The primary objective of the Women's Ischemic Syndrome Evaluation Study (WISE)- previously referred to as Evaluation of Ischemic Heart Disease in Women (EIHDW) under RFP NHLBI-HC-94-13, is to perform clinical studies to improve the diagnostic reliability of cardiovascular testing in evaluation of ischemic heart disease in women. Innovative approaches proposed in evaluation of ischemia will include physiologic or functional measurements such as impaired metabolism, perfusion, or endothelial function as well as assessment of epicardial coronary arteries by angiography. Objectives of this study are to develop safe, accurate, and cost effective diagnostic approaches for evaluating women with suspected ischemic heart disease, and to determine the frequency of myocardial ischemia in the absence of significant epicardial coronary stenosis, as well as the frequency of non-ischemic or non-cardiac chest pain. Key to these goals is the improved understanding of chest pain in women. Whether there are angina equivalents that are more accurate clinical descriptors of myocardial ischemia in women will be investigated. WISE will use new or innovative techniques such as Doppler flow, contrast perfusion or indirect measures of the microcirculation to assess myocardial function, perfusion, coronary tone and anatomy, or endothelial function, and to correlate these results with coronary arteriography. The study consists of four clinical centers that will evaluate innovative diagnostic methods designed to improve the diagnostic reliability of cardiovascular testing in evaluation of ischemic heart disease in women. The clinical centers will evaluate diagnostic methods and perform uniform study protocols, including angiography, on 234 participants over three years. The centers will perform analysis of the data in the fourth year. One clinical center will provide central collection, management, and analysis of uniform data and research evaluation data obtained by all of the WISE Clinical Centers. The period of performance is from September 3, 1996 through August 31, 2000.
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