Prevalence and pharmacological treatment of left-ventricular dysfunction in patients undergoing vascular surgery

European Journal of Heart Failure
Willem-Jan FluD Poldermans

Abstract

This study evaluated the prevalence of left-ventricular (LV) dysfunction in vascular surgery patients and pharmacological treatment, according ESC guidelines. Echocardiography was performed pre-operatively in 1,005 consecutive patients. Left ventricular ejection fraction (LVEF) <or=50% defined systolic LV dysfunction. Diastolic LV dysfunction was diagnosed based on E/A-ratio, pulmonary vein flow, and deceleration time. Optimal pharmacological treatment to improve LV function was considered as: (i) angiotensin-blocking agent (ACE-I/ARB) in patients with LVEF <or=40%; (ii) ACE-I/ARB and beta-blocker in patients with LVEF <or=40% + heart failure symptoms or previous myocardial infarction; and (iii) a diuretic in patients with symptomatic heart failure, regardless of LVEF. Left-ventricular dysfunction was present in 506 patients (50%), of whom 209 (41%) had asymptomatic diastolic LV dysfunction, 194 (39%) had asymptomatic systolic LV dysfunction, and 103 (20%) had symptomatic heart failure. Treatment with ACE-I/ARB and/or beta-blocker could be initiated/improved in 67 (34%) of the 199 patients with (a)symptomatic LVEF <or=40%. A diuretic could be initiated in 32 patients (31%) with symptomatic heart failure (regardless of LVEF). Th...Continue Reading

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Citations

Apr 30, 2010·Current Cardiology Reports·Willem-Jan FluDon Poldermans
May 26, 2011·Expert Opinion on Drug Safety·Fabio AngeliPaolo Verdecchia
Nov 27, 2010·Journal of the American College of Cardiology·Willem-Jan FluDon Poldermans
May 27, 2010·Anesthesiology·Leanne Groban, Dalane W Kitzman

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