This document describes performance measures for heart failure that are appropriate for public reporting or pay-for-performance programs and is meant to serve as a focused update of the “2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures.” The new performance measures are taken from the “2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines” and are selected from the strongest recommendations (Class 1 or Class 3). In contrast, quality measures may not have as much evidence base and generally comprise metrics that might be useful for clinicians and health care organizations for quality improvement but are not yet appropriate for public reporting or pay-for-performance programs. New performance measures include optimal blood pressure control in patients with heart failure with preserved ejection fraction, the use of sodium-glucose cotransporter-2 inhibitors for patients with heart failure with reduced ejection fraction, and the use of guideline-directed medical therapy in hospitalized patients. New quality measures include the use of sodium-glucose cotransporter-2 inhibitors in patients with heart failure with mildly reduced and preserved ejection fraction, the optimization of guideline-directed medical therapy prior to intervention for chronic secondary severe mitral regurgitation, continuation of guideline-directed medical therapy for patients with heart failure with improved ejection fraction, identifying both known risks for cardiovascular disease and social determinants of health, patient-centered counseling regarding contraception and pregnancy risks for individuals with cardiomyopathy, and the need for a monoclonal protein screen to exclude light chain amyloidosis when interpreting a bone scintigraphy scan assessing for transthyretin cardiac amyloidosis.

中文翻译：

---

2024 年成人心力衰竭 ACC/AHA 临床绩效和质量指标更新：美国心脏协会/美国心脏病学会绩效测量联合委员会报告


本文件描述了适用于公开报告或按绩效付费计划的心力衰竭绩效衡量标准，旨在作为“2020 年成人心力衰竭 ACC/AHA 临床绩效和质量衡量标准：美国心脏病学会/美国心脏协会绩效衡量工作组报告”的重点更新。新的绩效指标取自“2022 年 AHA/ACC/HFSA 心力衰竭管理指南：美国心脏病学会/美国心脏协会临床实践指南联合委员会报告”，并从最强的建议（1 级或 3 级）中选出。相比之下，质量衡量标准可能没有那么多的证据基础，并且通常包含可能对临床医生和医疗保健组织的质量改进有用的指标，但尚不适用于公开报告或按绩效付费计划。新的性能指标包括射血分数保留的心力衰竭患者的最佳血压控制，对射血分数降低的心力衰竭患者使用钠-葡萄糖协同转运蛋白-2 抑制剂，以及在住院患者中使用指南指导的药物治疗。 新的质量措施包括对射血分数轻度降低和保留的心力衰竭患者使用钠-葡萄糖协同转运蛋白 2 抑制剂，在慢性继发性严重二尖瓣反流干预前优化指南指导的药物治疗，对射血分数改善的心力衰竭患者继续指导的药物治疗，确定心血管疾病的已知风险和健康的社会决定因素， 以患者为中心的关于心肌病患者的避孕和妊娠风险的咨询，以及在解释评估转甲状腺素蛋白心脏淀粉样变性的骨闪烁显像扫描时需要单克隆蛋白筛查以排除轻链淀粉样变性。