Skip to main content
NCBI home page
Clinical Cardiology logoLink to Clinical Cardiology
. 2009 Feb 3;23(8):560–570. doi: 10.1002/clc.4960230804

Recent advances in dobutamine stress echocardiography

Bruce W Usher Jr 1, Terrence X O'Brien 2,1,3,✉
PMCID: PMC6654786  PMID: 10941540

Abstract

Dobutamine stress echocardiography (DSE) is a reliable cardiac risk stratifier that has widespread applicability because of its clinical accuracy and cost effectiveness. Dobutamine has positive inotropic and chronotropic effects and is commonly used in patients who cannot exercise or achieve an adequate heart rate response with exercise. Recently available long‐term results from several independent clinical trials, combined with enhancements in image quality, have improved the ability to detect significant coronary artery disease and determine myocardial viability. Dobutamine stress echocardiography has an excellent safety profile with clinical results superior to regular exercise electrocardiography and comparable with exercise echocardiography and radionucleotide perfusion stress imaging. Low‐dose dobutamine response can accurately predict dysfunctional yet viable myocardial regions that may improve with revascularization. Clinical studies are now available refining the common use of DSE preoperatively in female patients with valvular disease, as well as in the emergency department. Dobutamine stress echocardiography does have some limitations in discriminating particular regions of ischemia when multiple ventricular segments are involved and when the imaging is suboptimal. It can be applied using minimal additional resources in an otherwise functioning echocardiography laboratory and, with appropriate training, can result in clinical results comparable with those of large‐scale multi‐center trials. Ongoing improvements in technology and the development of new reagents such as myocardial contrast agents hold promise for further advancement in the near future.

Keywords: echocardiography, stress testing, dobutamine, diagnostic testing, coronary artery disease

Full Text

The Full Text of this article is available as a PDF (1.1 MB).

References

  • 1. Geleijnse ML, Fioretti PM, Roelandt JRTC: Methodology, feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography. J Am Coll Cardiol 1997; 30: 595–606 [DOI] [PubMed] [Google Scholar]
  • 2. Armstrong WF: Stress echocardiography: Introduction, history, and methods. Progr Cardiovasc Dis 1997; 39: 499–522 [DOI] [PubMed] [Google Scholar]
  • 3. Pellikka PA, Roger VL, Oh JK, Miller FA, Seward JB, Tajik AJ: Stress echocardiography. Part II. Dobutamine stress echocardiography: Techniques, implementation, clinical applications, and correlations. Mayo Clinic Proc 1995; 70: 16–27 [DOI] [PubMed] [Google Scholar]
  • 4. Marwick TH: Current status of stress echocardiography for diagnosis and prognostic assessment of coronary artery disease. Cor Art Dis 1998; 9: 411–426 [DOI] [PubMed] [Google Scholar]
  • 5. Tennant R, Wiggers CJ: The effect of coronary occlusion on myocardial contraction. Am J Physiol 1935; 351–361
  • 6. Bartunek J, Wijns W, Heyndrickx GR, de Bruyne B: Effects of dobutamine on coronary stenosis physiology and morphology: Comparison with intracoronary adenosine. Circulation 1999; 100: 243–249 [DOI] [PubMed] [Google Scholar]
  • 7. Ballal RS, Secknus M‐A, Mehta R, Kapadia S, Lauer MS, Marwick TH: Cardiac outcomes in coronary patients with submaximum dobutamine stress echocardiography. Am J Cardiol 1997; 80: 725–729 [DOI] [PubMed] [Google Scholar]
  • 8. Elhendy A, van Domburg RT, Bax JJ, Roelandt JR: Relation between the extent of coronary artery disease and tachyarrhythmias during dobutamine stress echocardiography. Am J Cardiol 1999; 83: 832–835 [DOI] [PubMed] [Google Scholar]
  • 9. Shaheen J, Luria D, Klutstein MW, Rosenmann D, Tzivoni D: Diagnostic value of 12‐lead electrocardiogram during dobutamine echocardiographic studies. Am Heart J 1998; 136: 1061–1064 [DOI] [PubMed] [Google Scholar]
  • 10. Elhendy A, van Domburg RT, Bax JJ, Poldermans D, Nierop PR, Kasprzak JD, Roelandt JRTC: Optimal criteria for the diagnosis of coronary artery disease by dobutamine stress echocardiography. Am J Cardiol 1998; 82: 1339–1344 [DOI] [PubMed] [Google Scholar]
  • 11. Tighe JF, Steiman DM, Vernalis MN, Taylor AJ: Observer bias in the interpretation of dobutamine stress echocardiography. Clin Cardiol 1997; 20: 449–454 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12. Secknus MA, Marwick TH: Evolution of dobutamine protocols and indications: Safety and side effects in 3011 studies over 5 years. J Am Coll Cardiol 1997; 29: 1234–1240 [DOI] [PubMed] [Google Scholar]
  • 13. Anthopoulos LP, Bonou MS, Kardaras FG, Sioras EP, Kardara DN, Sideris AM, Kranidis AI, Margaris NG: Stress echocardiography in elderly patients with coronary artery disease. J Am Coll Cardiol 1996; 28: 52–59 [DOI] [PubMed] [Google Scholar]
  • 14. Elhendy A, Cornel JH, Roelandt JR, van Domburg RT, Nierop PR, Geleynse ML, El‐Said GM, Fioretti PM: Relation between contractile response of akinetic segments during dobutamine stress echocardiography and myocardial ischemia assessed by simultaneous thallium‐201 single‐photon emission computed tomography. Am J Cardiol 1996; 77: 955–959 [DOI] [PubMed] [Google Scholar]
  • 15. Marwick T, Willemart B, D'Hondt AM, Baudhuin T, Wijns W, Detry JM, Melin J: Selection of the optimal nonexercise stress for the evaluation of ischemic regional myocardial dysfunction and malperfusion. Comparison of dobutamine and adenosine using echocardiography and 99mTc‐MIBI single photon emission computed tomography. Circulation 1993; 87: 345–354 [DOI] [PubMed] [Google Scholar]
  • 16. Sawada SG, Seger DS, Ryan T, Brown SE, Dohan AM, Williams R, Fineberg NS, Armstrong WF, Feigenbaum H: Echocardiographic detection of coronary artery disease during dobutamine infusion. Circulation 1991; 83: 1605–1614 [DOI] [PubMed] [Google Scholar]
  • 17. Marwick T, D'Hondt AM, Baudhuin T, Willemart B, Wijns W, Detry JM, Melin J: Optimal use of dobutamine stress echocardiography for the detection and evaluation of coronary artery disease: Combination with echocardiography or scintigraphy, or both? J Am Coll Cardiol 1993; 22: 159–167 [DOI] [PubMed] [Google Scholar]
  • 18. Chuah S‐C, Pellikka PA, Roger VL, McCully RB, Seward JB: Role of dobutamine stress echocardiography in predicting outcome in 860 patients with known or suspected coronary artery disease. Circulation 1998; 97: 1474–1480 [DOI] [PubMed] [Google Scholar]
  • 19. Krivokapich J, Child JS, Walter DO, Garfinkel A: Prognostic value of dobutamine stress echocardiography in predicting cardiac events in patients with known or suspected coronary artery disease. J Am Coll Cardiol 1999; 33: 708–716 [DOI] [PubMed] [Google Scholar]
  • 20. Secknus MA, Niedermaier ON, Lauer MS, Marwick TH: Diagnostic and prognostic implications of left ventricular cavity obliterations response to dobutamine echocardiography. Am J Cardiol 1998; 81: 1318–1322 [DOI] [PubMed] [Google Scholar]
  • 21. Poldermans D, Fioretti PM, Boersma E, Bax JJ, Thomson IR, Roelandt JRTC, Simoons ML: Long‐term prognostic value of dobutamine‐atropine stress echocardiography in 1737 patients with known or suspected coronary artery disease. Circulation 1999; 99: 757–762 [DOI] [PubMed] [Google Scholar]
  • 22. Steinberg EH, Madmon L, Patel CP, Sedlis SP, Kronzon I, Cohen JL: Long‐term prognostic significance of dobutamine echocardiography in patients with suspected coronary artery disease: Results of a 5‐year follow‐up study. J Am Coll Cardiol 1997; 29: 969–973 [DOI] [PubMed] [Google Scholar]
  • 23. Dhond MR, Donnell K, Singh S, Garapati S, Whitley TB, Nguyen T, Bommer W: Value of negative dobutamine stress echocardiography in predicting long‐term cardiac events. J Am Soc Echocardiogr 1999; 12: 471–475 [DOI] [PubMed] [Google Scholar]
  • 24. Cortigiani L, Picano E, Landi P, Previtali M, Pirelli S, Bellotti P, Bigi R, Magaia O, Galati A, Nannini E: Value of pharmacologic stress echocardiography in risk stratification of patients with single‐vessel disease: A report from the echo‐persantine and echo‐dobutamine international cooperative studies. J Am Coll Cardiol 1998; 32: 69–74 [DOI] [PubMed] [Google Scholar]
  • 25. Akosah KO, McDaniel S, Hanrahan JS, Mohanty PK: Dobutamine stress echocardiography early after heart transplantation predicts development of allograft coronary artery disease and outcome. J Am Coll Cardiol 1998; 31: 1607–1614 [DOI] [PubMed] [Google Scholar]
  • 26. Forster T, McNeill AJ, Salustri A, Reijs AEM, El‐Said EM, Roelandt JRTC, Fioretti PM: Simultaneous dobutamine stress echocardiography and technetium‐99m isonitrile single‐photon emission computed tomography in patients with suspected coronary artery disease. J Am Coll Cardiol 1993; 21: 1591–1596 [DOI] [PubMed] [Google Scholar]
  • 27. Macieira‐Coelho E, Dionisio I, Garcia‐Alves M, Cantinho G, Da Costa BB, Gouveia A, De Padua F: Comparison between dobutamine echocardiography and thallium‐201 scintigraphy in detecting residual stenosis, ischemia, and necrosis in patients with prior myocardial infarction. Clin Cardiol 1997; 20: 351–356 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 28. Quinones MA, Verani MS, Haichin RM, Mahmarian JJ, Suarez J, Zoghbi WA: Exercise echocardiography versus 201Tl single‐photon emission computed tomography in evaluation of coronary artery disease. Analysis of 292 patients. Circulation 1992; 85: 1026–1031 [DOI] [PubMed] [Google Scholar]
  • 29. Segar DS, Brown SE, Sawada SG, Ryan T, Feigenbaum H: Dobutamine stress echocardiography: Correlation with coronary lesion severity as determined by quantitative angiography. J Am Coll Cardiol 1992; 19: 1197–1202 [DOI] [PubMed] [Google Scholar]
  • 30. Elsasser A, Muller KD, Vogt A, Strasser R, Gagel C, Schlepper M, Klovekorn WP: Assessment of myocardial viability: Dobutamine echocardiography and thallium‐201 single‐photon emission computed tomographic imaging predict the postoperative improvement of left ventricular function after bypass surgery. Am Heart J 1998; 136: 463–175 [DOI] [PubMed] [Google Scholar]
  • 31. Picano E, Ostojic M, Varga A, Sicari R, Djordjevic‐Dikic A, Nedeljkovic I, Torres M: Combined low dose dipyridamole‐dobutamine stress echocardiography to identify myocardial viability. J Am Coll Cardiol 1996; 27: 1422–1428 [DOI] [PubMed] [Google Scholar]
  • 32. Cornel JH, Bax JJ, Elhendy A, Maat APWM, Kimman G‐JP, Geleijnse ML, Rambaldi R, Boersma E, Fioretti PM: Biphasic response to dobutamine predicts improvement of global left ventricular function after surgical revascularization in patients with stable coronary artery disease. J Am Coll Cardiol 1998; 31: 1002–1010 [DOI] [PubMed] [Google Scholar]
  • 33. Vanoverschelde J‐U, D'Hondt A‐M, Marwick T, Gerber BL, De Kock M, Dion R, Wijns W, Melin JA: Head‐to‐head comparison of exercise‐redistribution‐reinjection thallium single‐photon emission computed tomography and low dose dobutamine echocardiography for prediction of reversibility of chronic left ventricular ischemic dysfunction. J Am Coll Cardiol 1996; 28: 432–442 [DOI] [PubMed] [Google Scholar]
  • 34. Leclercq F, Messner‐Pellenc P, Moragues C, Rivalland F, Carabasse D, Davy J‐M, Grolleau‐Raoux R: Myocardial viability assessed by dobutamine echocardiography in acute myocardial infarction after successful primary coronary angioplasty. Am J Cardiol 1997; 80: 6–10 [DOI] [PubMed] [Google Scholar]
  • 35. Smart SC, Sawada S, Ryan T, Segar D, Atherton L, Berkovitz K, Bourdillon PDV, Feigenbaum H: Low‐dose dobutamine echocardiography detects reversible dysfunction after thrombolytic therapy of acute myocardial infarction. Circulation 1993; 88: 405—415 [DOI] [PubMed] [Google Scholar]
  • 36. Cigarroa CG, deFilippi CR, Brickner ME, Alvarez LG, Wait MA, Grayburn PA: Dobutamine stress echocardiography identifies hibernating myocardium and predicts recovery of left ventricular function after coronary revascularization. Circulation 1993; 88: 430–436 [DOI] [PubMed] [Google Scholar]
  • 37. Senior R, Kaul S, Lahiri A: Myocardial viability on echocardiography predicts long‐term survival after revascularization in patients with ischemic congestive heart failure. J Am Coll Cardiol 1999; 33: 1848–1854 [DOI] [PubMed] [Google Scholar]
  • 38. Pasquet A, Robert A, D'Hondt AM, Dion R, Melin JA, Vanoverschelde JLJ: Prognostic value of myocardial ischemia and viability in patients with chronic left ventricular ischemic dysfunction. Circulation 1999; 100: 141–148 [DOI] [PubMed] [Google Scholar]
  • 39. Baer FM, Voth E, Deutsch HJ, Schneider CA, Horst M, Devivie ER, Schicha H, Erdmann E, Sechtem U: Predictive value of low dose dobutamine transesophageal echocardiography and 18‐FDG positron emission tomography for recovery of regional left ventricular function after successful revascularization. J Am Coll Cardiol 1996; 28: 60–69 [DOI] [PubMed] [Google Scholar]
  • 40. Afridi I, Grayburn PA, Panza JA, Oh JK, Zoghbi WA, Marwick TH: Myocardial viability during dobutamine echocardiography predicts survival in patients with coronary artery disease and severe left ventricular systolic dysfunction. J Am Coll Cardiol 1999; 32: 921–926 [DOI] [PubMed] [Google Scholar]
  • 41. Smart SC, Dionisopoulos PN, Knickelbine TA, Schuchard T, Sagar KB: Dobutamine‐atropine stress echocardiography for risk stratification in patients with chronic left ventricular dysfunction. J Am Coll Cardiol 1999; 33: 512–521 [DOI] [PubMed] [Google Scholar]
  • 42. Belardinelli R, Georgiou D, Purcaro A: Low dose dobutamine echocardiography predicts improvement in functional capacity after exercise training in patients with ischemic cardiomyopathy: Prognostic implication. J Am Coll Cardiol 1998; 31: 1027–1034 [DOI] [PubMed] [Google Scholar]
  • 43. Picano E, Sicari R, Landi P, Cortigiani L, Bigi R, Coletta C, Galati A, Heyman J, Mattioli R, Previtali M, Mathias W Jr, Dodi C, Minardi G, Lowenstein J, Seveso G, Pingitore A, Salustri A, Raciti M: Prognostic value of myocardial viability in medically treated patients with global left ventricular dysfunction early after an acute uncomplicated myocardial infarction. Circulation 1998; 98: 1078–1084 [DOI] [PubMed] [Google Scholar]
  • 44. Carlos ME, Smart SC, Wynsen JC, Sagar KB: Dobutamine stress echocardiography for risk stratification after myocardial infarction. Circulation 1997; 95: 1402–1410 [DOI] [PubMed] [Google Scholar]
  • 45. Sicari R, Picano E, Landi R Pingitore A, Bigi R, Coletta C, Heyman J, Casazza F, Previtali M, Mathias W Jr, Dodi C, Minardi G, Lowenstein J, Garyfallidis X, Cortigiani L, Morales MA, Raciti M: Prognostic value of dobutamine‐atropine stress echocardiography early after acute myocardial infarction. J Am Coll Cardiol 1997; 29: 254–260 [DOI] [PubMed] [Google Scholar]
  • 46. Previtali M, Fetiveau R, Lanzarini L, Cavalotti C, Klersy C: Prognostic value of myocardial viability and ischemia detected by dobutamine stress echocardiography early after acute myocardial infarction treated with thrombolysis. J Am Coll Cardiol 1998; 32: 380–386 [DOI] [PubMed] [Google Scholar]
  • 47. Smart S, Wynsen J, Sagar K: Dobutamine‐atropine stress echocardiography for reversible dysfunction during the first week after acute myocardial infarction: Limitations and determinants of accuracy. J Am Coll Cardiol 1997; 30: 1669–1678 [DOI] [PubMed] [Google Scholar]
  • 48. Davila‐Roman VG, Waggoner AD, Sicard GA, Geltman EM, Schechtman KB, Perez JE: Dobutamine stress echocardiography predicts surgical outcome in patients with an aortic aneurysm and peripheral vascular disease. J Am Coll Cardiol 1993; 21: 957–963 [DOI] [PubMed] [Google Scholar]
  • 49. Poldermans D, Fioretti PM, Forster T, Thomson IR, Boersma E, el‐Said EM, du Bois NA, Roelandt JR, van Urk H: Dobutamine stress echocardiography for assessment of perioperative cardiac risk in patients undergoing major vascular surgery. Circulation 1993; 87: 1506–1512 [DOI] [PubMed] [Google Scholar]
  • 50. Poldermans D, Arnese M, Fioretti PM, Salustri A, Boersma E, Thomson IR, Roelandt JRTC, van Urk H: Improved cardiac risk stratification in major vascular surgery with dobutamine‐atropine stress echocardiography. J Am Coll Cardiol 1995; 23: 648–653 [DOI] [PubMed] [Google Scholar]
  • 51. Lane RT, Sawada SG, Segar DS, Ryan T, Lalka SG, Williams R, Brown SE, Armstrong WF, Feigenbaum H: Dobutamine stress echocardiography for assessment of cardiac risk before noncardiac surgery. Am J Cardiol 1991; 68: 976–977 [DOI] [PubMed] [Google Scholar]
  • 52. Secknus MA, Marwick TH: Influence of gender on physiologic response and accuracy of dobutamine echocardiography. Am J Cardiol 1997; 80: 721–724 [DOI] [PubMed] [Google Scholar]
  • 53. Elhendy A, Geleijnse ML, van Domburg RT, Nierop PR, Poldermans D, Bax JJ, TenCate FJ, Nosir YFM, Ibrahim MM, Roelandt JTRC: Gender differences in the accuracy of dobutamine stress echocardiography for the diagnosis of coronary artery disease. Am J Cardiol 1997; 80: 1414–1418 [DOI] [PubMed] [Google Scholar]
  • 54. Dionisopoulos PN, Collins JD, Smart SC, Knickelbine TA, Sagar KB: The value of dobutamine stress echocardiography for the detection of coronary artery disease in woman. J Am Soc Echocardiogr 1991; 10: 811–817 [DOI] [PubMed] [Google Scholar]
  • 55. Lewis JF, Lin L, McGorray S, Pepine CJ, Doyle M, Edmundowicz D, Holubkov R, Pohost G, Reichek N, Rogers W, Sharaf BL, Sopko G, Merz CN: Dobutamine stress echocardiography in women with chest pain. Pilot phase data from the National Heart, Lung and Blood Institute Women's Ischemia Syndrome Evaluation (WISE). J Am Coll Cardiol 1999; 33: 1462–1468 [DOI] [PubMed] [Google Scholar]
  • 56. Cortigiani L, Dodi C, Paolini EA, Bernardi D, Bruno G, Nannini E: Prognostic value of pharmacological stress echocardiography in women with chest pain and unknown coronary artery disease. J Am Coll Cardiol 1998; 32: 1975–1981 [DOI] [PubMed] [Google Scholar]
  • 57. Trippi JA, Lee KS, Kopp G, Nelson DR, Yee KG, Cordell WH: Dobutamine stress tele‐echocardiography for evaluation of emergency department patients with chest pain. J Am Coll Cardiol 1997; 30: 627–632 [DOI] [PubMed] [Google Scholar]
  • 58. DeFilippi CR, DuWayne LW, Brickner ME, Appleton CP, Yancy CW, Eichhorn EJ, Grayburn PA: Usefulness of dobutamine echocardiography in distinguishing severe from non‐severe valvular aortic stenosis in patients with depressed left ventricular function and low transvalvular gradients. Am J Cardiol 1995; 75: 191–194 [DOI] [PubMed] [Google Scholar]
  • 59. Cheitlin MD, Alpert JS, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davidson TW, Davis JL, Douglas PS, Gillam LD, Lewis RP, Peralman AS, Philbrick JT, Shah PM, Williams RG: ACC/AHA guidelines for the clinical application of echocardiography: Executive summary. J Am Coll Cardiol 1997; 29: 862–879 [DOI] [PubMed] [Google Scholar]
  • 60. Hoffmann R, Lethen H, Marwick T, Rambaldi R, Fioretti P, Pingitore A, Picano E, Buck T, Erbel R, Flackskampf FA, Hanrath P: Standardized guidelines for the interpretation of dobutamine echocardiography reduce interinstitutional variance in interpretation. Am J Cardiol 1998; 82: 1520–1524 [DOI] [PubMed] [Google Scholar]
  • 61. Armstrong WF, Pellikka PA, Ryan T, Crouse L, Zoghbi WA: Stress echocardiography: Recommendations for performance and interpretation of stress echocardiography. J Am Soc Echocardiogr 1998; 11: 97–104 [DOI] [PubMed] [Google Scholar]
  • 62. Falcone RA, Marcovitz PA, Perez JE, Dittrich HC, Hopkins WE, Armstrong WF: Intravenous albunex during dobutamine stress echocardiography: Enhanced localization of left ventricular endocardial borders. Am Heart J 1995; 130: 254–258 [DOI] [PubMed] [Google Scholar]
  • 63. Kaul S: Myocardial contrast echocardiography: 15 years of research and development. Circulation 1997; 96: 3745–3760 [DOI] [PubMed] [Google Scholar]
  • 64. DeMaria AN: The emerging role of contrast agents in echocardiography. Clin Cardiol 1997; 20: l‐3–l‐6 [DOI] [PubMed] [Google Scholar]
  • 65. DeFilippi CR, Willett DL, Irani WN, Eichhorn EJ, Velasco CE, Grayburn PA: Comparison of myocardial contrast echocardiography and low‐dose dobutamine stress echocardiography in predicting recovery of left ventricular function after coronary revascularization in chronic ischemic heart disease. Circulation 1995; 92: 2863–2868 [DOI] [PubMed] [Google Scholar]
  • 66. Nagueh SF, Vaduganathan P, Ali N, Blaustein A, Verani MS, Winters WL Jr, Zoghbi WA: Identification of hibernating myocardium: Comparative accuracy of myocardial contrast echocardiography, rest‐redistribution thallium‐201 tomography and dobutamine echocardiography. J Am Coll Cardiol 1997; 29: 985–993 [DOI] [PubMed] [Google Scholar]
  • 67. Waku S, Ohkubo T, Takada K, Ishihara T, Ohsawa N, Adachi I, Narabayashi I: Prediction of wall motion improvement after coronary revascularization in patients with postmyocardial infarction: Diagnostic value of dobutamine stress echocardiography and myocardial contrast echocardiography. J Cardiol 1997; 30: 197–203 [PubMed] [Google Scholar]
  • 68. Bremer ML, Monahan KH, Stussy VL, Miller FA, Seward JB, Pellikka PA: Safety of dobutamine stress echocardiography supervised by registered nurse sonographers. J Am Soc Echocardiogr 1998; 11: 601–605 [DOI] [PubMed] [Google Scholar]
  • 69. Garber AM, Solomon NA: Cost‐effectiveness of alternative test strategies for the diagnosis of coronary artery disease. Ann Intern Med 1999; 130: 719–728 [DOI] [PubMed] [Google Scholar]
  • 70. Spencer KT, Bednarz J, Rafter PG, Korcarz C, Lang RM: Use of harmonic imaging without echocardiographic contrast to improve two‐dimensional image quality. Am J Cardiol 1998; 82: 794–799 [DOI] [PubMed] [Google Scholar]
  • 71. Skolnick DG, Sawada SG, Feigenbaum H, Segar DS: Enhanced endocardial visualization with noncontrast harmonic imaging during stress echocardiography. J Am Soc Echocardiogr 1999; 12: 559–563 [DOI] [PubMed] [Google Scholar]
  • 72. Nishino M, Tanouchi J, Tanaka K, Ito T, Kato J, Iwai K, Tanahashi H, Hori M, Yamada Y, Kamada T: Dobutamine stress echocardiography at 7.5 mg/kg/min using color tissue Doppler imaging M‐mode safely predicts reversible dysfunction early after reperfusion in patients with acute myocardial infarction. Am J Cardiol 1999; 83: 340–344 [DOI] [PubMed] [Google Scholar]
  • 73. Hunziker PR, Picard MH, Jander N, Scherrer‐Crosbie M, Pfisterer M, Buser PT: Regional wall motion assessment in stress echocardiography by tissue Doppler bull's‐eyes. J Am Soc Echocardiogr 1999; 12: 196–202 [DOI] [PubMed] [Google Scholar]
  • 74. Spes CH, Klauss V, Mudra H, Schnaack SD, Tammen AR, Rieber J, Siebert U, Henneke KH, Uberfuhr P, Reichart B, Theisen K, Angermann CE: Diagnostic and prognostic value of serial dobutamine stress echocardiography for noninvasive assessment of cardiac allograft vasculopathy. Circulation 1999; 100: 509–515 [DOI] [PubMed] [Google Scholar]
  • 75. Kono T, Nishina T, Morita H, Hirota Y, Kawamura K, Fujiwara A: Usefulness of low‐dose dobutamine stress echocardiography for evaluating reversibility of brain death‐induced myocardial dysfunction. Am J Cardiol 1999; 84: 578–582 [DOI] [PubMed] [Google Scholar]

Articles from Clinical Cardiology are provided here courtesy of Wiley

RESOURCES