Heart failure syndromes and perioperative risk

The presence of significant valve disease or right ventricular dysfunction is associated with increased risk at any HF stage and LVEF. Among patients with HF, those with recent (eg, during the prior 3 months) hospitalization for HF generally have a worse prognosis than those with no recent HF hospitalization, irrespective of LVEF. Refer to UpToDate content on the stages of HF.

HF: heart failure; HFpEF: heart failure with preserved ejection fraction; HFmrEF: heart failure with mid-range ejection fraction; HFrEF: heart failure with reduced ejection fraction; LVEF: left ventricular ejection fraction.
* Structural heart disease includes cardiac structural or functional abnormalities such as left ventricular hypertrophy, left ventricular focal or global wall motion abnormalities, and echocardiographic evidence of diastolic dysfunction.
¶ Patients with stage C HF have had symptomatic HF and may or may not have current symptoms.
Δ Stage D is refractory HF requiring specialized interventions.

Reference:

Lerman BJ, Popat RA, Assimes TL, et al. Association of left ventricular ejection fraction and symptoms with mortality after elective noncardiac surgery among patients with heart failure. JAMA 2019; 321:572.

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Heart failure syndromes and perioperative risk