using Youden’s index. All hypothesis tests were two-sided at a 5% significance level. Results Of 27 patients with cardiac amyloidosis (74% ATTR-CA, n=20); 26% AL-CA, n=7) that were included, immunohistopathological evaluation identified myocardial inflammation in 10 (37%). The median VMCG for the entire group was 0.066 0.043-0.086. Patients with myocardial inflammation had significantly higher VMCG values than those without (0.093 0.058-0.183 vs. 0.052 0.039-0.073; p=0.01) (Exemplary MCG recordings shown in Figure). Compared to a random classifier, VMCG had significant ability to discriminate between patients with and without myocardial inflammation (area under the curve: 0.785, 95%CI 0.600-0.970; p0.01). The optimal diagnostic VMCG cut-off (i.e., ≥0.078) achieved sensitivity, specificity, positive predictive value, and negative predictive value for myocardial inflammation of 60.0%, 88.2%, 75.0%, and 78.9%, respectively. Conclusion This study presents preliminary evidence suggesting that MCG may serve as a non-invasive tool to detect myocardial inflammation in cardiac amyloidosis. Although further validation through larger prospective studies is needed, these findings could potentially improve personalised management of patients diagnosed with cardiac amyloidosis non-invasively in the future.Exemplary Magnetocardiography Recordings
Mueller et al. (Sat,) reported a other. Magnetocardiography detected myocardial inflammation in cardiac amyloidosis with 60% sensitivity and 88.2% specificity at a VMCG cut-off ≥0.078 (AUC 0.785).