Multifunctional Cardiogram Scans (MCG)

by Charles C. Adams, MD

Overview

The Multifunctional Cardiogram – The MCG

The MCG is on deck to become the “crystal ball” for ciphering an individual’s risk for having a heart attack, sooner vs later. or, determining the need for a stent or by-pass, sooner vs later….. This machine is a true revolution in heart and health care as it can

determine in minutes one’s heart status without an invasive, dangerous, toxic, or stressful evaluation.

Background

The Electro-Kardiogram, the standard 12 Lead EKG, is now about 100 years old and continues to do what it does well! (As the German scientists pioneered the machine, they spell Cardio as Kardio – hence “K”!) The EKG is a volt meter that measures the voltage across our heart from different angels which tells us how our electrical nervous

system in the heart is working. This is rather mind boggling, but the “normal” EKG of a 90 year old lady is going to be nearly identical to a “normal” EKG of a 20 year old armed services recruit! We’ll come back to this in a moment. The first 6 leads of the EKG are recorded from the leads on our ankles and wrists. The other 6 leads are attached across our chest. This is for the standard 12 lead EKG.

The MCG uses two of the original leads from the traditional EKG. These are Lead 2 (II) and Lead 5 (V). Lead 2 is “looking at” or evaluating the right side of the heart, whereas Lead 5, stuck on the left chest just to the left base of the left breast – the anterior axillary line, and “looks” at the left of the heart.

Now, the Science and the Math and the Computer for the past 20 years, Premier Heart has gathered over 1,000,000 data points comparing leads between Lead 2 and Amp Lead 5 to autopsies, surgeries, cardiac caths, and stress tests. The data was analyzed (and is still being analyzed!) by

mathematicians, electrophysiologists, and statisticians.

Their focus is, When Leads 2 and Amp Lead 5 look like “this”, or when Leads 2 & Amp Lead 5 look like “that”, What does that mean? (Best of all, Is the test trying to warn us?!?!) First, we’ve got to talk about some plumbing basics.

We humans are a homeostatic plumbing situation in that we stay at the same temperature and our blood stays at the same composition. So, it makes sense that the smaller pipes will get clogged up before the big pipes get clogged.

The next Uh-Oh is our cardiac tests and that is these tests look at the large arteries of the heart – they can’t see the smaller arteries getting clogged. But wait! There’s yet another dynamic afoot! Ladies have smaller arteries than guys. Ladies tend to stop up these littler arteries before they stop up the larger arteries. As you have probably guessed, all too often, the cardiac tests can’t see the blockage.

Keep in mind, the Number 1 killer of men and women is the heart attack, AND about 30% of these are sudden death, no warning events. The MCG and all of its data points have the ability to detect problems in the making! It can detect problems developing silently with no symptoms.

The sensitivity of the MCG is about 90.4% and its specificity is about 82.5%. (If the MCG says you’ve got an issue, there’s a 90.5% chance that indeed you do have an issue. If the MCG says you do not have a problem, there’s about an 82.5% you do not have a problem!) Thus far, our office has run about 70 of the MCG tests. NONE of these folks have had symptoms. Thus far, 4 of the 70 had low, near perfect

scores. The remaining 66 were spread out from minor, early blockages seeming to be forming to the other end of the spectrum of: WHOA! You are heading way up the creek!

The MCG can really ease a worried mind, or it can act as an early warning alert for one to make modifications. A re-test in 3 to 6 months can let you know if you are the same, worse, or improving.

Peer-Reviewed Publications

• 2020 ACEP Research Forum Results
• The MCG was featured in a landmark clinical study at the American College of Emergency Physicians (ACEP) October 2020 Research Forum. The results are publicly available in the Annals of Emergency Medicine (International Journal).
• Noninvasive mathematical analysis of spectral electrocardiographic components for coronary lesions of intermediate to obstructive stenosis severity–relationship with classic and functional SYNTAX score
• Catheterization Cardiovascular Interventions, Volume 86, Issue 1, July 2015, Pages 21–29
• The Diagnostic Performance of Multifunction Cardiogram (MCG) in Functional Myocardial Ischemia
• Annals of Noninvasive Electrocardiology / Volume 20, Issue 5, pages 508–510, September 2015
• TCTAP A-086 Comparison of a Two-Lead, Computerized, Resting ECG Signal Analysis Device, the Multifunction-CardioGram (MCG), to Coronary Angiography or MDCT, SPECT for the Detection of Revalent Coronary Artery Stenosis
• J Am Coll Cardiol. 2015;65(17_S):S45-S45. doi:10.1016/j.jacc.2015.03.148
• Non-invasive assessment of functionally significant coronary stenoses through mathematical analysis of spectral ECG components
• Open Heart 2014;1: doi:10.1136/openhrt-2014-000144
• A Paired-Comparision of the MultiFunction CardioGrams (MCG) and SPECT Myocardial Perfusion Imaging (MPI)
• International Journal of Medical Sciences 2011;8(8):717-72
• Comparing MCG and Coronary Angiography for detection of Coronary Artery Stenosis in Women
• Treatment Strategies – Cardiology Volume 3, Issue 1 pp.82-91
• Appropriateness Guidelines for the use of MCG in clinical settings are currently being revised in conjunction with the American College of Computational Electrophysiology. New guidelines will be posted shortly.
• A Meta-Analysis of the MCG clinical trials
• International Journal of Medical Sciences April 2009 6(4):143-155
• An analysis of the Asian Multi-Center Trial
• Congestive Heart Failure 2008 14: 251-260
• An analysis of the Siegburg clinical trial (post-revascularization)
• International Journal of Medical Sciences 2008 5(2): 50-61
• An analysis of the Siegburg clinical trial (no revascularization)
• International Journal of Medical Sciences 2007 4(5): 249-263
• An analysis of the Westchester clinical trial
• Heart Disease 2002 4: 2-12

The following peer-reviewed studies do not include a focus on the MCG™, but provide large-scale clinical evidence for the need of appropriate, accurate technology for risk-stratifying patients who present with chest pain and heart disease symptoms to the hospital ER.

• Cardiac Imaging Tests Beget More Tests, but No Benefit. Michael O’Riordan, Medscape, February 10, 2014.
• Low Diagnostic Yield of Elective Coronary Angiography. Manesh R. Patel, M.D., Eric D. Peterson et al. N Engl J Med 2010; 362:886-895 DOI: 10.1056/NEJMoa0907272