A comparison of dobutamine infusion and exercise during radionuclide ventriculography in the evaluation of coronary arterial disease.

Twenty-six patients with "chest pain" syndrome were subjected to radionuclide ventriculography during exercise and dobutamine infusion. All 10 patients with normal coronaries were identified correctly by normal ventriculographic responses to both tests. Of 16 patients with significant coronary arterial disease, dobutamine stress identified 15 patients correctly, whereas only 12 of these had an abnormal exercise response. Three patients with one-vessel disease with a normal exercise response had an abnormal dobutamine stress response. Dobutamine radionuclide stress testing is an acceptable alternative to exercise testing in patients who cannot exercise and its incremental diagnostic yield in patients with one-vessel disease requires further evaluation.