Cardiovascular Imaging for Ischemic Heart Disease in Women

Lozano, Patricia F. Rodriguez; Kaso, Elona Rrapo; Bourque, Jamieson M.; Morsy, Mohamed A.; Taylor, Angela M.; Villines, Todd C.; Kramer, Christopher M.; Salerno, Michael

doi:10.1016/j.jcmg.2022.01.006

Cited by 20 publications

(58 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Vasomotor tone is lower in women possibly due to hormonal effect. Women also have less LV mass, higher resting heart rate, higher LV contractility, larger ejection fraction, higher resting and stress coronary flow but similar CFR compared with men 3,12 . The relatively lower myocardial mass to coronary volume in women results in a higher volume to mass ratio, which perhaps contributes to microvascular dysfunction.…”

Section: Sex-specific Differences In Ihdmentioning

confidence: 99%

“…Advanced noninvasive cardiac imaging is a primary tool for assessing suspected CAD in women 18 . The most commonly used techniques are coronary computed tomography angiography (CCTA), cardiac magnetic resonance (CMR) imaging, and myocardial perfusion imaging (MPI), that is, 99mTechnetium (99mTc) and 201Thallium (201Tl) single photon emission computed tomography (SPECT) and positron emission tomography (PET) using 82Rubidium (82Rb), 13 N-ammonia (13N-NH3), or 15O-water (15O) 19 …”

Section: Noninvasive Evaluation Of Ischemia In Womenmentioning

confidence: 99%

“…Women also have less LV mass, higher resting heart rate, higher LV contractility, larger ejection fraction, higher resting and stress coronary flow but similar CFR compared with men. 3,12 The relatively lower myocardial mass to coronary volume in women results in a higher volume to mass ratio, which perhaps contributes to microvascular dysfunction. In postmenopausal women, reduced estrogen, nitric oxide, and endothelial dysfunction lead to blunted coronary vasodilator response and lower absolute coronary volume despite fewer obstructive lesions.…”

Section: Sex-specific Differences In Ihdmentioning

confidence: 99%

“…Over the last decade, there has been a paradigm shift in thinking of the diagnostic approaches to ischemia 2 . Emerging evidence supports sex-specific difference in risk factors, coronary artery anatomy, physiology, and pathophysiology of ischemic heart disease (IHD) 3 . Women tend to have less atherosclerosis, more calcified plaque, more nonobstructive disease, and more prevalence of ischemia with no obstructive disease.…”

mentioning

confidence: 99%

“…2 Emerging evidence supports sex-specific difference in risk factors, coronary artery anatomy, physiology, and pathophysiology of ischemic heart disease (IHD). 3 Women tend to have less atherosclerosis, more calcified plaque, more nonobstructive disease, and more prevalence of ischemia with no obstructive disease. Recent American and European guidelines have already highlighted these unique phenotypes and had sex-specific recommendations for women presenting with INOCA.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Approach to Imaging Ischemia in Women

Parwani

Mohammad

Liberman

et al. 2023

Journal of Thoracic Imaging

View full text Add to dashboard Cite

Approach to imaging ischemia in women Coronary artery disease in women tends to have a worse short-and long-term prognosis relative to men and remains the leading cause of mortality worldwide. Both clinical symptoms and diagnostic approach remain challenging in women due to lesser likelihood of women presenting with classic anginal symptoms on one hand and underperformance of conventional exercise treadmill testing in women on the other. Moreover, a higher proportion of women with signs and symptoms suggestive of ischemia are more likely to have nonobstructive coronary artery disease (CAD) that requires additional imaging and therapeutic considerations. New imaging techniques such as coronary computed tomography (CT) angiography, CT myocardial perfusion imaging, CT functional flow reserve assessment, and cardiac magnetic resonance imaging carry substantially better sensitivity and specificity for the detection of ischemia and coronary artery disease in women. Familiarity with various clinical subtypes of ischemic heart disease in women and with the major advantages and disadvantages of advanced imaging tests to ensure the decision to select one modality over another is one of the keys to successful diagnosis of CAD in women. This review compares the 2 major types of ischemic heart disease in womenobstructive and nonobstructive, while focusing on sex-specific elements of its pathophysiology.

show abstract

Section: Sex-specific Differences In Ihdmentioning

confidence: 99%

Section: Noninvasive Evaluation Of Ischemia In Womenmentioning

confidence: 99%

Section: Sex-specific Differences In Ihdmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Approach to Imaging Ischemia in Women

Parwani

Mohammad

Liberman

et al. 2023

Journal of Thoracic Imaging

View full text Add to dashboard Cite

show abstract

Imaging of heart disease in women: review and case presentation

Mikaïl

Rossi

Bengs

et al. 2022

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide. Although major diagnostic and therapeutic advances have significantly improved the prognosis of patients with CVD in the past decades, these advances have less benefited women than age-matched men. Noninvasive cardiac imaging plays a key role in the diagnosis of CVD. Despite shared imaging features and strategies between both sexes, there are critical sex disparities that warrant careful consideration, related to the selection of the most suited imaging techniques, to technical limitations, and to specific diseases that are overrepresented in the female population. Taking these sex disparities into consideration holds promise to improve management and alleviate the burden of CVD in women. In this review, we summarize the specific features of cardiac imaging in four of the most common presentations of CVD in the female population including coronary artery disease, heart failure, pregnancy complications, and heart disease in oncology, thereby highlighting contemporary strengths and limitations. We further propose diagnostic algorithms tailored to women that might help in selecting the most appropriate imaging modality.

show abstract