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Open Access Novel Imaging Approaches for the Diagnosis of Stable Ischemic Heart Disease in Women

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This article is Open Access under the terms of the Creative Commons CC BY-NC licence.

Conventional recommendations for diagnostic testing for the evaluation of stable ischemic heart disease in women have largely paralleled those in men. Although they are designed primarily for the identification of obstructive coronary artery disease (CAD), traditional approaches can lead to overtesting in women without differentiating who is truly at risk. Several unique factors related to the presentation, diagnosis, and underlying pathophysiology of stable ischemic heart disease in women necessitate a more specific approach to the assessment of their risk, complete with separate guidelines when appropriate. This overview highlights how advanced noninvasive imaging tools, including cardiac computed tomography angiography, positron emission tomography, and cardiac magnetic resonance imaging, are enabling very sensitive assessments of anatomic atherosclerotic plaque burden, macrovessel- and microvessel-related ischemia, and myocardial fibrosis, respectively. Moving forward, effective diagnostic testing will need to identify women at high risk of adverse cardiovascular events (not anatomically obstructive CAD per se) without overtesting those at low risk. Judicious application of novel imaging approaches will be critical to broadening the definitions of CAD and ischemia to better reflect the whole spectrum of pathological phenotypes in women, including nonobstructive CAD and coronary microvascular dysfunction, and aid in the development of needed evidence-based strategies for their management.
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Keywords: cardiovascular imaging; coronary microvascular dysfunction; heart disease in women; nonobstructive coronary artery disease; positron emission tomography; stable ischemic heart disease

Document Type: Research Article

Publication date: February 1, 2019

More about this publication?
  • Cardiovascular Innovations and Applications (CVIA) publishes focused articles and original clinical research that explore novel developments in cardiovascular disease, effective control and rehabilitation in cardiovascular disease, and promote cardiovascular innovations and applications for the betterment of public health globally. The journal publishes basic research that has clinical applicability in order to promote timely communication of the latest insights relating to coronary artery disease, heart failure, hypertension, cardiac arrhythmia, prevention of cardiovascular disease with a heavy emphasis on risk factor modification. Cardiovascular Innovations and Applications is the official journal of the Great Wall International Congress of Cardiology (GW-ICC). It aims to continue the work of the GW-ICC by providing a global scientific communication platform for cardiologists that bridges East and West.

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