Table 3:

Key elements to consider including in oncology clinical trials (Adapted from ECOG Baseline and Follow up Cardiovascular Form, see supplemental appendix)

History of Diagnosed CVD	Symptoms Suggestive of CVD	Physical Exam Findings	Lab and Imaging Data	Cardiac Medications
Coronary artery disease Myocardial Infarct (date) Revascularization history (Percutaneous coronary intervention of coronary artery bypass graft surgery) Angina class	Chest pain at rest or with exertion Shortness of breath at rest or with exertion Orthopnea Paroxysmal Nocturnal Dyspnea Edema Fatigue Weight gain In patients with heart failure: New York Heart Association Class: I: no symptoms II: mild limitation during ordinary activity III: Marked limitation in activity due to symptoms, comfortable only at rest IV: symptoms at rest	Blood Pressure Heart rate Height Weight BMI Jugular venous distension Carotid Bruits S3 S4 Murmur Distal pulses Rales Wheezing Hepatomegaly Ascites Edema (grade, extent)	Lab tests: serum creatinine brain natriuretic peptide N-terminal pro-brain natriuretic peptide Troponin I Troponin T Total cholesterol Triglycerides Low Density lipoprotein High density lipoprotein	Aspirin ACE-inhibitor Angiotensin Receptor Blocker Beta-blocker Alpha blocker Calcium channel blocker Diuretics Nitrates Statin Other lipid lowering therapy Anticoagulant therapy Other
Heart Failure/Cardiomyopathy Heart failure with preserved Ejection Fraction Heart Failure with Reduced Ejection Fraction Etiology of Cardiomyopathy Cardiac amyloidosis Prior heart failure hospitalization New York Heart Association Class
			Echocardiography: Left ventricular ejection fraction Institutional lower limit of normal Evidence of diastolic dysfunction (grade if present) Evidence of moderate to severe valvular disease (list) Left atrial dilation Right atrial dilation Right ventricular function Right ventricular dilation Regional wall motion abnormalities
Arrhythmias/ECG abnormalities Atrial fibrillation Atrial flutter Other supraventricular tachycardia Ventricular tachycardia Ventricular fibrillation Prior cardiac arrest Long QT Bradycardia Sick sinus syndrome Sinus tachycardia Left bundle branch block Arrhythmia - not otherwise listed Syncope Palpitations Implantable Cardioverter Defibrillator Pacemaker
Valvular Disease Aortic stenosis Aortic Regurgitation Aortic valve repair or replacement Mitral stenosis Mitral regurgitation Mitral valve prolapse Mitral valve repair or replacement Tricuspid stenosis Tricuspid regurgitation Tricuspid valve repair or replacement Pulmonic stenosis Pulmonic regurgitation Endocarditis
Vascular disease Carotid Disease Transient Ischemic Attack Stroke Peripheral Vascular Disease Thoracic Aortic Aneurysm Abdominal Aortic Aneurysm Deep Vein Thrombosis Pulmonary Embolism Pulmonary hypertension
Pericardial disease Pericarditis Pericardial Effusion
Cardiac Risk factors Hypertension Diabetes Tobacco Use (prior or current) Metabolic Syndrome Obesity Hyperlipidemia Family history of cardiomyopathy or coronary artery disease Alcohol use (>2 drinks/day) Prior chest radiation (dose, fractions, field, date) Prior anthracycline chemotherapy (agent, cumulative dose, year) Anti-HER2 agent (agent, duration, year)