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Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009821","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The utility of exercise\u2010induced ST\u2010segment depression for diagnosing ischemic heart disease (IHD) in women is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Based on evidence that IHD pathophysiology in women involves coronary vascular dysfunction, we hypothesized that coronary vascular dysfunction contributes to exercise electrocardiography (Ex\u2010ECG) ST\u2010depression in the absence of obstructive coronary artery disease, so\u2010called false positive results. We tested our hypothesis in a pilot study evaluating the relationship between peripheral vascular endothelial function and Ex\u2010ECG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010nine asymptomatic women without cardiac risk factors underwent maximal Bruce protocol exercise treadmill testing and peripheral endothelial function assessment using peripheral arterial tonometry (Itamar EndoPAT 2000) to measure reactive hyperemia index (RHI). The relationship between RHI and Ex\u2010ECG ST\u2010segment depression was evaluated using logistic regression and differences in subgroups using 2\u2010tailed <jats:italic>t<\/jats:italic> tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age was 54 \u00b1 7 years, body mass index 25 \u00b1 4 kg\/m<jats:sup>2<\/jats:sup>, and RHI 2.51 \u00b1 0.66. Three women (10%) had RHI &lt;1.68, consistent with abnormal peripheral endothelial function, whereas 18 women (62%) met criteria for positive Ex\u2010ECG based on ST\u2010segment depression in contiguous leads. Women with and without ST\u2010segment depression had similar baseline and exercise vital signs, metabolic equivalents achieved, and RHI (all <jats:italic>P<\/jats:italic> &gt; 0.05). RHI did not predict ST\u2010segment depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our pilot study demonstrates high prevalence of exercise\u2010induced ST\u2010segment depression in asymptomatic, middle\u2010aged, overweight women. Peripheral vascular endothelial dysfunction did not predict Ex\u2010ECG ST\u2010segment depression. Further work is needed to investigate the utility of vascular endothelial testing and Ex\u2010ECG for IHD diagnostic and management purposes in women.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23000","type":"journal-article","created":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T14:55:46Z","timestamp":1529420146000},"page":"1044-1048","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["False\u2010positive stress testing: Does endothelial vascular dysfunction contribute to ST\u2010segment depression in women? 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