Pharmacologic stress echocardiography in the assessment of coronary arterydisease

Pharmacologic stress echocardiography has gained widespread popularity in r ecent years because it is more feasible for the patient and less technicall y demanding for the echocardiographer than exercise stress testing. The two most popular pharmacologic stresses are dobutamine and dipyridamole. These agents provide similar prognostic value and diagnostic accuracy for angiog raphically assessed coronary artery disease; dobutamine has marginally high er sensitivity in single-vessel disease, and dipyridamole has marginally hi gher specificity in patients with normal coronary arteries. Both stresses a re safe, but a physician should always be in attendance when they are admin istered: Life-threatening reactions can occur in one of 300 to 500 cases wi th dobutamine and in one of 700 to 1500 cases with dipyridamole, For dipyri damole and dobutamine echocardiography, outcome data are available from mul ticenter, international, observational, prospective studies, such as the EP IC (Echo Persantine International Cooperative) and EDIC (Echo Dobutamine in ternational Cooperative) studies. (C) 1999 Lippincott Williams & Wilkins, I nc.