Table 1. Quality assessment of AHA/ACC and ESC guidelines63),66) .
| ACC/AHA clinical performance and quality measures | ESC HFA Quality Indicators | ||||
|---|---|---|---|---|---|
| Performance measures | Domain 1. Structural framework | ||||
| PM 1. LVEF assessment | 1–2. Multidisciplinary team and healthcare professional to manage and educate HF patients | ||||
| PM 2–3. Symptoms and activity assessment and management | |||||
| PM 4–9. Medication therapy and dose (in case of HFrEF patients) | |||||
| ACEI/ARB/ARNIs | |||||
| BB | |||||
| MRA | |||||
| PM 10. Laboratory monitoring in new MRA therapy | |||||
| PM 11. Hydralazine/isosorbide dinitrate therapy (in case of Black or African-American patients with HFrEF) | Domain 2. Patient assessment | ||||
| PM 12–13. ICD/CRT counseling | 3–7. Clinical type of HF assessed by LVEF | ||||
| ECG, NPs, other blood test (BUN, creatinine, electrolyte, blood count, glucose, HbA1c, TSH, LFTs, lipids, and iron profile) | |||||
| Cardiac rehabilitation referrals (both inpatient and outpatient) | |||||
| Quality measures | Domain 3. Initial treatment | ||||
| QM 1. Patient self-care education | 8–12. Medication therapy | ||||
| QM 2. Patient-reported outcome-health status | ACEI/ARB/ARNIs | ||||
| QM 3. Health status in HF (sustained or improved) | BB | ||||
| QM 4. Post-discharge appointment | MRA | ||||
| SGLT2I | |||||
| Loop diuretics | |||||
| Structural measures | Domain 4. Therapy optimization | ||||
| SM 1. HF registry participation | 13–14. Device therapy (in case of indication) | ||||
| CRT, ICD | |||||
| Rehabilitation performance measure | Domain 5. Assessment of patients Health-related Quality of Life | ||||
| Rehab PM 1–2. Cardiac rehabilitation referral from inpatient or outpatient setting | 15. Assessment using validated tools (ex. KCCQ) | ||||
ACC = American College of Cardiology; ACEI = angiotensin converting enzyme inhibitor; AHA = American Heart Association; ARB = angiotensin receptor blocker; ARNI = angiotensin receptor/neprilysin Inhibitor; BB = beta-blocker; BUN = blood urea nitrogen; CRT = cardiac resynchronization therapy; ECG = electrocardiography; ESC = European Society of Cardiology; HbA1c = hemoglobin A1c; HF = heart failure; HFA = Heart Failure Association; HFrEF = heart failure with reduced ejection fraction; ICD = implantable cardioverter defibrillator; KCCQ = Kansas City cardiomyopathy questionnaire; LFT = liver function test; LVEF = left ventricular ejection fraction; MRA = mineralocorticoid receptor antagonist; NP = natriuretic peptide; PM = performance measure; QM = quality measure; Rehab = rehabilitation; SGLT2I = sodium-glucose cotransporter-2 inhibitor; SM = structural measure; TSH = thyroid-stimulating hormone.