Which antifungal agent should be avoided in patients with evidence of ventricular dysfunction?

Itraconazole is an antifungal agent known to have potential cardiovascular side effects, particularly with respect to ventricular dysfunction. This is primarily due to its effect on the heart and its ability to exacerbate or lead to congestive heart failure in patients who have pre-existing conditions.

Patients with ventricular dysfunction may experience worsening symptoms or an increased risk of adverse outcomes when treated with itraconazole. This is because itraconazole can cause fluid retention and has been associated with negative inotropic effects, which can compromise cardiac output in individuals with already impaired heart function.

Other antifungal agents listed do not carry the same level of risk concerning ventricular dysfunction. For instance, micafungin and terbinafine have different mechanisms and profiles that do not affect cardiac function in the same manner, while posaconazole's effects on ventricle function are not as pronounced. Therefore, due to its potential cardiovascular implications, itraconazole should be avoided in patients with evidence of ventricular dysfunction.