Department of Cardiology, Deborah Heart and Lung Center, Trenton Road, Browns Mills, NJ, 08015, USA.
Institute of Cardiology and Cardiovascular Surgery, La Habana, Havana, Cuba.
Curr Cardiol Rep. 2022 May;24(5):553-566. doi: 10.1007/s11886-022-01673-w. Epub 2022 Mar 9.
To outline sex-specific features of coronary artery disease (CAD) that should be considered in the assessment of women, including those from ethnic minority populations with suspected stable ischemic heart disease (IHD). Second, to determine the latest nuclear imaging tools available to assess microvascular CAD.
Latest studies indicate that women are more likely to have ischemia with no obstructive coronary arteries (INOCA) and paradoxically have worse outcomes. Therefore, the evaluation of women with suspected IHD should include assessing microvascular and epicardial coronary circulation. The prevalence of CAD is increasing in younger women due to the increased cardiovascular disease (CVD) risk burden. CAD is often underrecognized in these patients. There is increasing recognition that INOCA is not benign and should be accurately diagnosed and managed. Nuclear imaging assesses the full spectrum of CAD from microvascular CAD to multivessel obstructive epicardial CAD. Further research on myocardial blood flow (MBF) assessment with PET MPI is needed.
概述应在疑似稳定型缺血性心脏病（IHD）的女性评估中考虑的冠状动脉疾病（CAD）的性别特异性特征，包括来自少数民族人群的女性。其次，确定评估微血管 CAD 可用的最新核成像工具。
最新研究表明，女性更有可能出现无阻塞性冠状动脉（INOCA）伴缺血，且具有矛盾的不良预后。因此，疑似 IHD 的女性评估应包括评估微血管和心外膜冠状动脉循环。由于心血管疾病（CVD）风险负担增加，年轻女性的 CAD 患病率正在增加。这些患者中 CAD 往往未被充分认识。越来越多的人认识到 INOCA 并非良性，应准确诊断和治疗。核成像评估从微血管 CAD 到多支阻塞性心外膜 CAD 的全谱 CAD。需要进一步研究正电子发射断层扫描心肌灌注 MPI 评估心肌血流（MBF）。
