Exercise treadmill testing is not a very accurate method of detecting clogged coronary arteries in women, new research suggests, even when a specially designed exercise protocol is used.

Previous reports have shown that treadmill testing is not as accurate in women as in men. To address this, a modified exercise protocol was developed to take into account women’s lower muscle mass than men and their difficulty with some of the strenuous ramp components of testing - but it hasn’t been clear if these changes actually solved the problem.

The new findings, which are reported in the American Heart Journal, are based on an analysis of data from 96 women who had suspected coronary disease and were referred for testing.

Twenty-nine women had significant narrowing seen in at least one coronary artery on heart x-ray films (angiography), Dr. Jannet F. Lewis, from George Washington University Medical Center in Washington, DC, and colleagues found. However, only nine of these women had an abnormal exercise treadmill test (ETT).

On the other hand, of the 67 women with little or no coronary artery blockage, only 35 had a normal ETT.

Even with a modified exercise protocol, “ETT appears to be of limited diagnostic value for detection of coronary (narrowing) in women with chest pain,” the investigators conclude.

SOURCE: American Heart Journal, March 2005.