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 identifi cation of obs...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 identifi cation 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 fi brosis,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 defi nitions of CAD and ischemia to better refl ect 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.展开更多
Positron emission tomography(PET)is a powerful noninvasive imaging tool for phenotyping patients at risk of or with known coronary artery disease(CAD).One of the key advantages over other imaging modalities is its uni...Positron emission tomography(PET)is a powerful noninvasive imaging tool for phenotyping patients at risk of or with known coronary artery disease(CAD).One of the key advantages over other imaging modalities is its unique ability to quantify physiologic processes,including myocardial blood fl ow(in milliliters per minute per gram of myocardium),metabolism,and cardiac receptors,and its high sensitivity for delineating and quantifying molecular targets in vivo using targeted imaging probes.Cardiac PET/CT offers opportunity for a comprehensive noninvasive evaluation of the consequences of atherosclerosis in the coronary arteries and the myocardium.展开更多
文摘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 identifi cation 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 fi brosis,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 defi nitions of CAD and ischemia to better refl ect 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.
文摘Positron emission tomography(PET)is a powerful noninvasive imaging tool for phenotyping patients at risk of or with known coronary artery disease(CAD).One of the key advantages over other imaging modalities is its unique ability to quantify physiologic processes,including myocardial blood fl ow(in milliliters per minute per gram of myocardium),metabolism,and cardiac receptors,and its high sensitivity for delineating and quantifying molecular targets in vivo using targeted imaging probes.Cardiac PET/CT offers opportunity for a comprehensive noninvasive evaluation of the consequences of atherosclerosis in the coronary arteries and the myocardium.
