| Modality |
Premier Heart 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: Premier Heart 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
|
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5 - Quantifies stress/strain between the myocardium and blood flow
|
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Notes on MCG
MCG is the evolution of Premier Heart's groundbreaking
3DMP 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 system assigns an MCG Score, representing the
overall severity of myocardial disease burden. The MCG
Score 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.
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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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