Dobutamine, a pharmacologic stressor, is useful for myocardial perfusion imaging in patients who cannot exercise. Patients with asthma or severe chronic obstructive pulmonary disease who are at risk for adverse effects from either dipyridamole or adenosine are prime candidates for dobutamine perfusion studies. Dobutamine is a predominant beta-1 agonist that increases heart rate, myocardial contractility and systolic blood pressure. The sensitivity and specificity of dobutamine myocardial perfusion imaging are comparable, for the most part, to those from perfusion studies using exercise, dipyridamole or adenosine.