poor

We  use it in dobutamine stress testing with good effect.no experience with dipyrodimole

The effect is poor and results are not sensitive or specific. Better in Dobutamine stress as the end results is stress in target heart rate.

I'm agree with Habib Khan.

The incremental value of atropine is poor in state-of-art protocol. The assessment of coronary flow reserve, itself, exceeds the limit of wall motion abnormalities assessment. Its use has a rational only in the protocol for  dypiridamole echostress  without CFR.

In my opinin, the add of Atropine is always a good method to reveal discrepancy between requests and supply of oxigen in a territory. I mean, from a physiologic point of wiew, one has to reach be highest double product (HR x SBP) to create a discrepancy. The discrepancy.. is dicrepancy ! It is necessari to reveal it. My habit is to record the distal CFR in at least 2 coronary arteries during Dip stress echo and this is the state of the art. Anyway, the kinesis can be affected (by steal mechanism) only when the requests are to high. Despite this  is not in GL protocol, sometimes, if HR doesn't rise with Dip alone, I add 0,5-1 mg Atropine just to create more discrepancy .  

I agree with Ketty Savino. With the accelerated DIP protocol (0.84 mg/Kg in 6 min) along with the assessment of CFR, the use of atropin provides not additive diagnostic informations. Atropin use could just make sense in the case of standard protocol without CFR assessment

We tried to use dipyridimole protocol but and we always used atropine to enhance stress. Our result and experiance were dubious and therefore we quit from dypiridamole anmd used only exercise or dobutamine stress. 

Any study which investigates the topic: stresso echo sensitivity with or without atropine? If no, I agree with Antonio Auriti that all stimuli which increase Double Product are useful.