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The role of pharmacological stress testing in women

  • Review Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Pharmacological stress is an alternative method to dynamic exercise that combined with noninvasive imaging allows the detection of flow-limiting coronary artery disease (CAD). It represents the stress procedure of choice in patients who cannot exercise appropriately. In women, pharmacological stress combined with myocardial perfusion scintigraphy (MPS) has demonstrated to be highly accurate for the detection of obstructive CAD and a valuable tool that helps separate patients at low cardiac risk from those with an adverse prognosis. Pharmacological stress with positron emission tomographic (PET) imaging is increasingly used in the investigation of suspected obstructive CAD; available evidence shows that the diagnostic profile and prognostic value of stress PET imaging is similar to that of stress MPS in women.

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Abbreviations

CAD:

Coronary artery disease

CMR:

Cardiovascular magnetic resonance

DASI:

Duke activity status index

IHD:

Ischemic heart disease

LBBB:

Left bundle branch block

LMS:

Left main stem

MET:

Metabolic equivalent

MI:

Myocardial infarction

MPS:

Myocardial perfusion scintigraphy

PET:

Positron emission tomography

References

  1. Henzlova MJ, Duvall WL, Einstein AJ, Travin MI, Verberne HJ. ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols and tracers. J Nucl Cardiol 2016;23:606–39.

    Article  PubMed  Google Scholar 

  2. Shaw LJ, Bairey Merz CN, Pepine CJ, Reis SE, Bittner V, Kelsey SF, et al. Insights from the NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation (WISE) Study: Part I: Gender differences in traditional and novel risk factors, symptom evaluation, and gender-optimized diagnostic strategies. J Am Coll Cardiol 2006;47:S4–20.

    Article  PubMed  Google Scholar 

  3. Baldassarre LA, Raman SV, Min JK, Mieres JH, Gulati M, Wenger NK, et al. Noninvasive imaging to evaluate women with stable ischemic heart disease. JACC Cardiovasc Imaging 2016;9:421–35.

    Article  PubMed  Google Scholar 

  4. Kohli P, Gulati M. Exercise stress testing in women: Going back to the basics. Circulation 2010;122:2570–80.

    Article  PubMed  Google Scholar 

  5. Alexander KP, Shaw LJ, Shaw LK, Delong ER, Mark DB, Peterson ED. Value of exercise treadmill testing in women. J Am Coll Cardiol 1998;32:1657–64.

    Article  CAS  PubMed  Google Scholar 

  6. Mieres JH, Gulati M, Bairey MN, Berman DS, Gerber TC, Hayes SN, et al. Role of noninvasive testing in the clinical evaluation of women with suspected ischemic heart disease: A consensus statement from the American Heart Association. Circulation 2014;130:350–79.

    Article  PubMed  Google Scholar 

  7. Pepine CJ, Ferdinand KC, Shaw LJ, Light-McGroary KA, Shah RU, Gulati M, et al. Emergence of nonobstructive coronary artery disease: A woman’s problem and need for change in definition on angiography. J Am Coll Cardiol 2015;66:1918–33.

    Article  PubMed  Google Scholar 

  8. Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. 2013 ESC guidelines on the management of stable coronary artery disease: The Task Force on the Management of Stable Coronary Artery Disease of the European Society of Cardiology. Eur Heart J 2013;34:2949–3003.

    Article  PubMed  Google Scholar 

  9. Shaw LJ, Mieres JH, Hendel RH, Boden WE, Gulati M, Veledar E, et al. Comparative effectiveness of exercise electrocardiography with or without myocardial perfusion single photon emission computed tomography in women with suspected coronary artery disease: Results from the What Is the Optimal Method for Ischemia Evaluation in Women (WOMEN) trial. Circulation 2011;124:1239–49.

    Article  PubMed  Google Scholar 

  10. Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, et al. ACC/AHA 2002 guideline update for exercise testing: Summary article: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation 2002;106:1883–92.

    Article  PubMed  Google Scholar 

  11. Hemal K, Pagidipati NJ, Coles A, Dolor RJ, Mark DB, Pellikka PA, et al. Sex differences in demographics, risk factors, presentation, and noninvasive testing in stable outpatients with suspected coronary artery disease: Insights from the PROMISE trial. JACC Cardiovasc Imaging 2016;9:337–46.

    Article  PubMed  Google Scholar 

  12. Dolor RJ, Patel MR, Melloni C, Chatterjee R, McBroom AJ, Musty MD, et al. Noninvasive technologies for the diagnosis of coronary artery disease in women. Rockville: Agency for Healthcare Research and Quality; 2012. p. 1–133.

    Google Scholar 

  13. Underwood SR, Anagnostopoulos C, Cerqueira M, Ell PJ, Flint EJ, Harbinson M, et al. Myocardial perfusion scintigraphy: The evidence. Eur J Nucl Med Mol Imaging 2004;31:261–91.

    Article  CAS  PubMed  Google Scholar 

  14. Blaha MJ, Hung RK, Dardari Z, Feldman DI, Whelton SP, Nasir K, et al. Age-dependent prognostic value of exercise capacity and derivation of fitness-associated biologic age. Heart 2016;102:431–37.

    Article  PubMed  Google Scholar 

  15. Shaw LJ, Olson MB, Kip K, Kelsey SF, Johnson BD, Mark DB, et al. The value of estimated functional capacity in estimating outcome: Results from the NHBLI-Sponsored Women’s Ischemia Syndrome Evaluation (WISE) Study. J Am Coll Cardiol 2006;47:S36–43.

    Article  PubMed  Google Scholar 

  16. Fihn SD, Blankenship JC, Alexander KP, Bittl JA, Byrne JG, Fletcher BJ, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2014;64:1929–49.

    Article  PubMed  Google Scholar 

  17. Iskandrian AS, Heo J, Kong B, Lyons E. Effect of exercise level on the ability of thallium-201 tomographic imaging in detecting coronary artery disease: Analysis of 461 patients. J Am Coll Cardiol 1989;14:1477–86.

    Article  CAS  PubMed  Google Scholar 

  18. Hachamovitch R, Hayes S, Friedman JD, Cohen I, Shaw LJ, Germano G, et al. Determinants of risk and its temporal variation in patients with normal stress myocardial perfusion scans: What is the warranty period of a normal scan? J Am Coll Cardiol 2003;41:1329–40.

    Article  PubMed  Google Scholar 

  19. Bairey Merz CN, Olson M, McGorray S, Pakstis DL, Zell K, Rickens CR, et al. Physical activity and functional capacity measurement in women: A report from the NHLBI-sponsored WISE study. J Womens Health Gend Based Med 2000;9:769–77.

    Article  CAS  PubMed  Google Scholar 

  20. Mieres JH, Shaw LJ, Arai A, Budoff MJ, Flamm SD, Hundley WG, et al. Role of noninvasive testing in the clinical evaluation of women with suspected coronary artery disease: Consensus statement from the Cardiac Imaging Committee, Council on Clinical Cardiology, and the Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention, American Heart Association. Circulation 2005;111:682–96.

    Article  PubMed  Google Scholar 

  21. Gulati M, Black HR, Shaw LJ, Arnsdorf MF, Merz CN, Lauer MS, et al. The prognostic value of a nomogram for exercise capacity in women. N Engl J Med 2005;353:468–75.

    Article  CAS  PubMed  Google Scholar 

  22. Mieres JH, Shaw LJ, Hendel RC, Miller DD, Bonow RO, Berman DS, et al. American Society of Nuclear Cardiology consensus statement: Task Force on Women and Coronary Artery Disease—The role of myocardial perfusion imaging in the clinical evaluation of coronary artery disease in women [correction]. J Nucl Cardiol 2003;10:95–101.

    Article  PubMed  Google Scholar 

  23. Anagnostopoulos C, Harbinson M, Kelion A, Kundley K, Loong CY, Notghi A, et al. Procedure guidelines for radionuclide myocardial perfusion imaging. Heart 2004;90 Suppl 1:i1–10.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Sasaki H, Shimizu M, Ogawa K, Okazaki F, Mizokami T, Kusaka M, et al. Defect images in stress thallium-201 myocardial scintigraphy in patients with complete left bundle branch block: Comparison of exercise stress and pharmacological stress. J Cardiol 2007;49:179–85.

    PubMed  Google Scholar 

  25. Berman DS, Kang X, Hayes SW, Friedman JD, Cohen I, Abidov A, et al. Adenosine myocardial perfusion single-photon emission computed tomography in women compared with men. Impact of diabetes mellitus on incremental prognostic value and effect on patient management. J Am Coll Cardiol 2003;41:1125–33.

    Article  PubMed  Google Scholar 

  26. Heller GV, Brown KA, Landin RJ, Haber SB. Safety of early intravenous dipyridamole technetium 99m sestamibi SPECT myocardial perfusion imaging after uncomplicated first myocardial infarction. Early Post MI IV Dipyridamole Study (EPIDS). Am Heart J 1997;134:105–11.

    Article  CAS  PubMed  Google Scholar 

  27. Kulhanek J, Sorrell VL, Ershadi RE, Cabarrus BR, Short DB, Movahed A. Adenosine myocardial perfusion single photon emission computed tomographic stress testing 24–72 h after uncomplicated myocardial infarction. Int J Cardiovasc Imaging 2002;18:269–72.

    Article  PubMed  Google Scholar 

  28. Iskandrian AE, Bateman TM, Belardinelli L, Blackburn B, Cerqueira MD, Hendel RC, et al. Adenosine versus regadenoson comparative evaluation in myocardial perfusion imaging: Results of the ADVANCE phase 3 multicenter international trial. J Nucl Cardiol 2007;14:645–58.

    Article  PubMed  Google Scholar 

  29. Klocke FJ, Baird MG, Lorell BH, Bateman TM, Messer JV, Berman DS, et al. ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging—Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging). J Am Coll Cardiol 2003;42:1318–33.

    Article  PubMed  Google Scholar 

  30. Iskandar A, Limone B, Parker MW, Perugini A, Kim H, Jones C, et al. Gender differences in the diagnostic accuracy of SPECT myocardial perfusion imaging: A bivariate meta-analysis. J Nucl Cardiol 2013;20:53–63.

    Article  PubMed  Google Scholar 

  31. Taillefer R, DePuey EG, Udelson JE, Beller GA, Latour Y, Reeves F. Comparative diagnostic accuracy of Tl-201 and Tc-99m sestamibi SPECT imaging (perfusion and ECG-gated SPECT) in detecting coronary artery disease in women. J Am Coll Cardiol 1997;29:69–77.

    Article  CAS  PubMed  Google Scholar 

  32. Iskandrian AE, Heo J, Nallamothu N. Detection of coronary artery disease in women with use of stress single-photon emission computed tomography myocardial perfusion imaging. J Nucl Cardiol 1997;4:329–35.

    Article  CAS  PubMed  Google Scholar 

  33. Amanullah AM, Kiat H, Friedman JD, Berman DS. Adenosine technetium-99m sestamibi myocardial perfusion SPECT in women: Diagnostic efficacy in detection of coronary artery disease. J Am Coll Cardiol 1996;27:803–9.

    Article  CAS  PubMed  Google Scholar 

  34. Zellweger MJ, Hachamovitch R, Kang X, Hayes SW, Friedman JD, Germano G, et al. Prognostic relevance of symptoms versus objective evidence of coronary artery disease in diabetic patients. Eur Heart J 2004;25:543–50.

    Article  PubMed  Google Scholar 

  35. Travin MI, Katz MS, Moulton AW, Miele NJ, Sharaf BL, Johnson LL. Accuracy of dipyridamole SPECT imaging in identifying individual coronary stenoses and multivessel disease in women versus men. J Nucl Cardiol 2000;7:213–20.

    Article  CAS  PubMed  Google Scholar 

  36. Gordon III DE. Advances in cardiac processing software. Semin Nucl Med 2014;44:252–73.

    Article  Google Scholar 

  37. DePuey EG. Traditional gamma cameras are preferred. J Nucl Cardiol 2016;23:795–802.

    Article  PubMed  Google Scholar 

  38. Anagnostopoulos C, Neill J, Reyes E, Prvulovich E. Myocardial perfusion scintigraphy: Technical innovations and evolving clinical applications. Heart 2012;98:353–59.

    Article  PubMed  Google Scholar 

  39. Gimelli A, Bottai M, Quaranta A, Giorgetti A, Genovesi D, Marzullo P. Gender differences in the evaluation of coronary artery disease with a cadmium–zinc telluride camera. Eur J Nucl Med Mol Imaging 2013;40:1542–48.

    Article  CAS  PubMed  Google Scholar 

  40. Gulati M, Pratap P, Kansal P, Calvin Jr JE, Hendel RC. Gender differences in the value of ST-segment depression during adenosine stress testing. Am J Cardiol 2004;94:997–1002.

    Article  CAS  PubMed  Google Scholar 

  41. Apostolopoulos DJ, Davlouros P, Alexiou S, Patsouras N, Spyridonidis T, Vassilakos PJ, et al. ST-segment depression during vasodilator stress is of minor clinical importance in women with normal myocardial perfusion imaging and low or intermediate risk of coronary artery disease. Eur J Nucl Med Mol Imaging 2012;39:437–45.

    Article  PubMed  Google Scholar 

  42. Elhendy A, van Domburg RT, Bax JJ, Roelandt JR. Gender differences in the relation between ST-T-wave abnormalities at baseline electrocardiogram and stress myocardial perfusion abnormalities in patients with suspected coronary artery disease. Am J Cardiol 1999;84:865–69.

    Article  CAS  PubMed  Google Scholar 

  43. Bateman TM, Heller GV, McGhie AI, Friedman JD, Case JA, Bryngelson JR, et al. Diagnostic accuracy of rest/stress ECG-gated Rb-82 myocardial perfusion PET: Comparison with ECG-gated Tc-99m sestamibi SPECT. J Nucl Cardiol 2006;13:24–33.

    Article  PubMed  Google Scholar 

  44. Sampson UK, Dorbala S, Limaye A, Kwong R, Di Carli MF. Diagnostic accuracy of rubidium-82 myocardial perfusion imaging with hybrid positron emission tomography/computed tomography in the detection of coronary artery disease. J Am Coll Cardiol 2007;49:1052–8.

    Article  CAS  PubMed  Google Scholar 

  45. Ziadi MC, Dekemp RA, Williams K, Guo A, Renaud JM, Chow BJ, et al. Does quantification of myocardial flow reserve using rubidium-82 positron emission tomography facilitate detection of multivessel coronary artery disease? J Nucl Cardiol 2012;19:670–80.

    Article  PubMed  Google Scholar 

  46. Boiten HJ, van Domburg RT, Valkema R, Zijlstra F, Schinkel AF. Dobutamine stress myocardial perfusion imaging: 8-Year outcomes in patients with diabetes mellitus. Eur Heart J Cardiovasc Imaging 2016;17:871–6.

    Article  PubMed  Google Scholar 

  47. Farzaneh-Far A, Shaw LK, Dunning A, Oldan JD, O’Connor CM, Borges-Neto S. Comparison of the prognostic value of regadenoson and adenosine myocardial perfusion imaging. J Nucl Cardiol 2015;22:600–7.

    Article  PubMed  Google Scholar 

  48. Iqbal FM, Hage FG, Ahmed A, Dean PJ, Raslan S, Heo J, et al. Comparison of the prognostic value of normal regadenoson with normal adenosine myocardial perfusion imaging with propensity score matching. JACC Cardiovasc Imaging 2012;5:1014–21.

    Article  PubMed  Google Scholar 

  49. Lee DS, Husain M, Wang X, Austin PC, Iwanochko RM. Cardiovascular outcomes after pharmacologic stress myocardial perfusion imaging. Am Heart J 2016;174:138–46.

    Article  PubMed  Google Scholar 

  50. Navare SM, Mather JF, Shaw LJ, Fowler MS, Heller GV. Comparison of risk stratification with pharmacologic and exercise stress myocardial perfusion imaging: A meta-analysis. J Nucl Cardiol 2004;11:551–61.

    Article  PubMed  Google Scholar 

  51. Poulin MF, Alexander S, Doukky R. Prognostic implications of stress modality on mortality risk and cause of death in patients undergoing office-based SPECT myocardial perfusion imaging. J Nucl Cardiol 2016;23:202–11.

    Article  PubMed  Google Scholar 

  52. Shaw LJ, Hage FG, Berman DS, Hachamovitch R, Iskandrian A. Prognosis in the era of comparative effectiveness research: Where is nuclear cardiology now and where should it be? J Nucl Cardiol 2012;19:1026–43.

    Article  PubMed  Google Scholar 

  53. Rozanski A, Gransar H, Hayes SW, Friedman JD, Hachamovitch R, Berman DS. Comparison of long-term mortality risk following normal exercise vs adenosine myocardial perfusion SPECT. J Nucl Cardiol 2010;17:999–1008.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Romero-Farina G, Candell-Riera J, Guade-Bruix S, Ferreira-Gonzalez I, Cuberas-Borros G, Pizzi N, et al. Warranty periods for normal myocardial perfusion stress SPECT. J Nucl Cardiol 2015;22:44–54.

    Article  Google Scholar 

  55. Uthamalingam S, Gurm GS, Ahmado I, Sidhu MS, Flynn J. Outcome of patients with regadenoson-induced ST-segment depression but normal perfusion on single-photon emission computed tomography. Angiology 2013;64:46–8.

    Article  PubMed  Google Scholar 

  56. Klodas E, Miller TD, Christian TF, Hodge DO, Gibbons RJ. Prognostic significance of ischemic electrocardiographic changes during vasodilator stress testing in patients with normal SPECT images. J Nucl Cardiol 2003;10:4–8.

    Article  PubMed  Google Scholar 

  57. Iqbal FM, Al JW, Sanam K, Sweeney A, Heo J, Iskandrian AE, et al. Reclassification of cardiovascular risk in patients with normal myocardial perfusion imaging using heart rate response to vasodilator stress. Am J Cardiol 2013;111:190–5.

    Article  PubMed  Google Scholar 

  58. Amanullah AM, Berman DS, Erel J, Kiat H, Cohen I, Germano G, et al. Incremental prognostic value of adenosine myocardial perfusion single-photon emission computed tomography in women with suspected coronary artery disease. Am J Cardiol 1998;82:725–30.

    Article  CAS  PubMed  Google Scholar 

  59. Sharir T, Kang X, Germano G, Bax JJ, Shaw LJ, Gransar H, et al. Prognostic value of poststress left ventricular volume and ejection fraction by gated myocardial perfusion SPECT in women and men: Gender-related differences in normal limits and outcomes. J Nucl Cardiol 2006;13:495–506.

    Article  PubMed  Google Scholar 

  60. Hachamovitch R, Berman DS, Kiat H, Bairey CN, Cohen I, Cabico A, et al. Effective risk stratification using exercise myocardial perfusion SPECT in women: Gender-related differences in prognostic nuclear testing. J Am Coll Cardiol 1996;28:34–44.

    Article  CAS  PubMed  Google Scholar 

  61. Shaw LJ, Min JK, Hachamovitch R, Hendel RC, Borges-Neto S, Berman DS. Nomograms for estimating coronary artery disease prognosis with gated stress myocardial perfusion SPECT. J Nucl Cardiol 2012;19:43–52.

    Article  PubMed  Google Scholar 

  62. Shaw LJ, Iskandrian AE. Prognostic value of gated myocardial perfusion SPECT. J Nucl Cardiol 2004;11:171–85.

    Article  PubMed  Google Scholar 

  63. Van Tosh A, Supino PG, Nichols KJ, Garza D, Horowitz SF, Reichek N. Prognosis of a normal positron emission tomography 82Rb myocardial perfusion imaging study in women with no history of coronary disease. Cardiology 2010;117:301–6.

    Article  PubMed  Google Scholar 

  64. Kay J, Dorbala S, Goyal A, Fazel R, Di Carli MF, Einstein AJ, et al. Influence of sex on risk stratification with stress myocardial perfusion Rb-82 positron emission tomography: Results from the PET (Positron Emission Tomography) Prognosis Multicenter Registry. J Am Coll Cardiol 2013;62:1866–76.

    Article  PubMed  Google Scholar 

  65. Hage FG, Dean P, Iqbal F, Heo J, Iskandrian AE. A blunted heart rate response to regadenoson is an independent prognostic indicator in patients undergoing myocardial perfusion imaging. J Nucl Cardiol 2011;18:1086–94.

    Article  PubMed  Google Scholar 

  66. Abidov A, Hachamovitch R, Hayes SW, Ng CK, Cohen I, Friedman JD, et al. Prognostic impact of hemodynamic response to adenosine in patients older than age 55 years undergoing vasodilator stress myocardial perfusion study. Circulation 2003;107:2894–99.

    Article  PubMed  Google Scholar 

  67. Gorur GD, Ciftci EA, Kozdag G, Isgoren S, Oc MA, Haksal C, et al. Reduced heart rate response to dipyridamole in patients undergoing myocardial perfusion SPECT. Ann Nucl Med 2012;26:609–15.

    Article  CAS  PubMed  Google Scholar 

  68. Cerqueira MD, Nguyen P, Staehr P, Underwood SR, Iskandrian AE, on behalf of the ADVANCE-MPI Trial Investigators. Effects of age, gender, obesity, and diabetes on the efficacy and safety of the selective A2A agonist regadenoson versus adenosine in myocardial perfusion imaging: Integrated ADVANCE-MPI trial results. J Am Coll Cardiol Imaging 2008;1:307–16.

    Article  Google Scholar 

  69. Geleijnse ML, Elhendy A, Fioretti PM, Roelandt JR. Dobutamine stress myocardial perfusion imaging. J Am Coll Cardiol 2000;36:2017–27.

    Article  CAS  PubMed  Google Scholar 

  70. Cerqueira MD, Verani MS, Schwaiger M, Heo J, Iskandrian AS. Safety profile of adenosine stress perfusion imaging: Results from the Adenoscan Multicenter Trial Registry. J Am Coll Cardiol 1994;23:384–89.

    Article  CAS  PubMed  Google Scholar 

  71. Ranhosky A, Kempthorne-Rawson J. The safety of intravenous dipyridamole thallium myocardial perfusion imaging. Intravenous Dipyridamole Thallium Imaging Study Group. Circulation 1990;81:1205–9.

    Article  CAS  PubMed  Google Scholar 

  72. Kong BA, Shaw L, Miller DD, Chaitman BR. Comparison of accuracy for detecting coronary artery disease and side-effect profile of dipyridamole thallium-201 myocardial perfusion imaging in women versus men. Am J Cardiol 1992;70:168–73.

    Article  CAS  PubMed  Google Scholar 

  73. Thomas GS, Thompson RC, Miyamoto MI, Ip TK, Rice DL, Milikien D, et al. The RegEx trial: A randomized, double-blind, placebo- and active-controlled pilot study combining regadenoson, a selective A(2A) adenosine agonist, with low-level exercise, in patients undergoing myocardial perfusion imaging. J Nucl Cardiol 2009;16:63–72.

    Article  PubMed  Google Scholar 

  74. Thomas GS, Prill NV, Majmundar H, Fabrizi RR, Thomas JJ, Hayashida C, et al. Treadmill exercise during adenosine infusion is safe, results in fewer adverse reactions, and improves myocardial perfusion image quality. J Nucl Cardiol 2000;7:439–46.

    Article  CAS  PubMed  Google Scholar 

  75. Rangel MO, Demori RM, Doukky R. Age and gender as predictors of benefit from aminophylline administration in patients undergoing regadenoson stress myocardial perfusion imaging: A substudy of the ASSUAGE trial. Am J Ther 2013;20:622–9.

    Article  PubMed  Google Scholar 

  76. Hiro J, Hiro T, Reid CL, Ebrahimi R, Matsuzaki M, Gardin JM. Safety and results of dobutamine stress echocardiography in women versus men and in patients older and younger than 75 years of age. Am J Cardiol 1997;80:1014–20.

    Article  CAS  PubMed  Google Scholar 

  77. Lette J, Tatum JL, Fraser S, Miller DD, Waters DD, Heller G, et al. Safety of dipyridamole testing in 73,806 patients: The Multicenter Dipyridamole Safety Study. J Nucl Cardiol 1995;2:3–17.

    Article  CAS  PubMed  Google Scholar 

  78. AlJaroudi WA, Alraies MC, Cerquiera MD, Jaber WA. Safety and tolerability of regadenoson in 514 SPECT MPI patients with and without coronary artery disease and submaximal exercise heart rate response. Eur J Nucl Med Mol Imaging 2013;40:341–48.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Nuclear Medicine Department, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London, SW3 6NP, United Kingdom

    Katherine Standbridge BA (Hons), MSc & Eliana Reyes MD, PhD, FESC

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  1. Katherine Standbridge BA (Hons), MSc
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  2. Eliana Reyes MD, PhD, FESC
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Correspondence to Eliana Reyes MD, PhD, FESC.

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Standbridge, K., Reyes, E. The role of pharmacological stress testing in women. J. Nucl. Cardiol. 23, 997–1007 (2016). https://doi.org/10.1007/s12350-016-0602-4

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