Cardiovascular multimodality imaging in women. A scientific statement of the European Association of Cardiovascular Imaging (EACVI) of the ESC.

Cardiovascular diseases (CVD) represent an important cause of mortality and morbidity in women. It is now recognized that there are sex differences regarding the prevalence and the clinical significance of the traditional cardiovascular (CV) risk factors as well as the pathology underlying a range of CVDs. Unfortunately, women have been underrepresented in most CVD imaging studies and trials regarding diagnosis, prognosis and therapeutics. There is therefore a clear need for further investigation of how CVD affects women along their life span. Multimodality CV imaging plays a key role in the diagnosis of CVD in women as well as in prognosis, decision-making and monitoring of therapeutics and interventions. However, multimodality imaging (MMI) in women requires specific consideration given the differences in CVD between the sexes. These differences relate to physiological changes that only women experience (e.g. pregnancy, menopause) as well as variation in the underlying pathophysiology of CVD and also differences in the prevalence of certain conditions such as connective tissue disorders, Takotsubo and spontaneous coronary artery dissection, which are all more common in women. This scientific statement on cardiovascular multimodality in women, an initiative of the EACVI of the ESC reviews the role of multimodality CV imaging in the diagnosis, management and risk-stratification of CVD, as well as highlighting important gaps in our knowledge that require further investigation.