心磁图探索主动脉瓣狭窄与冠心病心肌电磁特征的差异:一项前瞻性队列研究OA

Objective To investigate the value of magnetocardiography(MCG)in distinguishing the different electromagnetic characteristics of myocardial ischemia caused by aortic stenosis(AS)and coronary heart disease(CHD).Methods This single-center,prospective cohort study enrolled 141 patients with suspected myocardial ischemia who were presented to the First Medical Center of Chinese PLA General Hospital between October 2023 and December 2025.According to the findings of echocardiography and coronary angiography,we identified AS group(30 patients)and CHD group(111 patients)for subsequent analysis.Differences in baseline characteristics between the two groups were compared,followed by extraction of magnetocardiography(MCG)parameters.Weighted LASSO regression combined with Bootstrap validation was used to screen characteristic parameters,and binary logistic regression was applied to construct a diagnostic model.The performance of the model was assessed using the area under the receiver operating characteristic(ROC)curve(AUC),5-fold cross-validation,calibration curve,and Hosmer-Lemeshow test.Results Significant differences were observed between AS group and CHD group in age,as well as cardiac function indicators including N-terminal pro-B-type natriuretic peptide(NT-proBNP)and left ventricular ejection fraction(LVEF)(P<0.05).The model was constructed by incorporating the following MCG parameters:average negative magnetic pole eccentricity in the RS segment,magnetic pole dispersion at the R-wave peak,distance of dipole center trajectory in QR segment,average dipole moment in TT segment,and magnetic field angle at T-wave peak.ROC curve analysis showed that the model achieved an AUC of 0.881(95%CI 0.817-0.946)for distinguishing AS from CHD on the full dataset,with a sensitivity of 84.68%and a specificity of 80.00%.The 5-fold cross-validated AUC was 0.836.The Hosmer-Lemeshow test indicated no significant calibration bias(P=0.228).Conclusion The model constructed based on specific MCG parameters can preliminarily distinguish AS from CHD,quantifies their different electrophysiological patterns,and provides novel insights for identifying the etiology of angina pectoris.