Top Things to Know: 2021 ACC/AHA Key Data Elements and Definitions for Heart Failure
Published: March 23, 2021
- This document (an update of the 2005 “ACC/AHA Key Data Elements and Definitions for Measuring the Clinical Management and Outcomes of Patients With Chronic Heart Failure”) presents a clinical lexicon comprising data elements related to heart failure (HF), without differentiation for chronic HF versus acute decompensated HF; inpatient versus outpatient; or medical management with or without palliative care, or hospice. Because HF is a chronic condition, and a patient can experience periodic acute decompensation, the writing committee considered data elements that are pertinent to the full range of care provided to these patients and intended to be useful for all care venues.
- Data elements for HF risk factors, cardiovascular history, and noncardiovascular health determinants, including COVID-19 infection, are included.
- Patient assessment with more detailed elements for symptoms, signs and physical exam findings, stages, and functional assessment were updated.
- Structural and ejection fraction sub-phenotypes were added, including data elements for heart failure with reduced ejection fraction (HFrEF), heart failure with mid-range ejection fraction (HFmEF), and heart failure with preserved ejection fraction (HFpEF).
- Data elements related to cause of HF and cardiomyopathy were added, emphasizing the importance of specific diagnoses such as cardiac amyloidosis and peripartum cardiomyopathy.
- Data elements for noninvasive and invasive diagnostic modalities (echocardiogram, cardiac MRI, cardiopulmonary exercise testing, left and right heart catheterization) were expanded and updated.
- Data elements for invasive therapeutic procedures, device therapies, and percutaneous mechanical circulatory support devices were added.
- Pharmacological treatment options with new classes of medications were updated, and new data elements for new classes of medications were added.
- Data elements for patient education and counseling on self-care and patient-reported outcome measures were added.
- These clinical data standards should be broadly applicable in various settings, including clinical programs such as HF clinics, transitions of care, clinical registries, clinical research, quality performance improvement initiatives, electronic health records and digital health information technology interoperability, public reporting programs, and education/self-care.
Citation
Bozkurt B, Hershberger RE, Butler J, Grady KL, Heidenreich PA, Isler ML, Kirklin JK, Weintraub WS. 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) [published online ahead of print March 23, 2021]. Circ Cardiovasc Qual Outcomes. doi: 10.1161/HCQ.0000000000000102