Q63 – 72: Cardiac Assessments

*Cardiac Assessments
Report cardiac assessments prior to the start of the preparative regimen / infusion using results measured within 60 days prior to the start of the preparative regimen. If the assessment was performed multiple times, report the closest value to the start of the preparative regimen.

Question 64: Was an echocardiogram performed?

Indicate if an echocardiogram was performed within 60 days prior to the start of the preparative regimen / infusion.

If an echocardiogram was not performed or it is not known if performed, report No or Unknown, respectively, and continue with Cardiac iron T2 imaging.

The Unknown option be selected sparingly and only when no information is available to determine if an echocardiogram was performed at any time prior to the start of the preparative regimen / infusion.

Questions 65 – 68: 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 reported and provide the percentage(s). If the LVEF and left ventricular shortening fraction were assessed, report the results of both. If the LVEF or left ventricular shortening fraction were assessed multiple times, report the most recent value(s).

Report No if both the LVEF and left ventricular shortening fraction were not reported.

Additionally, indicate whether the echocardiogram report is attached to this form. For instructions on how to attach documents in FormsNet3^SM, refer to the Training Guide.

Question 69-70: Cardiac iron T2 imaging

Indicate if cardiac iron T2 imaging is known within 60 days prior to the start of the preparative regimen / infusion. If Known, specify the value and units of measurement. If the cardiac iron T2 imaging was done multiple times, report the most recent assessment prior to the start of the preparative regimen.

Questions 71 – 72: 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. Confirm with the attending physician on where to locate immunoassay results measuring BNP, if available.

Indicate if the BNP was assessed at any time between diagnosis and the start of the preparative regimen. 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.

Section Updates:

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