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European Heart Journal 1995 16(Supplement J):26-30; doi:10.1093/eurheartj/16.suppl_J.26
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

Dipyridamole and dobutamine: Competitors or allies in pharmacological stress echocardiography?

M. Ostojic, E. Picano*, B. Beleslin, A. Djordjevic-Dikic, A. Distante*, J. Stepanovic, S. Stojkovic, M. Nedeljkovic, G. Stankovic, J. Saponjski, V. Kanjuh, A. L'Abbate* and S. Nedeljkovic

University Institute for Cardiovascular Disease Belgrade, Serbia, Italy
* CNR, Institute of Clinical Physiology Pisa, Italy

Correspondence: Miodrag Ostojic. MD. PhD. University Institute for Cardiovascular Diseases. 8 Koste Todorovica, Belgrade, Serbia

Stress echocardiography has become an accepted and cost-effective method for diagnosing coronary artery disease. However, as exercise stress echocardiography is a demanding technique, difficult to reproduce, pharmacological stress echocardiography has become very popular in recent years. The two most popular tests from the pharmacological stress echocardiography arena are dipyridamole and dobutamine. They have enabled the technical limitations inherent in exercise echocardiography to be overcome, and have provided the opportunity to obtain, during stress, images of unchanged quality in comparison to baseline. However, the sensitivity of both pharmacological stresses applied separately is less than ideal in patients with milder forms of coronary artery disease and in patients under therapy. To overcome this, a new generation of pharmacological stress tests, the combined dipyridamole-dobutamine tests were introduced. A combined dipyridamole-dobutamine echocardiography stress test should suggest that the agents are natural allies rather than competitors but in some instances they are applicable only in selected patients, and each pharmacological agent may be clinically contraindicated for administration. This is the message from a large scale study of recent years.

Key Words: Dipyridamole • dobutamine • stress echocardiography • coronary artery disease


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