title: Comparison of exercise, dobutamine-atropine and dipyridamole-atropine stress echocardiography in detecting coronary artery disease.
abstract: BACKGROUND
  Dipyridamole and dobutamine stress echocardiography testing are most widely utilized, but their sensitivity remained suboptimal in comparison to routine exercise stress echocardiography. The aim of our study is to compare, head-to-head, exercise, dobutamine and dipyridamole stress echocardiography tests, performed with state-of-the-art protocols in a large scale prospective group of patients.
  
  
  METHODS
  Dipyridamole-atropine (Dipatro: 0.84 mg/kg over 10 min i.v. dipyridamole with addition of up to 1 mg of atropine), dobutamine-atropine (Dobatro: up to 40 mcg/kg/min i.v. dobutamine with addition of up to 1 mg of atropine) and exercise (Ex, Bruce) were performed in 166 pts. Of them, 117 pts without resting wall motion abnormalities were enrolled in study (91 male; mean age 54 +/- 10 years; previous non-transmural myocardial infarction in 32 pts, angina pectoris in 69 pts and atypical chest pain in 16 pts). Tests were performed in random sequence, in 3 different days, within 5 day period under identical therapy. All patients underwent coronary angiography.
  
  
  RESULTS
  Significant coronary artery disease (CAD; > or =50% diameter stenosis) was present in 69 pts (57 pts 1-vessel CAD, 12 multivessel CAD) and absent in 48 pts. Sensitivity (Sn) was 96%, 93% and 90%, whereas specificity (Sp) was 92%, 92% and 87% for Dobatro, Dipatro and Ex, respectively (p = ns). Concomitant beta blocker therapy did not influence peak rate-pressure product and Sn of Dobatro and Dipatro (p = ns).
  
  
  CONCLUSIONS
  When state-of-the-art protocols are used, dipyridamole and dobutamine stress echocardiography have comparable and high diagnostic accuracy, similar to maximal post-exercise treadmill stress echocardiography.
authors: University Institute for Cardiovascular Diseases, Department for Diagnostic and Catheterization Laboratories, Clinical Center of Serbia, Serbia and Montenegro. ivannanedeljkovic@yahoo.com
authors: Ivana
authors: I
authors: Nedeljkovic
authors: Miodrag
authors: M
authors: Ostojic
authors: Branko
authors: B
authors: Beleslin
authors: Ana
authors: A
authors: Djordjevic-Dikic
authors: Jelena
authors: J
authors: Stepanovic
authors: Milan
authors: M
authors: Nedeljkovic
authors: Sinisa
authors: S
authors: Stojkovic
authors: Goran
authors: G
authors: Stankovic
authors: Jovica
authors: J
authors: Saponjski
authors: Zorica
authors: Z
authors: Petrasinovic
authors: Vojislav
authors: V
authors: Giga
authors: Predrag
authors: P
authors: Mitrovic