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

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摘要 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.
出处 《心血管创新与应用》 2019年第B02期375-389,共15页 Cardiovascular Innovations and Applications
作者简介 Correspondence:Viviany R.Taqueti,MD,MPH,Cardiovascular Imaging Program,Heart and Vascular Center,Division of Cardiology,Department of Medicine,Division of Nuclear Medicine and Molecular Imaging,Department of Radiology,Brigham and Women’s Hospital,Harvard Medical School,75 Francis Street,Boston,MA 02115,USA,E-mail:vtaqueti@bwh.harvard.edu.
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