Accuracy of Dobutamine Stress Echocardiography as A Predictor for Major Adverse Cardiovascular Events in Patients with Reduced Exercise Capacity Undergoing Major Non-Cardiac Surgery

Introduction Death and complication rates after major non cardiac surgeries are not rare, major morbidity complicates 3–16% of all inpatient surgical procedures in developed countries, with permanent disability or death rates of about 0·4–0·8%. Nearly half of the adverse events in these studies were identified as preventable [1]. Annually about 10 million patients develop major adverse cardiac events (MACE) within 30 days post major surgeries [2]. Proper preoperative cardiovascular evaluation could minimize this risk and should assess the decision‐making regarding risk reduction and optimal timing of surgery [3]. Previous guidelines recommended cardiac stress testing for patients with estimated preoperative risk of MACE >1% and poor exercise tolerance of less than four metabolic equivalents (METS) [4]. The role of DSE in preoperative risk assessment in patients undergoing non-cardiac surgery has been evaluated in several studies [5]. ABSTRACT Background: Before major non cardiac surgeries, non-invasive functional testing widely indicated for evaluating patients with reduced exercise capacity.