Inclusion Criteria:  Adult (≥ 18 years of age) Elective surgery On-pump cardiac surgery (CABG and/or valvular surgery)  Exclusion Criteria:  Heart transplantation (HTX) ACS at presentation (< 14 days) Emergency surgery Preoperative inotropic or mechanical circulatory support Left or right ventricular assist device implantation Unwilling or unable to provide consent Inability to follow the procedures of the study, e.g. due to language barriers, psychiatric disorders, dementia