The role of treadmill exercise testing in women Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology The role of treadmill exercise testing in women Wanda Acampa, MD, PhD, Roberta Assante, MD, Emilia Zampella, MD Department of Advanced Biomedical Sciences, University Federico II, Naples Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology BACKGROUND 1- Treadmill exercise electrocardiogram (ECG) is the most commonly used of noninvasive tests for assessment of ischemic heart disease (IHD) 2- exercise ECG has been indicated as initial test for the symptomatic women at intermediate risk for IHD who has a normal resting ECG and is capable of maximal exercise 2-ECG diagnostic accuracy has been demonstrated gender related, showing lower values in women as compared to men in detecting IHD 3-In recently published guidelines more weight is given to testing patients according to pre-test probability, age and sex using the most recent estimates of IHD prevalence as basis of clinical algorithm Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology RESULTS Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology CONCLUSIONS 1- ECG remains the recommended method of initial evaluation only in selected women with symptoms consistent of IHD 2- In women at intermediate pre-test probability of disease a non- invasive imaging based test for ischemia, combining exercise ECG with MPI, is preferred when local expertise and availability permit 3- A large body of evidence on the diagnostic and prognostic power of exercise MPI according to new advanced imaging technologies supports this approach Copyright American Society of Nuclear Cardiology