Utility of Magnetocardiography and Stress Speckle Tracking in Detection of Coronary Artery Disease

Introduction: Coronary artery disease (CAD) is a leading cause of death and disability in developed countries. While exercise testing is recommended for diagnosing stable angina pectoris, its limited sensitivity and specificity have been questioned. Myocardial strain is a promising predictor of significant CAD. Aim: To evaluate the utility of myocardial strain obtained by 2D speckle tracking at rest and under stress combined with stress magnetocardiography for detecting CAD in patients with stable or low-risk unstable angina pectoris. Methods: A total of 108 patients meeting the inclusion criteria underwent coronary angiography within 48 h of admission. Myocardial strain was assessed using 2D speckle tracking at rest and during dobutamine stress alongside stress magnetocardiography. Results: Global longitudinal strain at stress showed a moderate correlation with significant CAD (r = 0.41, p <0.0001) and with coronary occlusion severity (r = 0.62, p <0.0001). Strain at stress had a sensitivity of 74.1% and specificity of 76.7% for detecting CAD at a cut-off value of -19.1. The ST fluctuation rate from magnetocardiography demonstrated the highest sensitivity for CAD detection. Conclusions: Longitudinal strain parameters and stress magnetocardiography are effective non-invasive methods for predicting CAD in patients with stable angina, potentially reducing the need for invasive assessments.