Backgrounds : Assessment of coronary endothelial vasomotion is important for the evaluation of patients with coronary artery disease(CAD), however, noninvasive and direct measurement method has not been developed yet. Low-dose adenosine infusion and cold water immersion have been suggested to be a method for the evaluation of endothelial-depecdent vasomotion. The aim of this study was to elucidate the usefulness of these noninvasive method in humans. Methods: In 94 subjects (mean age 53짹11 yrs, M:F=57 :37) with chest pain and normal coronary angiogram, the changes of peak diastolic velocity were measured before and during cold pressure test(CPT-CFR), the infusion of low dose adenosine (Low-CFR, 15 g/min/kg) and the infusion of high dose adenosine(High-CFR, 140 g/min/kg) with transthoracic Doppler echocardiography(TTE) in distal left anterior descending coronary artery. Results: 1. CPT-CFR was closely related to Low-CFR(r=0.472, p<0.0005)(Figure). 2. CPT-CFR and Low-CFR were closely related to High-CFR(r= 0.311, p=0.005, respectively). 3.CPT-CFR was closely related to age(r=0.226, p<0.05). 4. Low-CFR was 1.16짹0.09 in subjects with more than 2 risk factors of CAD and 1.43짹0.17 in subjects with less than 1 risk factor.(p<0.005) Conclusion: Measurement of flow reserve capacity using low-dose adenosine and cold water immersion with TTE is a promising noninvasive and direct method to assess coronary endothelial-dependent vasomotion.