Introduction: The easy accessibility of invasive coronary angiogram in stable coronary artery disease (SCAD) made fractional flow reserve (FFR) a widely applied functional test for the evaluation of moderate stenoses, although the prognostic value for hard endpoints such as mortality and myocardial infarction is equivocal. There are robust data available confirming the prognostic value of dobutamine stress echocardiography (DSE) for the same hard endpoints. In our prospective trial, we sought to compare the DSE to FFR in patients with stable coronary artery disease.Methods: SCAD patients with moderate coronary stenoses (40-80 %, diameter) were investigated both by FFR and DSE. Fractional flow reserve <0.8 or new wall motion abnormality in ≥2 contiguous myocardial segments on DSE was considered abnormal. Number of affected myocardial segments (AMS), affected segments’ wall motion score (AMS-WMS), the wall motion score index (WMSI) at peak dose of dobutamine and delta WMSI (rest/peak) were determined.Results: From 2014 december to 2016 december 92 patients (56 male, age: 62.3±7.7 years; previous PCI: 42 %; ejection fraction: 55±12.3 %; SYNTAX score: 12.3±7.5) were enrolled with 116 lesions (69 LAD, 20 LCx, 27 RCA). FFR compared to DSE has a diagnostic accuracy, positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity of 69 %, 35 %; 87 %, 58 % and 72 %, respectively. There was a significant correlation between the FFR value and AMS (r=-0.240; p<0.001), AMS-WMS (r=-0.239; p=0.001), WMSI (r=-0.255; p<0.01) and delta WMSI (r=0.195; p=0.035). If we dichotomized the FFR value (positive or negative), its association was also significant with AMS, AMS-WMS and WMSI (p<0.001; <0.001; <0.01, respectively).Conclusions: In our prospective trial, significant correlation was found between the FFR values and specific DSE parameters. Fractional flow reserve had an excellent NPV, however the PPV was poor. In SCAD patients with a positive FFR, DSE might be useful to confirm the indication of revascularisation.