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Left ventricular systolic dysfunction is common postoperatively and is treated with optimization of preload, maintenance of a high normal heart rate (e.g., with pacing at 90/min), and inotropic support (see Chapter 21). Echocardiography and a pulmonary artery catheter are helpful to guide therapy.
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LVEF can be normal in the presence of impaired LV systolic function, since it does not reflect intrinsic myocardial contractility. 1 In addition, LVEF is highly load-dependent and suffers from significant intraobserver and interobserver variability. 2 Assessment of myocardial strain can potentially overcome many of the limitations of LVEF in ass.
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