DOBUTAMINE STRESS echocardiography (DSE) has been widely used as adiagnostic and prognostic modality in the management of STRESS. DSE isassociated with limited complications and adverse effects on the health ofpatients. In this case report, we described a 42-year-old female patientwith DOBUTAMINE-induced coronary artery spasm with history ofexertional dyspnea, which had deteriorated recently. No risk factors ofcoronary artery disease were observed in the patient, and she hadprevious non-diagnostic exercise tolerance test. DSE was performed on thepatient, and at the end of the infusion rate of 30 mcg/min, retrosternalpain was detected. Standard 12-lead electrocardiogram was indicative ofST segment elevation in inferior leads. Moreover, echocardiographicimaging of the patient revealed concomitant akinesia in the right coronaryartery. On the other hand, subsequent coronary angiograms showed onlymild coronary atherosclerosis.

Dear Editor, I read with interest the article by Chandraprakasam et al. published ahead of print on May 23, 2015 in the Journal, about a 48 year-old woman, whosuffered an episode of midventricular Takotsubo syndrome (TTS), in the setting of a DOBUTAMINE STRESS testing (DST) carried out for evaluation of an intermittent chest pain, and from which she had an excellent recovery (1). . . .

Dear Editor: DOBUTAMINE STRESS echocardiography is one of the several noninvasive methods for detection of coronary artery disease (1). New regional wall motion abnormalities have been reported in DOBUTAMINE STRESS echocardiograpghy after intravenous beta blocker administration (2, 3) Thus, this method has been recommended for increasing the test sensitivity (4).

Background: For the evaluation of coronary artery disease simultaneous DOBUTAMINE STRESS myocardial perfusion imaging and DOBUTAMINE STRESS echocardiography (DSE) assessed for a head to head comparison regarding the diagnostic accuracy of the two tests. The objective was to investigate the sensitivity, specificity, diagnostic accuracy of DSE and DOBUTAMINE STRESS SPECT‐MPI with Tc‐99m tetrofosmin in the detection of coronary artery disease (CAD).Materials and Methods: A total 80 patients with mean age 55.0±1.02 years were included in this study. All patients underwent simultaneous DSE followed by DOBUTAMINE STRESS myocardial perfusion imaging in a single day STRESS –est protocol with Tc‐99m Tetrofosmin. Coronary angiogram was performed within one month of the perfusion scan.Results: The overall sensitivity, specificity, diagnostic accuracy of DOBUTAMINE STRESS perfusion imaging for the detection of CAD were 96.9%, 62.5% and 90% respectively. Positive predictive value was 91% and negative predictive value was 83.3% for DOBUTAMINE STRESS myocardial perfusion. For the detection of CAD the sensitivity of MPI and DSE were 96.9 and 92.2% (p>0.05), while the specificity was 62.5 and 75% respectively (p>0.05). The negative predictive value of MPI was somewhat higher (83.3%) than that of DSE (70.6%), although the difference between the two did not reach the level of significance (p=0.064).The predictive accuracies of MPI (90%) and DSE (88.7%) were also fairly comparable (p>0.05).Conclusion: Compare to DSE DOBUTAMINE STRESS myocardial perfusion demonstrated higher sensitivity but was low in specificity.

Background- Several well-established echocardiographic parameters such as tricuspid annular plane systolic excursion (TAPSE), right ventricular outflow tract (RVOT) fractional shortening (FS), myocardial performance index, and Doppler tissue imaging have been used for the assessment of right ventricular (RV) performance. The aim of this study was to evaluate the response of various parameters of RV function to DOBUTAMINE infusion in healthy individuals.Methods- Thirty-eight participants with negative DOBUTAMINE STRESS testing for the left ventricle and with a mean age of 57 years (range: 40-85 yrs) underwent echocardiography, including measurement of TAPSE, fractional shortening (FS), and TDI (S velocity, strain and strain rate of base, mid, and apex) of the right ventricle at rest and after DOBUTAMINE infusion according to standard DOBUTAMINE STRESS testing (DSE) for the evaluation of changes in RV function after DSE.Results- There were significant increases in S velocity (61.1%, P<0.001), FS (19.7%, P<0.001), TAPSE (6.4%, PV=0.026), strain rate (SR) in base (201%), apex (114%) and mid-wall (71%, all P<0.001), and strain in the apical portion (21%, PV=0.001) after DOBUTAMINE. There was no significant difference in SR between the RV free wall segments, but strain at mid-segment was more than that in the apical and basal segments at rest.Conclusion- All RV performance parameters increased with the infusion of DOBUTAMINE. The mean values for strain rate were homogenous in basal, mid, and apical segments at rest and significantly increased in all the segments. This was in marked contrast to mean strain values, which were greatest in the mid part of the RV free wall at rest and increased only in the apical segment after DSE.