The aim of the study was to determine the sensitivity and specificity of combined high-dose dipyridamole and dobutamine stress echocardiography (stress EchoCG) in the diagnosis of coronary artery stenotic lesions in coronary heart disease in a group of patients who were unable to perform physical exercise, by using different assessment criteria (local contractile impairments and systolic velocity changes during tissue Doppler imaging). The study enrolled 68 men who had undergone dipyridamole and dobutamine stress EchoCG, longitudinal tissue Doppler imaging, and coronary angiography. Stress EchoCG could bring up to diagnostic criteria in all the patients. Coronary angiography revealed no coronary artery lesion in 18 patients, but showed single and multiple vascular lesions in 31 and 19 patients, respectively. The sensitivity and specificity of combined stress EchoCG were significantly higher than those of stress EchoCG examination. The results of combined stress EchoCG allow one to judge to a greater validity (96% sensitivity and 100% specificity) local contractile impairments corresponding to the blood supply area in the atherosclerosis-afflicted coronary artery. Analysis of systolic velocity parameters during tissue Doppler imaging permits the diagnostic value of the technique to be insignificantly improved particularly when the test results are controversial.
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