AUTHOR=Wessel N. , Kim J. S. , Joung B. Y. , Ko Y. G. , Dischl D. , Gapelyuk A. , Lee Y. H. , Kim K. W. , Park J. W. , Landmesser U. 

TITLE=Magnetocardiography at rest predicts cardiac death in patients with acute chest pain

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1258890

DOI=10.3389/fcvm.2023.1258890

ISSN=2297-055X

ABSTRACT=Sudden cardiac death is a major cause of morbidity and mortality worldwide and remains a major public health problem for which better non-invasive prediction tools are needed. Primary preventive therapies, such as implantable cardioverter defibrillators, are not personalized and not predictive: Most devices do not deliver life-saving therapy during their lifetime. The individual relationship between fatal arrhythmias and cardiac function abnormalities in predicting cardiac death risk has rarely been explored. We retrospectively analyzed the measurements at rest of 191 patients with acute chest pain (ACP) magnetocardiographically. Our recently introduced analyses are able to detect inhomogeneities of the depolarization and repolarization. Moreover, electrically silent phenomena -intracellular ionic currents as well as vortex currents -can be measured and quantified. All ACP patients were recruited in 2009 at Yonsei University Hospital and were followed up until 2022. During half of the follow up period (6.5 years) 11 patients died. Out of all included 9 clinical, 8 magnetocardiographical and 9 newly introduced magnetoionographical parameters we tested in this study three parameters revealed as outstanding in predicting death: QTc prolongation, depression of repolarization current IKr+IKs and serum creatinine (all significant in Cox regression, p<0.05). They clearly predicted cardiac death over the 6.5 years duration (sensitivity 90.9%, specificity 85.6%, negative predictive accuracy 99.4%). Cardiac death risk was more than 9-fold higher in patients with low repolarization reserve and QTc prolongation in comparison to the remaining ACP patients (p<0.001). The non-parametric Kaplan-Meier statistics estimated significantly lower survival functions from their lifetime data (p<0.001). To the best of our knowledge, these are the first data linking magnetocardiographical and magnetoionographical parameters and subsequent significant fatal events in people, suggesting structural and functional components to clinical life-threatening ventricular arrhythmogenesis. The findings support investigation of new prevention strategies and herald those new noninvasive techniques as complementary risk stratification tools.