The authors report a case of tight aortic stenosis, without coronary artery disease, presenting with heart failure, alteration of global left ventricular contractility and a low gradient. Increasing-dose dobutamine echocardiography demonstrated an improvement of myocardial contractility and an accentuation of the transvalvular gradient. The place of this examination in the therapeutic strategy and follow-up of the disease is discussed in the light of the current data of the literature.