Question 256: Was the left ventricular ejection fraction measured?

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). Indicate if the left ventricular ejection fraction (LVEF) was measured at the last evaluation prior to the start of the preparative regimen. If “yes,” continue with question 257. If “no,” continue with question 259.

Question 257: Specify results of left ventricular fraction:

Indicate the left ventricular ejection fraction at the last evaluation prior to the start of the preparative regimen. Most imaging reports will report the LVEF. If the LVEF is not explicitly documented it should be determined by dividing the stroke volume (SV, the volume of blood pumped into the aorta from the left ventricle) by the end diastolic volume (EDV, the volume of blood in the left ventricle just prior to contraction) of the left ventricle. For example, if the stroke volume was 75 ml and the end diastolic volume was 150 ml, the ejection fraction would be 50%.

Question 258: Specify the method used to determine the left ventricular ejection fraction:

Indicate the method used to determine the LVEF reported in question 258.

Question 259: Was diastolic dysfunction present?

Diastole is the period in which chambers of the heart fill with blood. Diastolic dysfunction may be characterized by the difficulty of the ventricles to expand and contract appropriately due to stiffening of the heart walls by amyloid deposits. Indicate if diastolic dysfunction was present at the last evaluation prior to the start of the preparative regimen. Specify “yes,” “no,” or “unknown,” and continue with question 260.

Questions 260-261: Specify the intraventricular septal wall thickness measured by echocardiogram:

The heart is divided into the right and left sides by the septum. The area between the left and right ventricles is the intraventricular septum. Indicate if the intraventricular septal thickness is “known” or “unknown.” If “known,” based on evaluation by echocardiogram, indicate the thickness of the intraventricular septal wall in question 261. If “unknown” or not measured by echocardiogram, continue with question 262.

Questions 262-263: Specify left ventricular (LV) strain percentage:

A strain pattern, as determined by electrocardiography, is a well-recognized marker of hypertrophy of the left ventricular (LVH) and is characterized by ST depression and T wave inversion on a resting ECG / EKG. The LV strain percentage is typically a negative percentage. The normal range for the LV global longitudinal strain (LV GLS) is -15.9% to -22.1%. Indicate if the left ventricular strain percentage is “known” or “unknown.” If “known,” based on evaluation by electrocardiogram, indicate the strain percentage in question 263. If “unknown,” or not measured by electrocardiogram, continue with question 264.

Questions 264-265: Were any serum cardiac biomarkers assessed?

Assessment of cardiac biomarkers helps determine if injury to cardiac tissue has occurred. Cardiac biomarkers include brain natriuretic peptide (BNP), N-terminal prohormone brain natriuretic peptide (NT-proBNP), Troponin I, and Troponin T. Indicate if serum cardiac biomarkers were assessed at the last evaluation prior to the start of the preparative regimen. If “yes,” report the date assessed in question 265. If “no” or “unknown” continue with question 281.

Questions 266-267: Brain natriuretic peptide (BNP):

Indicate if the BNP was assessed at the last evaluation prior to the start of the preparative regimen. If “yes,” report the value (in pg/mL) in question 267 and continue with question 268. If “no,” continue with question 269.

Question 268: Upper limit of normal for BNP:

Indicate the upper limit of normal for BNP (in pg/mL) found on the laboratory report.

Questions 269-270: N-terminal prohormone brain natriuretic peptide (NT-proBNP):

Indicate if the NT-proBNP was assessed at the last evaluation prior to the start of the preparative regimen. If “yes,” report the value (in pg/mL) in question 270 and continue with question 271. If “no,” continue with question 272.

Question 271: Upper limit of normal for NT-proBNP:

Indicate the upper limit of normal (in pg/mL) for NT-proBNP found on the laboratory report.

Questions 272-273: Troponin I:

Indicate if the Troponin I was assessed at the last evaluation prior to the start of the preparative regimen. If “yes,” report the value (in µg/L) in question 273 and continue with question 274. If “no,” continue with question 275.

Question 274: Upper limit of normal for troponin I:

Indicate the upper limit of normal (in µg/L) for Troponin I found on the laboratory report.

Questions 275-276: Troponin T:

Indicate if the Troponin T was assessed at the last evaluation prior to the start of the preparative regimen. If “yes,” report the value (in µg/L) in question 276 and continue with question 277. If “no,” continue with question 278.

Question 277: Upper limit of normal for Troponin T:

Indicate the upper limit of normal (in µg/L) for Troponin T found on the laboratory report.

Questions 278-279: High-sensitivity troponin T:

Indicate if the high-sensitivity troponin T was assessed at the last evaluation prior to the start of the preparative regimen. If “yes,” report the value (in ng/L) in question 279 and continue with question 280. If “no,” continue with question 281.

Question 280: Upper limit of normal for high-sensitivity troponin T:

Indicate the upper limit of normal (in ng/L) for high-sensitivity troponin T found on the laboratory report.

Questions 281-282: Was a 6-minute walk test performed?

A 6-minute walk test is used to assess total distance walked within 6 minutes to determine aerobic capacity and endurance. Indicate if a 6-minute walk test was performed at the last evaluation prior to the start of the preparative regimen. If “yes,” report the total distance walked and specify the unit of measure in question 282. If “no,” continue with question 283.

Question 283: Specify the recipient’s New York Heart Association functional classification of heart failure: (Symptoms may include dyspnea, chest pain, fatigue, and palpitations; activity level should be assessed with consideration for patient’s age group)

Indicate the recipient’s New York Heart Association functional classification at the last evaluation prior to the start of the preparative regimen using the following guidelines:

  • Class I – Able to perform ordinary activities without symptoms; no limitation of physical activity
  • Class II – Ordinary physical activity produces symptoms; slight limitation of physical activity
  • Class III – Less-than-ordinary physical activity produces symptoms; moderate limitation of physical activity
  • Class IV – Symptoms present even at rest; severe limitation of physical activity

If the recipient’s NYHA functional classification it not known, select “unknown.”

Question 284: Recipient blood pressure:

Indicate if the recipient’s blood pressure was assessed at the last evaluation prior to the start of the preparative regimen. If “known,” continue with question 285. If “unknown,” continue with question 287.

Questions 285-286: Recipient blood pressure results:

Report the recipient’s blood pressure at the last evaluation prior to the start of the preparative regimen in question 285 and indicate in which body position the measurement was taken in question 286.

Question 287: Was hepatomegaly present on radiographic imaging (liver span > 15 cm) or on examination (liver edge palpable > 3 cm below right costal margin)?

At the last evaluation prior to the start of the preparative regimen, indicate if the liver spanned more than 15 cm (by radiographic imaging) or the edge of the liver was palpable more than 3 cm below the right costal margin (by physical examination). Indicate “yes” if hepatomegaly was present. Indicate “no” if hepatomegaly was not present. Indicate “unknown” if it was not possible to determine the presence or absence of hepatomegaly.

Questions 288-289: Specify the level of serum alkaline phosphatase:

Indicate whether the alkaline phosphatase (ALP) level at the last evaluation prior to the start of the preparative regimen is “known” or “unknown.” If “known,” report the laboratory count and unit of measure documented on the laboratory report in question 289 and continue with question 290. If “unknown,” continue with question 291.

Question 290: Upper limit of normal for alkaline phosphatase:

Report the upper limit of normal for ALP found on the laboratory report.

Section Updates:

Question Number Date of Change Add/Remove/Modify Description Reasoning (If applicable)
. . . . .
Last modified: Dec 22, 2020

Need more help with this?
Don’t hesitate to contact us here.

Was this helpful?

Yes No
You indicated this topic was not helpful to you ...
Could you please leave a comment telling us why? Thank you!
Thanks for your feedback.