Integrated use of natriuretic peptides and DASI for cardiac reserve evaluation in high-risk surgical patients: a narrative review

The perioperative management of high-risk patients undergoing major noncardiac surgery remains a significant challenge in modern healthcare. Accurate preoperative risk stratification is crucial for optimizing patient outcomes and resource allocation. This narrative review explores the emerging approach of combining natriuretic peptide measurements with the Duke Activity Status Index (DASI) to evaluate cardiac reserve in high-risk surgical patients. We examine the individual roles of natriuretic