Diagnostic Accuracy of Exercise Electrocardiogram in Women

Shaikh, Kashif; Budoff, Matthew J.

doi:10.1089/jwh.2017.6864

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…As aforementioned, non-invasive functional tests able to allow detection of perfusion abnormalities or wall motion abnormalities under stress were identified as more accurate in CCS than s-ECG, which downgraded it to a lower level of recommendation because of its poor accuracy in detecting CAD, especially in females and in patients with resting ECG abnormalities [ 30 , 31 ].…”

Section: The Role Of Multimodality Imaging In Identifying Patients Wo...mentioning

confidence: 99%

The Role of Multimodality Imaging (CT & MR) as a Guide to the Management of Chronic Coronary Syndromes

Tassetti,

Sfriso,

Torlone

et al. 2024

JCM

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Chronic coronary syndrome (CCS) is one of the leading cardiovascular causes of morbidity, mortality, and use of medical resources. After the introduction by international guidelines of the same level of recommendation to non-invasive imaging techniques in CCS evaluation, a large debate arose about the dilemma of choosing anatomical (with coronary computed tomography angiography (CCTA)) or functional imaging (with stress echocardiography (SE), cardiovascular magnetic resonance (CMR), or nuclear imaging techniques) as a first diagnostic evaluation. The determinant role of the atherosclerotic burden in defining cardiovascular risk and prognosis more than myocardial inducible ischemia has progressively increased the use of a first anatomical evaluation with CCTA in a wide range of pre-test probability in CCS patients. Functional testing holds importance, both because the role of revascularization in symptomatic patients with proven ischemia is well defined and because functional imaging, particularly with stress cardiac magnetic resonance (s-CMR), gives further prognostic information regarding LV function, detection of myocardial viability, and tissue characterization. Emerging techniques such as stress computed tomography perfusion (s-CTP) and fractional flow reserve derived from CT (FFRCT), combining anatomical and functional evaluation, appear capable of addressing the need for a single non-invasive examination, especially in patients with high risk or previous revascularization. Furthermore, CCTA in peri-procedural planning is promising to acquire greater importance in the non-invasive planning and guiding of complex coronary revascularization procedures, both by defining the correct strategy of interventional procedure and by improving patient selection. This review explores the different roles of non-invasive imaging techniques in managing CCS patients, also providing insights into preoperative planning for percutaneous or surgical myocardial revascularization.

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Section: The Role Of Multimodality Imaging In Identifying Patients Wo...mentioning

confidence: 99%

The Role of Multimodality Imaging (CT & MR) as a Guide to the Management of Chronic Coronary Syndromes

Tassetti,

Sfriso,

Torlone

et al. 2024

JCM

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“…Historically, non-invasive assessment of suspected CAD has relied on functional techniques. One of the most prescribed functional tests is exercise electrocardiography (Ex-ECG) due to its wide availability and simple reporting [10]; however, overall diagnostic accuracy has been proven to be limited for the detection of obstructive CAD [11], especially in specific settings such as female gender [12] and ECG resting abnormalities [13]. In light of the poor overall diagnostic performance, this approach has formally been downgraded to a lower level of recommendation [6].…”

Section: Last Updates Regarding Available Second-line Non-invasive Testsmentioning

confidence: 99%

Changing Paradigms in the Diagnosis of Ischemic Heart Disease by Multimodality Imaging

Baggiano

Italiano

Guglielmo

et al. 2022

JCM

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Coronary artery disease (CAD) represents the most common cardiovascular disease, with high morbidity and mortality. Historically patients with chest pain of suspected coronary origin have been assessed with functional tests, capable to detect haemodynamic consequences of coronary obstructions through depiction of electrocardiographic changes, myocardial perfusion defects or regional wall motion abnormalities under stress condition. Stress echocardiography (SE), single-photon emission computed tomography (SPECT), positron emission tomography (PET) and cardiovascular magnetic resonance (CMR) represent the functional techniques currently available, and technical developments contributed to increased diagnostic performance of these techniques. More recently, cardiac computed tomography angiography (cCTA) has been developed as a non-invasive anatomical test for a direct visualisation of coronary vessels and detailed description of atherosclerotic burden. Cardiovascular imaging techniques have dramatically enhanced our knowledge regarding physiological aspects and myocardial implications of CAD. Recently, after the publication of important trials, international guidelines recognised these changes, updating indications and level of recommendations. This review aims to summarise current standards with main novelties and specific limitations, and a diagnostic algorithm for up-to-date clinical management is also proposed.

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Diagnostic Accuracy of Exercise Electrocardiogram in Women

Cited by 2 publications

References 23 publications

The Role of Multimodality Imaging (CT & MR) as a Guide to the Management of Chronic Coronary Syndromes

The Role of Multimodality Imaging (CT & MR) as a Guide to the Management of Chronic Coronary Syndromes

Changing Paradigms in the Diagnosis of Ischemic Heart Disease by Multimodality Imaging

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