Non-Invasive Test Detects Heart Disease in Women
Cardiovascular magnetic resonance stress test has high diagnostic accuracy
TUESDAY, July 22 (HealthDay News) -- Multi-component cardiovascular magnetic resonance stress perfusion testing can accurately diagnose coronary artery disease in women, according to research published in the July issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.
Igor Klem, M.D., of the Duke Cardiovascular Magnetic Resonance Center in Durham, N.C., and colleagues studied 136 women (mean age 63) who had chest pain or other symptoms suggestive of coronary artery disease. The subjects underwent a stress test consisting of cine rest function, adenosine-stress and rest perfusion, and delayed-enhancement cardiovascular magnetic resonance infarction imaging. Within 24 hours, the subjects underwent X-ray coronary angiography, which showed that 37 (27 percent) of them had coronary artery disease.
The researchers found that the combined stress test had a sensitivity, specificity and accuracy of 84 percent, 88 percent and 87 percent, respectively, and a diagnostic accuracy of 82 to 90 percent. But they found that its diagnostic accuracy was lower in women with small hearts, single-vessel disease, or intermediate-grade stenosis.
"The benefits of non-invasive testing are greatest in patients with an intermediate-to-high pre-test likelihood of coronary artery disease, that is, the population that was mainly addressed by Klem et al," states the author of an accompanying editorial. "Patients with intermediate risk who have a negative test are unlikely to have coronary disease and usually do not require further testing. Although more work needs to be performed, particularly in women with chest pain and normal coronary arteries, this study by Klem et al. is an important step in bridging the gender gap in the performance of diagnostic procedures for the investigation of coronary artery disease."