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See doi:10.1016/S1095-668X(03)00099-Xfor the article to which this editorial refers Both the practice and indications for dobutamine stress echocardiography (DSE) have changed over the past 15 years. At first DSE was the prerogative of a few enthusiastic cardiologists working at specialized centres, but this technique has developed into a commonly used practical tool with widespread availability. In the early years DSE was used for the assessment of coronary artery disease; test results were either positive or negative. Nowadays the scope of DSE has expanded to the detection of viable myocardium in patients with heart failure, preoperative cardiac risk assessment and prognostication for late cardiac events. The introduction of technical advances such as quad-screen format, second harmonic imaging, and contrast agents have substantially improved the image quality. Thus, even in the case of patients with poor image quality and chronic pulmonary disease it is now possible to examine these patients. A recent development in DSE is the introduction of semi-quantitative stress test results to assess the severity of coronary artery disease. Myocardial ischaemia was described according to the extent (number of segments), severity (hypokinesia, akinesia, or dyskinesia), and the heart rate at which …

Dobutamine echocardiography: a diagnostic tool comes of age