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Are we 'WISE'r? Findings from the NHLBI-sponsored Women's Ischemia Syndrome Evaluation study

Bina Ahmed1, C Noel Bairey Merz, George Sopko

  • 1Division of Cardiology, Department of Medicine, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Women'S Health (London, England)
|October 7, 2009
PubMed

Insights

The Women's Ischemia Syndrome Evaluation (WISE) study found microvascular coronary dysfunction in women with chest pain but no significant blockages. This finding improves diagnosis and treatment for heart disease in women.

Area of Science:

  • Cardiology
  • Women's Health
  • Diagnostic Strategies

Background:

  • Cardiovascular disease is a primary health concern for women.
  • The Women's Ischemia Syndrome Evaluation (WISE) study was initiated to address gaps in diagnosing and treating heart disease in women.
  • Existing research often overlooked specific pathophysiologies in women, including those without obstructive coronary artery stenosis.

Purpose of the Study:

  • To optimize symptom evaluation and diagnostic testing for ischemic heart disease in women.
  • To investigate the pathophysiologic mechanisms underlying symptoms and myocardial ischemia in women, particularly in the absence of epicardial coronary artery stenosis.
  • To explore the role of psychosocial variables and reproductive hormones in the presentation of ischemic heart disease.

Main Methods:

  • The WISE study employed coronary vasomotor testing during angiography.
  • Investigated the spectrum of anginal symptoms and diagnostic strategies for microvascular and macrovascular coronary disease.
  • Examined psychosocial variables and reproductive hormones in relation to ischemic heart disease presentation.

Main Results:

  • Pivotal findings identified chest pain in the absence of significant obstructive epicardial luminal coronary stenosis (Cardiac Syndrome X).
  • Prevalent abnormalities in coronary flow reserve were observed, indicating microvascular coronary dysfunction.
  • Microvascular dysfunction was linked to adverse morbidity and mortality in women.

Conclusions:

  • The WISE study significantly advanced the understanding of heart disease in women, especially those with non-obstructive coronary artery disease.
  • Identified microvascular coronary dysfunction as a key factor in women presenting with anginal symptoms.
  • Findings contribute to improved diagnostic and management strategies for cardiovascular conditions in women.

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