OBJECTIVE To investigate the usefulness of fractional area change of entire left ventricular areas obtained from apical views for quantitative analysis of dobutamine-atropine stress echocardiography in the presence of mild to moderately reduced left ventricular function and abnormal intra-thoracic heart motion after coronary artery bypass surgery. RESULTS Stress echocardiograms from 38 echogenic patients before and 3 months after bypass surgery and from 44 echogenic healthy subjects were analysed. In successfully revascularized patients the fractional area change at peak stress was correlated to the baseline left ventricular ejection fraction (r=0.54, P<0.01), whereas the increase from baseline to peak stress was constant over a wide range of baseline ejection fractions. With respect to identifying the pre-revascularization examination as diseased, the area under the receiver operator characteristics curve based on Delta fractional area change from baseline to peak stress was 0.78 (95% CI 0.55-1.00) indicating moderate accuracy comparable with the results obtained with conventional analysis. CONCLUSIONS Fractional area change of entire left ventricular cavity areas is a useful parameter for quantitative analysis of dobutamine-atropine stress echocardiography. The diagnostic properties of the parameter are not offset by moderate reduction in left ventricular function or by surgery-induced abnormal intra-thoracic heart motion.