2021 ACC/AHA Key Heart Failure Data Elements and Definitions

Bozkurt B, Hershberger RE, Butler J, et al.
2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure). J Am Coll Cardiol 2021;Mar 23:[Epub ahead of print].

The following are key points to remember from the 2021 American College of Cardiology/American Heart Association (ACC/AHA) Key Data Elements and Definitions for Heart Failure (HF) document:

  1. The document provides a lexicon to standardize terms used in clinical practice for HF patients. The definitions do not differ for chronic or acute, inpatient or outpatient HF care.
  2. It includes definitions for HF risk factors including diabetes, hypertension, dyslipidemia, substance abuse, exposure to cardiotoxic agents, amyloidosis, and family history of cardiomyopathy.
  3. Elements of cardiovascular history such as angina, acute myocardial infarction, peripheral vascular disease, stroke, and atrial and ventricular arrhythmias are also defined. This includes details on congenital cardiac disease as well.
  4. Procedural details of cardiac interventions such as percutaneous coronary interventions, bypass and valvular surgeries, implantable cardioverter-defibrillator (ICD), and cardiac resynchronization therapy (CRT) are also included.
  5. Various noncardiovascular comorbidities such as renal disease, pulmonary disease, dementia, sleep apnea, and autoimmune disorders have detailed definitions provided. Notably, infections include coronavirus disease 2019 (COVID-19) with its detailed cardiac and noncardiac manifestations in the data elements.
  6. The document also specifies definitions of patient symptoms related to HF such as dyspnea, bendopnea, and orthopnea, to name a few. Similarly, HF signs on physical exam also have specific definitions provided.
  7. Additional characterization of HF by ACC/AHA staging and New York Heart Association class is specified. HF with reduced ejection fraction (EF) is defined as EF ≤40%, HF with preserved EF as EF >50%, and HF with midrange EF as EF >40% and <50%.
  8. Notably, the document includes patient health status as determined by various validated measures such as the Kansas City Cardiomyopathy Questionnaire, among others.
  9. Noninvasive and invasive diagnostic measures such as echocardiogram, stress testing, and coronary angiography have clearly defined data elements. This includes procedures such as cardiopulmonary exercise testing with details on its components. It also provides definitions on indices of volume overload by indirect measurements from ICD, implanted left atrial pressure monitoring systems.
  10. Elements for pharmacological therapeutics including dose and class of medications are also provided.
  11. There is also an appendix for end-of-life management as well as patient education and counseling.

Clinical Topics: Arrhythmias and Clinical EP, COVID-19 Hub, Diabetes and Cardiometabolic Disease, Dyslipidemia, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Prevention, Vascular Medicine, Atherosclerotic Disease (CAD/PAD), Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Interventions and Imaging, Interventions and Vascular Medicine, Angiography, Echocardiography/Ultrasound, Nuclear Imaging, Hypertension, Sleep Apnea

Keywords: Amyloidosis, Arrhythmias, Cardiac, Autoimmune Diseases, Cardiac Resynchronization Therapy, Cardiomyopathies, Cardiotoxins, Coronary Angiography, Coronavirus, COVID-19, Dataset, Defibrillators, Implantable, Dementia, Diabetes Mellitus, Dyslipidemias, Dyspnea, Echocardiography, Exercise Test, Health Status, Heart Failure, Hypertension, Myocardial Infarction, Percutaneous Coronary Intervention, Peripheral Vascular Diseases, Pharmaceutical Preparations, Physical Examination, Risk Factors, Secondary Prevention, Sleep Apnea Syndromes, Stroke, Stroke Volume, Substance-Related Disorders, Ventricular Dysfunction, Left

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