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Myocardial perfusion imaging in women for the evaluation of stable ischemic heart disease—state-of-the-evidence and clinical recommendations
- Source :
- Journal of Nuclear Cardiology. 24:1402-1426
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- This document from the American Society of Nuclear Cardiology represents an updated consensus statement on the evidence base of stress myocardial perfusion imaging (MPI), emphasizing new developments in single-photon emission tomography (SPECT) and positron emission tomography (PET) in the clinical evaluation of women presenting with symptoms of stable ischemic heart disease (SIHD). The clinical evaluation of symptomatic women is challenging due to their varying clinical presentation, clinical risk factor burden, high degree of comorbidity, and increased risk of major ischemic heart disease events. Evidence is substantial that both SPECT and PET MPI effectively risk stratify women with SIHD. The addition of coronary flow reserve (CFR) with PET improves risk detection, including for women with nonobstructive coronary artery disease and coronary microvascular dysfunction. With the advent of PET with computed tomography (CT), multiparametric imaging approaches may enable integration of MPI and CFR with CT visualization of anatomical atherosclerotic plaque to uniquely identify at-risk women. Radiation dose-reduction strategies, including the use of ultra-low-dose protocols involving stress-only imaging, solid-state detector SPECT, and PET, should be uniformly applied whenever possible to all women undergoing MPI. Appropriate candidate selection for stress MPI and for post-MPI indications for guideline-directed medical therapy and/or invasive coronary angiography are discussed in this statement. The critical need for randomized and comparative trial data in female patients is also emphasized.
- Subjects :
- Male
medicine.medical_specialty
Cost-Benefit Analysis
Myocardial Ischemia
Disease
030204 cardiovascular system & hematology
Coronary artery disease
03 medical and health sciences
Myocardial perfusion imaging
0302 clinical medicine
Coronary Circulation
medicine
Humans
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Tomography, Emission-Computed, Single-Photon
medicine.diagnostic_test
business.industry
Myocardial Perfusion Imaging
Coronary flow reserve
medicine.disease
Comorbidity
Fractional Flow Reserve, Myocardial
Positron emission tomography
Positron-Emission Tomography
Exercise Test
Female
Radiology
Tomography
Cardiology and Cardiovascular Medicine
business
Ischemic heart
Subjects
Details
- ISSN :
- 15326551 and 10713581
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Journal of Nuclear Cardiology
- Accession number :
- edsair.doi.dedup.....de46e2dbce20093d902c08e8fb9b81a0