Acute heart failure in non-cardiac surgery
Gualandro, Danielle M. (Universität Basel)
Masip, Josep (Universitat de Barcelona)
Halvorsen, Sigrun (University of Oslo)
Price, Susanna (Royal Brompton Hospital (Londres, Regne Unit))
Rossello, Xavier (Universitat de les Illes Baleares (UIB))
Chioncel, O. (University of Medicine Carol Davila)
Peacock, W. Frank (Baylor College of Medicine (Houston, Estats Units d'Amèrica))
Miró, Oscar (Hospital Clínic i Provincial de Barcelona)
Mebazaa, Alexandre (Université Paris Cité)
Amir, Offer (Hadassah-Hebrew University Medical Center)
Grand, Johannes (Copenhagen University Hospital Amager-Hvidovre)
Sionis, Alessandro (Institut de Recerca Sant Pau)
Tavazzi, Guido (Università di Pavia)
Arrigo, Mattia (Università della Svizzera Italiana (Lugano, Suïssa))
Mueller, Christian (Universität Basel)
Tavares Oliveira, Mucio (University of Sao Paulo Medical School)
Platz, Elke (Brigham and Woman's Hospital and Harvard Medical School)
Schaubroeck, Hannah (Universitair Ziekenhuis Gent)
Pöss, Janine (Herzzentrum Leipzig)
Verbrugge, Frederik H. (Vrije Universiteit Brussel)
Gambaro, Alessia (Azienda Ospedaliera Universitaria Integrata Verona)
Tica, Otilia (Emergency County Clinical Hospital of Bihor)
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2025
Resum:	More than 64 million people worldwide have heart failure (HF), and these numbers are expected to rise. Acute HF (AHF) is the leading cause of hospitalization in patients over 65 years old and is linked to high mortality and readmission rates. AHF may also be a frequent complication in patients hospitalized for other medical reasons as well as after cardiac or non-cardiac surgery. These three entities are summarized as secondary AHF. As secondary AHF has been largely overlooked by medical research and education, little is known about its pathophysiology, phenotypes, diagnosis, management, and prognosis. Secondary AHF occurring after non-cardiac surgery warrants particular attention due to its very high mortality rates of up to 44% within 1 year and is therefore the focus of this review. The scope of this document is to summarize the available evidence regarding the pathophysiology, prevention, diagnosis, treatment, and prognosis of AHF after non-cardiac surgery. Key to prevention is understanding and addressing the pathophysiology of AHF after non-cardiac surgery, which involves close monitoring of fluid status to avoid volume overload and/or hypovolemia, avoiding hypo- and/or hypertension, treating pain and anaemia to prevent tachycardia, and avoiding electrolyte disturbances to prevent arrhythmias. Cardiac biomarkers, such as cardiac troponins and natriuretic peptides, serve as important diagnostic tools and enhance risk stratification in the perioperative setting. A low threshold to perform echocardiography in this population is suggested. Vigilant post-operative care is essential for the early recognition and treatment of AHF after non-cardiac surgery, which could help improve outcomes for patients.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	Acute heart failure ; Heart failure ; Natriuretic peptides ; Non-cardiac surgery ; Perioperative complications
Publicat a:	European heart journal, Vol. 46, Num. 40 (21 2025) , p. 4042-4059, ISSN 1522-9645

DOI: 10.1093/eurheartj/ehaf559
PMID: 40838822

18 p, 1.5 MB

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