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

Willem-Jan Flu1, Jan-Peter van Kuijk, Wael Galal

  • 1Department of Anesthesia, Erasmus Medical Center, Rotterdam, The Netherlands.

European Journal of Heart Failure
|January 26, 2010
PubMed

Insights

Left-ventricular (LV) dysfunction is common in vascular surgery patients, yet guideline-recommended treatments are underused. Pre-operative evaluation can help bridge this gap in care for improved patient outcomes.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Cardiovascular Imaging

Background:

  • Left-ventricular (LV) dysfunction is a significant concern in patients undergoing vascular surgery.
  • Current guidelines recommend specific pharmacological treatments to manage LV dysfunction.

Purpose of the Study:

  • To evaluate the prevalence of LV dysfunction in vascular surgery patients.
  • To assess the utilization of guideline-recommended pharmacological treatments for LV dysfunction.

Main Methods:

  • Pre-operative echocardiography was performed in 1,005 vascular surgery patients.
  • LV dysfunction was defined by left ventricular ejection fraction (LVEF) and diastolic parameters.
  • Optimal pharmacological treatment was defined according to ESC guidelines.

Main Results:

  • 50% of patients (506/1005) exhibited LV dysfunction.
  • Prevalence included asymptomatic diastolic (41%), asymptomatic systolic (39%), and symptomatic heart failure (20%).
  • Guideline-recommended treatment initiation/improvement was suboptimal, particularly for ACE-I/ARB and beta-blocker therapy.

Conclusions:

  • A high prevalence of LV dysfunction exists in vascular surgery patients.
  • There is significant under-utilization of recommended pharmacological treatments.
  • Standardized pre-operative LV function assessment is crucial to address this care gap.
Abstract

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