Head to Head Comparison of Stress Echocardiography with Exercise Electrocardiography for the Detection of Coronary Artery Stenosis in Women.

BACKGROUND: Exercise-stress electrocardiography (ECG) is initially recommended for the diagnosis of coronary artery disease. But its value has been questioned in women because of suboptimal diagnostic accuracy. Stress echocardiography had been reported to have comparable test accuracy in women. But the data comparing the diagnostic accuracy of exercise-stress ECG and stress echocardiography directly are few. The aim of the study was to compare the diagnostic accuracy of exercise-stress ECG and dobutamine stress echocardiography (DSE) in Korean women. METHODS: 202 consecutive female patients who presented with chest pain in outpatient clinic, and who underwent treadmill exercise test (TET), DSE and coronary angiography were included for the study. The diagnostic accuracy TET and DSE were calculated by the definition of > 50% or > 75% coronary artery stenosis (CAS). RESULTS: The sensitivity and specificity were higher with DSE (70.4, 94.6%) than TET (53.7, 73.6%) for detection of > 50% CAS. The higher accuracy of DSE was maintained after exclusion of the patients who could not achieve over 85% age predicted heart rate before ischemia induction. DSE also showed greater diagnostic accuracy than TET by > 75% CAS criteria, and in subsets of patient with intermediate pretest probability. CONCLUSION: In the diagnosis of CAS, DSE showed higher accuracy than TET in female patients who presented with chest pain. As well as the test accuracy, adequate stress was more feasible with DSE than TET. These finding suggests DSE may be used as the first-line diagnostic tool in the detection of CAS in women with chest pain.

Association of depression with coronary artery disease and QTc interval prolongation in women with chest pain: data from the KoRean wOmen'S chest pain rEgistry (KoROSE) study.

The presence of depression is reportedly related with cardiovascular diseases, including coronary artery disease (CAD), but little is known concerning the association between depressive symptoms reflecting the cultural constructions of female patients with chest pain as well as coronary artery stenosis, coronary vasospasm, and the corrected QT (QTc) interval. In a multicenter prospective cross-sectional survey of 163 Korean women with chest pain, the presence of depression was evaluated using the Beck Depression Inventory (BDI) and Lee and Rhee Depression (LRD) scales. The differences in the QTc interval and the presence of CAD (defined as ≥ 50% coronary artery stenosis on coronary angiography) and coronary vasospasm were compared between depressed and non-depressed women. Significant CAD was present in 83 of 163 female patients (mean age, 61 years), and coronary vasospasm was present in 11 of 80 patients. The mean BDI and LRD scores were significantly higher in patients with significant CAD (BDI: 13.4 ± 9.6 vs. 6.9 ± 5.6, p < 0.001; LRD: 46.9 ± 21.4 vs. 39.8 ± 15.2, p = 0.027) and coronary vasospasm (BDI: 12.3 ± 6.4 vs. 4.6 ± 2.8; and LRD: 49.8 ± 12.3 vs. 30.5 ± 13.9; both p < 0.05). On multivariate analysis, BDI scores were important risk factors for the presence of CAD (odds ratio [OR] = 1.138; 95% confidence interval [CI] = 1.071-1.210; p=0.021) and coronary vasospasm (OR = 2.534; 95% CI = 1.161-2.028; p = 0.003), with similar findings obtained for LRD scores (CAD: OR = 1.034; 95% CI = 1.013-1.056; p = 0.001; coronary vasospasm: OR = 1.125; 95% CI = 1.050-1.206; p = 0.001). The mean QTc interval was also significantly higher in the depressed group than in the non-depressed group (440.1 ± 32.0 ms vs. 408.2 ± 26.4ms; p < 0.001). The QTc interval displayed significant positive with the BDI (r = 0.595; p < 0.001) and LRD scores (r = 0.467; p< 0.001). This study demonstrated that depression is associated with a prolonged QTc interval, CAD, and coronary vasospasm in female patients with chest pain, suggesting a possible mechanism by which depressive mood may be linked with coronary endothelial dysfunction and atherosclerosis.

Visual contents adaptation for colour vision deficiency using customised ICC profile.

PURPOSE: Approximately, 1 of 12 persons in the world has colour vision deficiency (CVD), named colour blindness. While the amount of graphic information in digital contents is continuing to increase dramatically, assistive tools for colour vision deficiencies remain scarce. METHODS: We developed a method to generate customised International Colour Consortium (ICC) colour profiles for patients suffering from CVD, which could adjust graphic contents according to individual needs. Compensation rules for the pale or dark range of red and green colours were established, and an ICC profile was generated using this set of rules. RESULTS: The passing rate for Ishihara test was 99.5% when the generated profile was applied to 10 Ishihara plates and tested on individuals suffering from red deficiency, and green deficiency (5, and 15 participants, respectively). The time used to generate the compensation profile was 12.9 min on average, including the time taken to explain the test to the participants. CONCLUSION: Reliable results were achieved with a relatively low effort in comparison with methods currently utilised in professional clinics, and does not need expensive instruments.