Three studies (n=341) were conducted exclusively in women; sample sizes ranged from 26 to 158 participants. Two studies compared dobutamine stress echocardiography with exercise ECG and noninvasive imaging techniques, where the reference standard was coronary angiography. In both of these studies the specificity of pharmacological stress echocardiography was higher than either thallium scintigraphy, sestamibi single-photon emission computed tomography (MIBI-SPECT) or exercise ECG, but the sensitivities were similar. A third study, which used a clinical algorithm incorporating the three tests being evaluated and coronary angiography as the reference standard (applied where other test results were positive or indeterminate), indicated higher specificity for pharmacological stress echocardiography than for exercise stress echocardiography or ECG; sensitivity data were of limited value, as only four participants were diagnosed with coronary artery disease. In one study, pharmacological stress testing resulted in smaller increases in heart rate and systolic blood-pressure than exercise.
Two studies (n=71, of which 20 were female) of mixed populations compared dobutamine stress echocardiography with MIBI-SPECT and 210-thallium exercise SPECT, respectively. The first used a clinical algorithm in combination with the index test as the reference standard, while the second did not report a reference standard. The results of these two studies were consistent with those obtained from the studies of exclusively female populations.
Adverse effects, where reported, were mild and transient.