| Modality |
MCG
|
Angiogram |
EST2
EKG |
EST2
Echo |
EST2
Nuclear |
12-lead
Resting EKG |
Troponin |
MRI
Angiogram3 |
CT
Angiogram3 |
|
Measures
|
Myocardial Systems Expression5 |
Coronary Anatomy |
Physical Stress Induced EKG Changes |
Physical Stress Induced Echo Changes |
K+ Channel Effect from Physical
Stress |
2D Vectorized Time-Domain ECG
Signal |
Heart Muscle Enzymes |
Coronary Anatomy |
Coronary Anatomy |
Sensitivity
40-50%1
(Partial Occlusion) |
80 to 90% |
Gold Standard |
—N/A— |
—N/A— |
—N/A— |
—N/A— |
—N/A— |
—N/A— |
—N/A— |
Sensitivity
50-70%1
(Partial Occlusion) |
90 to 95% |
Gold Standard |
—N/A— |
—N/A— |
—N/A— |
20% (CAD) |
—N/A— |
74% |
82 to 92% |
Sensitivty
>70%1
(Stenosis) |
95 to 100% |
Gold Standard |
45% |
31 to 90%+% |
44 to 91% |
20% CAD
52% MI |
—N/A— |
54% |
82% |
|
Specificity
|
80+ to 90%
|
Gold Standard |
85% |
46 to 100% |
81 to 90% |
97% CAD
9% MI |
—N/A— |
75% |
75% |
|
Time Required
|
5 Minute Test
1-5Minute Report4 |
Long prep and testing time |
30-40 Minutes |
30-40 Minutes
Technically Demanding |
~6 Hours |
Minimal Lag Time |
~6 Hours |
A few minutes |
A few minutes |
|
Quantitative & Objective
|
Yes |
No
|
No
|
No
|
No
|
No
|
Yes
|
Yes
|
Yes
|
Information (except
MCG data) from: Cleveland Clinic
Intensive Cardiology Review Course,
2001.
MCG Data from: MCG
Clinical Trials
1 - Percentage
of lumenal encroachment
by atherosclerotic plaque
|
3 - Ann.
Intern. Med. 2006; 145:407-415
|
2 - EST indicates
Exercise Stress
Testing
|
4 - Dependent
on internet connection
speed |
|
5 - Quantifies
stress/strain between
the myocardium and blood
flow |
|
Notes on MCG
MCG is the evolution of groundbreaking
technology, applying the principles
of multiphase systems analysis to
the ECG. It is the only non-invasive
diagnostic technique currently available
which has been clinically proven
to be capable of identifying early-stage
coronary artery disease with accuracy
approaching that of coronary angiography.
Additionally, a positive correlation
exists between the increasing severity
of CAD and the sensitivity of MCG
in detecting ischemia.
The MCG diagnostic technoloy assigns
an overall severity score for myocardial
disease burden, which enables physisicans
to quickly assess a patient and
determine if additional evaluation
and treatment is required.
The short testing time, rapid report
turnaround and exceptional accuracy
combine to make MCG ideal for urgent
care situations where fast, accurate
results are critical to saving lives.
The low cost and easy-to-understand
reports make the technology practical
over a wide range of applications
from family practitioners performing
routine examinations to large hospitals
and cardiology practices monitoring
the progress of a patient's treatment.
|
Notes on Other Modalities
Coronary Angiography is considered
the "Gold Standard", permitting
both diagnosis and treatment in
the same procedure, however it is
an invasive procedure which requires
significant preparation and testing
time.
Additionally, coronary angiography
was able to detect atheromas only
3.0% of the time in 17% of those
under 20 years, 37% of those aged
20 to 29, and 60% of those aged
30 to 39 years. This means that
angiography results were negative
in 97% of these populations when
they in fact had atheromas in their
coronary arteries.
All stress testing modalities share
relatively low sensitivity in detecting
ischemia. The outlier (EST Echo)
requires quick and careful work
by the technician in order to produce
usable results.
A conventional 12-lead resting EKG
is an excellent tool for detecting
arrhythmias, however it typically
has poor sensitivity for detecting
ischemia.
MRI and CT Angiongraphy are expensive
tests, neither of which is universally
available.
Additionally, MRI Angiography has
a high noise rejection rate (13-18%)
and is subject to the usual contraindications
for MRI procedures.
CT Angiography has a 7% noise rejection
rate, however it invoves radiation
exposure and the use of IV contrast,
and so is not suitable for all patients.
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