It is a trial aimed to evaluate the ejection fraction in the preoperative phase and during follow-up in two groups of subjects undergoing major orthopedic surgery: the first consisting of subjects without history of cardiac disease, and the second from subjects with a history of cardiopulmonary disease

Inclusion Criteria:

• Age: < or equal 18 and > or equal 85 years
• major orthopedic surgery
• rehabilitation at our site
• a positive history for the cardiopathic group

Exclusion Criteria:

• Age: > 85 and < 18
• impossibility to participate to the rehabilitative protocol or come to the follow up visit
• lack of consensus
• previous acute cerebrovascular and / or cardiological events within 6 months prior to enrollment
• previous myocardial (percutaneous and / or surgical) revascularization interventions within the 6 months prior to enrollment
• previous (even in pediatric age) interventions of surgical correction of congenital heart disease
• severe heart failure
• reimplantation of prosthesis

the population consists of 188 subjects (94 subjects for the cardiopathic arm and 94 subjects for the non-cardiopathic arm) undergoing to major orthopedic surgery (hip and knee prosthesis)