Table 5: Suggested timing for measurement of LVEF, according to clinical scenario
| Clinical scenario: New-onset HF |
|---|
| Timing of measurement |
| Immediately or within 2 weeks for baseline assessment |
| Modality of measurement |
| ECHO (preferred when available); or CMRI |
| Comments |
| Report should include numeric EF or small range of EF and diastolic function evaluation |
| Clinical scenario: Following titration of triple therapy for HFrEF, or consideration of ICD/CRT implantation |
| Timing of measurement |
| 3 Months after completion of titration |
| Modality of measurement |
| ECHO or CMRI (preferably the same modality and laboratory test as initial test) |
| Comments |
| LVEF after medical therapy might increase, obviating device therapy |
| Clinical scenario: Stable HF |
| Timing of measurement |
| Approximately every 1-3 years, and possibly less frequent if EF is persistently > 40% |
| Modality of measurement |
| ECHO or CMRI |
| Comments |
| Clinical rationale is to identify improving (better prognosis) or worsening ventricular function (worse prognosis, need for additional therapy such as ICD/CRT) |
| After significant clinical event (ie, after some HF hospitalizations) |
| Timing of measurement |
| Within 30 days, during hospitalization if possible Not necessary when repeated admissions occur without need to identify a cause |
| Modality of measurement |
| ECHO or CMRI |
| Comments |
| Frequently helpful information such as EF, degree of valvular dysfunction, and RVSP |
Nuclear, CT or other measures are appropriate and acceptable in certain circumstances taking into account radiation, cost and information gained.
ACS, acute coronary syndrome;