Heart rate recovery after orthostatic challenge and cardiopulmonary exercise testing in older individuals: prospective multicentre observational cohort study.

Background: Impaired vagal function in older individuals, quantified by the 'gold standard' delayed heart rate recovery after maximal exercise (HRR), is an independent predictor of cardiorespiratory capacity and mortality (particularly when HRR ≤12 beats min). Heart rate also often declines after orthostatic challenge (HRR), but the mechanism remains unclear. We tested whether HRR reflects similar vagal autonomic characteristics as HRR.

Peak power output testing: novel method for preoperative assessment of exercise capacity.

Background: Assessment of exercise capacity is an important component of risk assessment before major surgery. Cardiopulmonary exercise testing (CPET) provides comprehensive assessment but is resource-intensive, limiting widespread adoption. Measurement of a patient's peak power output (PPO) using a simplified test on a cycle ergometer has the potential to identify patients likely to have abnormal CPET findings and to be at increased perioperative risk.

Assessment of the Frail Patient With End-Stage Liver Disease: A Practical Overview of Sarcopenia, Physical Function, and Disability.

Frailty has emerged as a powerful predictor of clinical outcomes (e.g., decompensation, hospitalization, mortality) in patients with end-stage liver disease (ESLD).

Predicting morbidity in liver resection surgery: external validation of the revised frailty index and development of a novel predictive model.

Background: Perioperative complications of liver resection surgery are common but individual patient-level prediction is difficult. Most risk models are unvalidated and may not be clinically useful. We aimed to validate a risk prediction model for complications of liver resection, the Revised Frailty Index (rFI), at a high volume centre.

Perioperative Management of a Patient With Decompensated Upper Limb Arteriovenous Malformation Undergoing Shoulder Disarticulation: A Case Report.

Surgical resection of arteriovenous malformations (AVMs) is indicated in the presence of life-threatening and severe morbidity, including symptomatic heart failure, ischemic pain, and recurrent bleeding, where other less invasive treatment strategies have been unable to halt the progression of disease. We present the challenges encountered in the perioperative care of a 23-year-old man with high output cardiac failure, gangrenous hand, and severe chronic pain undergoing shoulder disarticulation for a high-flow complex AVM of the upper limb.

Diagnosis of apical hypertrophic cardiomyopathy: T-wave inversion and relative but not absolute apical left ventricular hypertrophy.

Background: Diagnosis of apical HCM utilizes conventional wall thickness criteria. The normal left ventricular wall thins towards the apex such that normal values are lower in the apical versus the basal segments. The impact of this on the diagnosis of apical hypertrophic cardiomyopathy has not been evaluated.