title: Heart failure hospitalization in women with signs and symptoms of ischemia: A report from the women's ischemia syndrome evaluation study.
abstract: BACKGROUND
  Women with signs and symptoms of ischemia, no obstructive coronary artery disease, and preserved left ventricular ejection fraction enrolled in the National Heart Lung and Blood Institute (NHLBI) sponsored Women's Ischemia Syndrome Evaluation (WISE) study have an unexpectedly high rate of subsequent heart failure (HF) hospitalization. We sought to verify and characterize the HF hospitalizations.
  
  
  METHODS
  A retrospective chart review was performed on 223 women with signs and symptoms of ischemia, undergoing coronary angiography for suspected coronary artery disease followed for 6±2.6years. Data were collected from a single site in the WISE study.
  
  
  RESULTS
  At the time of study enrollment, the women were 57±11years of age, all had preserved left ventricular ejection fraction, and 81 (36%) had obstructive CAD (defined as >50% stenosis in at least one epicardial artery). Among the 223 patients, 25 (11%) reported HF hospitalizations, of which 14/25 (56%) had recurrent HF hospitalizations (>2 hospitalizations). Medical records were available in 13/25 (52%) women. Left ventricular ejection fraction was measured in all verified cases and was found to be preserved in 12/13 (92%). HF hospitalization was not related to obstructive CAD.
  
  
  CONCLUSIONS
  Among women with signs and symptoms of ischemia undergoing coronary angiography for suspected obstructive CAD, HF hospitalization at 6-year follow-up was predominantly characterized by a preserved ejection fraction and not associated with obstructive CAD.
authors: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
authors: May
authors: M
authors: Bakir
authors: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
authors: Michael D
authors: MD
authors: Nelson
authors: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
authors: Erika
authors: E
authors: Jones
authors: Biostatistics and Bioinformatics, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Quanlin
authors: Q
authors: Li
authors: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
authors: Janet
authors: J
authors: Wei
authors: Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Behzad
authors: B
authors: Sharif
authors: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
authors: Margo
authors: M
authors: Minissian
authors: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
authors: Chrisandra
authors: C
authors: Shufelt
authors: National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
authors: George
authors: G
authors: Sopko
authors: University of Florida, Gainesville, FL, USA.
authors: Carl J
authors: CJ
authors: Pepine
authors: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA. Electronic address: merz@cshs.org.
authors: C Noel Bairey
authors: CNB
authors: Merz
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D013223:Statistics as Topic; D013318:Stroke Volume; D063189:Symptom Assessment / Q000379:methods; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left
keywords: Coronary artery disease; Coronary microvascular disease; Heart failure; Heart failure with preserved ejection fraction; Women