Forms in CV (2)
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MUGA or Echocardiogram
Sources: DB1 | Forms loaded: 2
CV (Cardiovascular System Findings)
Show domain info
Primary Domain
CV
All Domains
CV
# Question Response / annotation
1
Date of assessment
field_001
CVDTC
2
Method
field_002
CVMETHOD
3
LVEF Result
field_003
CVORRES when CVTESTCD = LVEF
4
LVEF Unit
field_004
CVORRESU when CVTESTCD = LVEF
Heart Failure History
Sources: DB1 | Forms loaded: 2
MH (Medical History)
RS (Disease Response and Clin Classification)
CM (Concomitant Medications)
HO (Healthcare Encounters)
CV (Cardiovascular System Findings)
Show domain info
Primary Domain
MH
All Domains
MH, RS, CM, HO, CV
# Question Response / annotation
1
What type of heart failure does the subject have?
MHTERM
MHTERM
2
What was the date of diagnosis of heart failure?
MHSTDAT
MHSTDTC
3
What was the primary cause of heart failure?
MHPRC
MHPRC in SUPPMH
4
Specify Other
MHPRCOTH
MHPRCOTH in SUPPMH
5
What is the etiology of the heart failure?
MHETOLGY
MHETOLGY in SUPPMH
6
What was the NYHA functional classification at entry into the study?
NHYACLS_RSORRES
RSORRES when RSTEST = NYHA Functional Classification
7
Was the subject ever administered IV diuretics for heart failure?
IVD_CM_OCCUR
CMOCCUR
CMTRT = DIURETICS
CMPRESP = Y
CMROUTE = INTRAVENOUS
8
Did the subject have any episodes of worsening heart failure in the last 6 months?
HFWOR_MHOCCUR
MHOCCUR when MHTERM = WORSENING HEART FAILURE
MHPRESP = Y
9
What was the start date of the most recent episode of worsening heart failure in the last 6 months?
HFWOR_MHSTDAT
MHSTDTC when MHTERM = WORSENING HEART FAILURE
10
Did this event require hospitalization?
HOCCUR
HOOCCUR
HOTERM = HOSPITALIZATION
HOPRESP = Y
11
What was the date of the test to determine estimated LVEF?
CVDAT
CVDTC when CVTESTCD = LVEF
12
What was the estimated LVEF at entry into the study?
CVORRES
CVORRES when CVTESTCD = LVEF
13
What was the method used to determine the estimated LVEF?
CVMETHOD
CVMETHOD when CVTESTCD = LVEF