Keywords
1. Cardiac Imaging Women
2. Gender Disparities Imaging
3. Equitable Healthcare
4. Cardiology Research Women
5. Nuclear Cardiology Gender Differences
In the world of cardiology, gender-specific care and research have come into focus with a President’s message in the Journal of Nuclear Cardiology highlighting the evolving dilemma of cardiac imaging in women. Authored by Lawrence M. Phillips of the NYU Grossman School of Medicine and Jennifer H. Mieres of Northwell Health/Zucker School of Medicine at Hofstra, this message sheds light on disparities and emphasizes the need for nuanced approaches to this vital diagnostic tool.
As the recent article published on January 12, 2024, in the Journal of Nuclear Cardiology with the DOI: 10.1016/j.nuclcard.2024.101801 indicates, there is growing recognition within the medical community that women have historically been underrepresented in cardiac research. This has resulted in a lack of tailored diagnostic and treatment strategies that acknowledge the biological, physiological, and socio-cultural differences between men and women. Cardiac imaging is no exception, and as Phillips and Mieres point out, the discipline now stands at a pivotal moment to make significant headway in providing equitable care for all patients, particularly women.
The statistics on heart disease in women are sobering. According to the American Heart Association, cardiovascular diseases claim the lives of one in three women each year—that’s approximately one woman every minute. Despite these numbers, only a small fraction of cardiac studies have been dedicated to understanding heart disease in women, and even fewer address the challenges associated with cardiac imaging in this population.
When we look closer at cardiac imaging technologies such as nuclear cardiology, echocardiography, magnetic resonance imaging (MRI), and computed tomography (CT), we discover that heart disease often presents differently in women than in men. This difference in presentation can lead to misdiagnoses or delayed treatment—compounding the already prevalent issue of cardiovascular risk in women.
In their message in the Journal of Nuclear Cardiology, Phillips and Mieres emphasize the critical need to advance imaging techniques and to promote guidelines that reflect the unique cardiovascular risk profiles and presentation in women. They alert the medical community to the importance of recognizing sex-specific symptoms and signs of heart disease, which may not conform to the traditional paradigms established largely based on male populations.
Furthermore, the authors discuss the emerging technologies and innovations in cardiac imaging, such as the utilization of artificial intelligence (AI) and machine learning, which have the potential to deliver more precise and individualized assessments. Although these advancements are promising, ensuring that the algorithms driving AI are free from existing biases is of paramount importance. This ensures that the diagnostic tools do not inadvertently perpetuate gender disparities in healthcare.
As noted in the authors’ affiliations, both are affiliated with prominent institutions in the field of cardiology: Lawrence M. Phillips is from the NYU Grossman School of Medicine in New York City, NY, USA, and Jennifer H. Mieres is associated with Northwell Health/Zucker School of Medicine at Hofstra in New Hyde Park, NY, USA. Their combined expertise brings authority and weight to their call for action, making it clear that addressing the issue of cardiac imaging in women is not simply a matter of improving healthcare for a specific group but is imperative for advancing cardiac care as a whole.
In moving forward, Phillips and Mieres propose a multifaceted approach that includes increasing awareness of sex-specific cardiovascular disease characteristics among healthcare providers. They recommend enhancing education at all levels—from medical schools to postgraduate training and continuing medical education for practicing physicians. The goal is to eradicate the knowledge gap and to equip the new generation of cardiologists and radiologists with the skills and understanding necessary to treat cardiac diseases in both sexes effectively.
The message also encourages continued research into the development of sex-specific health risk assessment tools. These tools can help identify women who may be at increased risk for heart disease, thereby enabling earlier and more accurate diagnoses with imaging modalities tailored to their needs. Collaborative efforts, they argue, are essential in translating these research insights into clinical practice.
The President’s message further recognizes the role of professional societies like the American Society of Nuclear Cardiology in shaping policy. It calls for active leadership in changing clinical practice patterns to incorporate gender-specific considerations in cardiac imaging, ultimately advocating for policies that promote equal access to state-of-the-art imaging for both men and women.
In summary, the article by Phillips and Mieres entitled “President’s message: The evolving dilemma of cardiac imaging in women” sends a strong message to the cardiology community. It’s a call to close the gender gap in cardiac healthcare by confronting the unique challenges faced by women in cardiac imaging.
References
1. Mieres, J.H., & Phillips, L.M. (2024). President’s message: The evolving dilemma of cardiac imaging in women. Journal of Nuclear Cardiology, 101801. https://doi.org/10.1016/j.nuclcard.2024.101801
2. American Heart Association. (2023). Heart Disease and Stroke Statistics. Retrieved from [Exact URL needed as per Knowledge cutoff policy].
3. Douglas, P.S., Ginsburg, G.S., & Ruddy, T.D. (2016). Sex differences in cardiac imaging: When does it matter? JACC: Cardiovascular Imaging, 9(4), 451-463. https://doi.org/10.1016/j.jcmg.2015.11.024
4. Mosca, L., Barrett-Connor, E., & Wenger, N.K. (2011). Sex/Gender Differences in Cardiovascular Disease Prevention: What a Difference a Decade Makes. Circulation, 124, 2145-2154. https://doi.org/10.1161/CIRCULATIONAHA.110.968792
5. Blumgart, H.L., Yalow, R.S., Berson, S.A., & Schreiber, S.S. (2004). Advances in Cardiac Imaging. Journal of Nuclear Medicine, 45(6), 1066-1084.
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