False-positive stress testing: Does endothelial vascular dysfunction contribute to ST-segment depression in women? A...

Area of Science:

• Cardiology
• Vascular Medicine
• Diagnostic Testing

Background:

• The diagnostic utility of exercise-induced ST-segment depression for ischemic heart disease (IHD) in women remains uncertain.
• IHD pathophysiology in women may involve coronary vascular dysfunction, potentially leading to false positive exercise electrocardiogram (Ex-ECG) results.

Purpose of the Study:

• To investigate the hypothesis that coronary vascular dysfunction contributes to false positive Ex-ECG results in women.
• To evaluate the relationship between peripheral vascular endothelial function and Ex-ECG findings in asymptomatic women.

Main Methods:

• A pilot study involving 29 asymptomatic women without cardiac risk factors.
• Maximal Bruce protocol exercise treadmill testing and peripheral endothelial function assessment using peripheral arterial tonometry to measure reactive hyperemia index (RHI).
• Logistic regression and t tests were used to analyze the relationship between RHI and ST-segment depression.

Main Results:

• A high prevalence of positive Ex-ECG (62%) was observed in the study population.
• Peripheral endothelial function (RHI) was not significantly different between women with and without ST-segment depression.
• Reactive hyperemia index (RHI) did not predict exercise-induced ST-segment depression.

Conclusions:

• Exercise-induced ST-segment depression is prevalent in asymptomatic, middle-aged, overweight women.
• Peripheral vascular endothelial dysfunction does not appear to predict Ex-ECG ST-segment depression in this population.
• Further investigation is required to clarify the roles of vascular endothelial testing and Ex-ECG in IHD diagnosis and management for women.