DIPYRIDAMOLE AND DOBUTAMINE - COMPETITORS OR ALLIES IN PHARMACOLOGICAL STRESS ECHOCARDIOGRAPHY

Stress echocardiography has become an accepted and cost-effective meth od for diagnosing artery disease. However, an exercise stress echocard iography is a demanding technique, difficult to reproduce, pharmacolog ical stress echocardiography has become very popular in recent years. the two most popular tests from the pharmacological stress echocardiog raphy arena are dipyridamole and dobutamine. They have enabled the tec hnical limitations inherent in exercise echocardiography to be overcom e, and have provided the opportunity to obtain, during stress images o f unchanged quality in comparison to baseline. However, the sensitivit y of both pharmacological stresses applied separately is less than ide al in patients with milder forms of coronary artery disease and in pat ients under therapy. To overcome this, a new generation of pharmacolog ical stress tests, the combined depyridamole-dobutamine tests were int roduced. A combined dipyridamole-dobutamine echocardiography stress te st should suggest that the agents are natural allies rather than compe titors but in some instances they are applicable only in selected pati ents, and each pharmacological agent may be clinically contraindicated for administration. This is the message from a large scale study of r ecent years.