Acampa Wanda, Assante Roberta, Zampella Emilia
Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy.
J Nucl Cardiol. 2016 Oct;23(5):991-996. doi: 10.1007/s12350-016-0596-y. Epub 2016 Jul 25.
Treadmill exercise electrocardiogram (ECG) is one of the most commonly used noninvasive tests for the assessment of ischemic heart disease (IHD). Sex-specific challenges in diagnostic and prognostic tests methods for IHD outlined the importance of pretest probability evaluation and referral bias using risk-prediction charts available for both asymptomatic and symptomatic women. Accordingly, exercise ECG has been indicated as the initial test for the symptomatic women at intermediate risk of IHD who has a normal resting ECG and is capable of maximal exercise. However, the difficulties of using exercise testing for diagnosing IHD in women have led to an initial speculation that stress imaging may be preferred to standard stress testing. This editorial analyzed a large body of evidence on the diagnostic and prognostic powers of treadmill ECG and exercise myocardial perfusion imaging (MPI) according to new advanced imaging technologies.
跑步机运动心电图（ECG）是评估缺血性心脏病（IHD）最常用的非侵入性检查之一。IHD诊断和预后检测方法中存在的性别特异性挑战凸显了使用适用于无症状和有症状女性的风险预测图表进行预测试概率评估和转诊偏倚的重要性。因此，运动心电图已被指定为IHD中度风险、静息心电图正常且能够进行最大运动量运动的有症状女性的初始检查。然而，在女性中使用运动试验诊断IHD存在困难，这最初引发了一种推测，即与标准负荷试验相比，负荷成像可能更受青睐。这篇社论根据新的先进成像技术，分析了大量关于跑步机心电图和运动心肌灌注成像（MPI）诊断和预后能力的证据。
