A paired-comparision of the Multifunction Cardiogram (MCG) and sestamibi SPECT myocardial perfusion imaging (MPI) to quantitative coronary angiography for the detection of relevant coronary artery obstruction (≥70%) - a single-center study of 116 consecutive patients referred for coronary angiography

Int J Med Sci. 2011;8(8):717-24. doi: 10.7150/ijms.8.717. Epub 2011 Oct 28.


Background: An analysis of the US National Cardiovascular Data Registry has revealed that only 38% of patients referred for coronary angiography after non-invasive coronary testing have relevant coronary obstruction (CO) (≥70%) of one or more coronary arteries.

Methods: A single-center trial was undertaken in 165 consecutive, symptomatic patients with either known or suspected coronary disease and/or valve disease(VHD) who agreed to undergo cardiac catheterization and coronary angiography if stress myocardial perfusion imaging was abnormal. A total of 116 patients with abnormal SPECT MPI tests, persistent chest pain, or significant VHD underwent final analysis. An MCG coronary obstruction (CO) score of ≥ 4.0 was considered indicative of relevant CO (≥70%) in one or more coronary arteries. Angiographic results were finalized by consensus of two angiographers.

Results: CO (≥70%) was present in 53 of 116 patients (46%). The MCG CO score was significantly higher for patients with relevant CO (5.4 ± 1.9 vs. 2.5 ± 1.9). The MCG correctly classified 103 of the 116 patients (89%) enrolled in the study as either having or not having CO (≥70%) (sensitivity- 91%; specificity- 87%; NPV- 92%; PPV- 86%). SPECT MPI was abnormal in 99 of the 116 (85%) patients undergoing catheterization, but correctly classified only 54 of the 116 patients (47%) entered in the study as either having or not having relevant CO (sensitivity-85%; specificity-14%; NPV - 53%; PPV- 45%).

Conclusions: The MCG was shown in this paired-comparison trial with SPECT MPI to safely and accurately identify patients with relevant CO (≥70%) prior to catheterization.

Keywords: Coronary Angiography; Coronary Artery Stenosis; MultiFunction CardioGram.

MeSH terms

  • Adult
  • Aged
  • Coronary Angiography / statistics & numerical data*
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / diagnostic imaging
  • Female
  • Humans
  • Male
  • Middle Aged
  • Referral and Consultation*
  • Technetium Tc 99m Sestamibi*
  • Tomography, Emission-Computed, Single-Photon / methods*


  • Technetium Tc 99m Sestamibi