<International Circulation>:What are some of the limitations and issues with the more common non-invasive tests for angina when used for women? In clinical trials， finding are made using IVUS but for the practicing clinician， what is the best approach?

 《国际循环》：对于女心绞痛患者进行常见的非侵入性检查的局限性和问题是什么？在临床试验中，是通过血管内超声来发现问题所在，对于临床执业医师什么是最好的方法？

    Prof.  Wenger: If you are trying to evaluate a woman who can exercise and who has a normal resting ECG， the plain stress test， the treadmill ECG， is the best test. If the woman has an abnormal resting ECG， you must undertake an imaging study， either echo or nuclear. If the woman can’t exercise， then you have to use an imaging study because you have to use a pharmacologic agent and that’s the issue. The challenge is that very many women can’t exercise to achieve a heart rate that is about 75% to 80% of the age-predicted maximal heart rate and that is what they have to do in order to get a good test. If they don’t exercise adequately， it is an inconclusive test. 

    Wenger教授:如果评估一个有正常静息心电图并且可以自行运动的女性患者，运动平板实验是最好的测试方法。如果有静息心电图异常的女性患者，必须进行影像学检查，超声或者核磁共振。如果女病人不能运动，那么也要使用影像学检查，问题的关键是你不得不对病人采用药物治疗。目前面临的最大的挑战是女性患者不能运动以达到她们年龄估计最大心率的75%至85%的心率，这是她们必须要做的，以获得一个良好的测试结果。如果她们没有充分地运动，那么这就是一个不确定的测试。

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