Question 14: Were lipid profiles assessed?

A lipid profile is a blood test that measures the amount of cholesterol and triglycerides within the blood. Indicate if lipid profiles were assessed since the date of last report. If lipid profiles were assessed in the current reporting period, report Yes. If lipid profiles were not assessed or if no information is available to determine if lipid profiles were evaluated during the current reporting period, report No or Unknown, respectively.

Questions 15 – 19: Specify which lipids were assessed (check all that apply)

Indicate which lipids were assessed and report the value in mg / dL. Select all that apply. If multiple lipid profile assessments were performed, report the results of the most recent assessment.

Question 20: Was an echocardiogram performed?

Indicate if an echocardiogram was performed since the date of last report. If an echocardiogram was performed during the current reporting period, report Yes. If an echocardiogram was not performed or if no information is available to determine if an echocardiogram was performed, select No or Unknown, respectively and go to question 27.

Questions 21 – 22: Was tricuspid regurgitant jet velocity (TRJV) measured?

Tricuspid regurgitant jet velocity (TRJV) measurements are used in determining the pulmonary artery pressure for recipients with sickle cell and other hemolytic disorders. An elevated TRJV is an indication of pulmonary hypertension, a condition common in adults with hemolytic diseases. TRJV is typically documented in the echocardiogram report.

Report Yes if TRJV was measured in the current reporting period and provide the TRJV value as documented on the echo report. If the TRJV was measured multiple times in the reporting period, report the most recent value. Report No if TRJV was not assessed or is not documented on the echo report.

Questions 23 – 25: Was left ventricular ejection fraction (LVEF) or left ventricular shortening fraction reported?

The left ventricular ejection fraction (LVEF) is a percentage that represents the volume of blood pumped from the left ventricle into the aorta (also known as stroke volume) compared to the volume of blood in the ventricle just prior to the heart contraction (also known as end diastolic volume). The left ventricular shortening fraction is the percentage change in cavity dimensions of the left ventricle with systolic contraction.

Report Yes if either the LVEF or left ventricular shortening fraction were assessed in the current reporting period and provide the percentage(s). If the LVEF or left ventricular shortening fraction were assessed multiple times in the reporting period, report the most recent value(s). Report No if the LVEF and left ventricular shortening fraction were not assessed in the current reporting period.

Question 26: Is a copy of the echocardiogram report attached?

Indicate whether an echocardiogram report is attached to this form. For further instructions on how to attach documents in FormsNet3 SM, refer to the Training Guide.

Questions 27 – 28: Was brain natriuretic peptide (BNP) assessed?

Brain natriuretic peptide (BNP) is a hormone secreted by cardiac ventricle cells in response to increased ventricular blood volume. BNP is typically measured using various immunoassay techniques.

Indicate if the BNP was assessed during the current reporting period. If Yes, report the value as documented on the laboratory report (in pg / mL). If BNP was assessed multiple times, report the results of the most recent test. If BNP was not assessed or if no information is available to determine if BNP was tested, report No or Unknown, respectively and go to question 29.

Questions 29 – 30: Is there a new onset of pulmonary hypertension? (developed since last report)

Pulmonary hypertension (PH) refers to elevated pulmonary arterial pressure and is diagnosed either by an echocardiogram or right heart catherization. PH can be due to a primary elevation of pressure in the pulmonary arterial system alone (pulmonary arterial hypertension) or secondary to elevations of pressure in the pulmonary venous and pulmonary capillary systems (pulmonary venous hypertension; post-capillary PH).

Indicate Yes if there was a new onset of pulmonary hypertension (has never been previously diagnosed) since the date of last report and specify if either an echocardiogram or right heart catherization was used to diagnose PH.

Report No in in the following scenarios:

  • There was not a new onset of PH in the current reporting period.
  • PH was diagnosed prior to HCT or in a prior reporting period, resolved, and developed in the current reporting period.
  • PH was diagnosed in a prior reporting period and persisted into the current reporting period.

If documentation is not clear or there is not enough information available to determine if PH was present, report Unknown.

Last modified: Jul 26, 2020

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