Comparison of Exercise Electrocardiography, Technetium-99m Sestamibi Single Photon Emission Computed Tomography, and Dobutamine and Dipyridamole Echocardiography for Detection of Coronary Artery Disease in Hypertensive Women

Prediction of 8-year cardiovascular outcomes in patients with systemic arterial hypertension: Value of stress 99mTc-tetrofosmin myocardial perfusion imaging in a high-risk cohort

“…Long-lasting systemic arterial hypertension may cause left ventricular hypertrophy. Lu et al 13 demonstrated that patients with left ventricular hypertrophy may show false-positive SPECT MPI results. Schulman et al 14 showed that hypertension affects the results of thallium-201 exercise stress testing in patients with low, but not in those with a mid to high, likelihood of CAD.…”

Head to Head Comparison of Stress Echocardiography with Exercise Electrocardiography for the Detection of Coronary Artery Stenosis in Women

“… 4) 5) The exercise induced ST segment depression has been known to have low specificity as a marker of myocardial ischemia because of higher frequency of abnormal baseline ECG or low electrocardiogram voltage in women and digoxin like effect of estrogen. 5) 6) Another point that makes lower accuracy of exercise test is women commonly have difficulties in performing optimal exercise level. As the initiation of coronary disease in women is later in their life than men, many women patients have associated comorbidity or musculoskeletal problems to reach sufficient exercise level.…”

“…Because of above mentioned shortcomings of exercise-stress ECG, it has been suggested that exercise or pharmacologic stress echocardiography may be better noninvasive tests to diagnose CAD in women. 6) 8) 9) But in Korea, the diagnostic utility of stress echocardiography has not been clearly investigated in large number of cases and reported publications were mostly focused to male gender. And the diagnostic accuracy of stress echocardiography was not evaluated by gender difference.…”

Hypertension and stable coronary artery disease

“…, administered in 1000 individuals, would average 36% if disease prevalence is 5%,[44/(44 þ 124)], in, say, a younger, non-smoking hypertensive woman with atypical chest pain, rising to 87%, [440/(440 þ 65)], that is close to certainty, for disease prevalence of 50% as in a middleaged hypertensive, dyslipidaemic male smoker with typical chest pain, showing quite clearly the essential contribution of clinical judgement to diagnostic work-up.In contrast to PPV, negative predictive value (NPV) (the ratio of true-negative results to both true-negative and false-negative results), that is the probability that a person with a negative (N) test does not have aThe diagnostic performance of non-invasive stress tests in hypertensive patients with chest painTable 2provides the diagnostic ORs and other indicators of diagnostic performance of non-invasive stress tests for the detection of coronary stenoses in hypertensive patients with chest pain. The table compiles a series of angiographically validated studies comparing electrocardiogram (EKG) exercise stress, stress echocardiography and SPECT[16][17][18][19][20][21][22][23][24][25][26][27][28] and does not refer to diagnostic techniques still sparsely validated in hypertensive patients, such as exercise echocardiography, nuclear computed tomography, MRI and PET reviewed in previous work, which the interested reader is referred to.…”