Exercise (EX) and dobutamine stress echocardiography (DSE) has not been standardized for evaluation of diastolic function. Methods: We performed EX and DSE (up to 30 關g/kg/min) in 50 normal controls (31 men; age 30짹5 years). Graded bicycle EX started at 25 W; workload was increased stepwise by 25 W at 3-minute intervals. The starting dobutamine dose was 5 關g/kg/min, which was increased to 10, 20, and 30 關g/kg/min. At each stage of both tests, comprehensive echocardiographic measurement of left ventricular (LV) volume, systolic (S`), early (E`) and late (A`) diastolic annular velocity and transmitral inflow velocities (E and A) was done. Results: Similar heart rate-pressure product was achieved at workload of 75 W in EX and dobutamine dose of 30 關g/kg/min. Increase of heart rate (82짹29 vs 46짹26%, p<0.001) was more prominent in EX, and systolic BP (33짹14 vs 51짹20%, p<0.001) in DSE; although LV ejection fraction increased in both tests, progressive decrease of LV volume was characteristic in EX, whereas LV diastolic volume increased in DSE. All Doppler indices including E, S`, and E` showed gradual increase during testing. Despite similar peak double product, increase of S` (57짹21 vs 92짹30%, p<0.001) was significantly greater in DSE, whereas increase of E (79짹31 vs 42짹24%, p<0.001) and E` (59짹28 vs 19짹18%, p<0.001) in EX. E/E` did not change significantly in both tests. Conclusions: Diastolic Doppler indices showed more prominent changes during exercise testing than during dobutamine infusion despite similar peak double product.