Large numbers of patients referred for evaluation of chest pain are unable to perform adequate, diagnostic exercise testing. In these patients, dobutamine stress echocardiography (DSE) represents an alternative, exercise- independent stress modality. Apart from the ~5% of patients with an inadequate acoustic window, 10% of patients referred for this test have nondiagnostic (sub-maximal negative) test results. Serious side effects during or shortly after DSE are uncommon, with ventricular fibrillation or myocardial infarction occurring in ~1 of 2,000 studies. No deaths have been reported. On the basis of a total number of 2,246 patients, reported in 28 studies, the sensitivity, specificity and accuracy of the test for the detection of coronary artery disease (CAD) were 80%, 84% and 81%, respectively. Mean sensitivities for one-, two- and three-vessel disease were 74%, 86% and 92%, respectively. The sensitivity for detection of disease in the left circumflex coronary artery (55%) was lower, both compared with that for left anterior descending (72%) and right coronary artery disease (76%). The sensitivity of predicting multivessel disease by multiregion echocardiographic abnormalities varied widely, from 8% to 71%. In direct comparisons, DSE was superior to exercise electrocardiography and dipyridamole echocardiography and comparable to exercise echocardiography and radionuclide imaging. DSE is a useful, feasible and safe exercise-independent stress modality for assessing the presence, localization and extent of CAD.,
Journal of the American College of Cardiology
Department of Cardiology

Geleijnse, M., Fioretti, P., & Roelandt, J. (1997). Methodology, feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography. Journal of the American College of Cardiology (Vol. 30, pp. 595–606). doi:10.1016/S0735-1097(97)00206-4