Perioperative Management of Novel Pharmacotherapies for Heart Failure and Pulmonary Hypertension

Anesthesiol Clin. 2024 Mar;42(1):117-130. doi: 10.1016/j.anclin.2023.09.004. Epub 2023 Oct 14.


Heart failure (HF) and pulmonary hypertension (PH) are increasingly prevalent comorbidities in patients presenting for noncardiac surgery. The unique pathophysiology and pharmacotherapies associated with these syndromes have important perioperative implications. As new medications for HF and PH emerge, it is imperative that anesthesiologists and other perioperative providers understand their mechanisms of action, pharmacokinetics, and potential adverse effects. We present an overview of the novel HF and PH pharmacotherapies and strategies for their perioperative management.

Keywords: Angiotensin receptor-neprilysin inhibitor; Endothelin receptor antagonist; Heart failure; Nitric oxide pathway mediator; Perioperative pharmacotherapy; Prostacyclin agonist; Pulmonary hypertension; Sodium-glucose cotransporter 2.

Publication types

  • Review

MeSH terms

  • Heart Failure* / complications
  • Heart Failure* / drug therapy
  • Humans
  • Hypertension, Pulmonary* / drug therapy