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©2013 UpToDate ® Print Email ACC/AHA guideline summary: Preoperative noninvasive evaluation of left ventricular (LV) function Class IIa - The evidence or opinion is in favor of benefit from preoperative noninvasive evaluation of LV function prior to noncardiac surgery in the following settings: • Patients with dyspnea of unknown origin • Patients with current or prior heart failure with worsening dyspnea or other changes in clinical status who have not undergone testing within 12 months Class IIb - The weight of evidence or opinion is less well established for the benefit of preoperative noninvasive evaluation of LV function • Routine evaluation Class III - There is evidence and/or general agreement that preoperative noninvasive evaluation of LV function prior to noncardiac surgery is not useful in the following setting: • Routine testing Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. J Am Coll Cardiol 2007; 50:e159.