The Jordanian Heart Failure Registry (JoHFR)
Conditions: Heart Failure, Chronic Heart Failure, Acute Heart Failure
Sponsor: Jordan Cardio Vascular Research Group

Study protocol cover page
Official study title: Multicenter registry to study the characteristic and outcomes of Jordanian Heart Failure patients
The Jordanian Heart Failure Registry (JoHFR)
NCT04829591
The actual  document date and approval date  30/3/ 2021
The updated document date 17/4/2021

A Multicenter Registry to Study the Characteristics and Outcomes of Jordanian Heart Failure
Patients.
The Jordanian Heart Failure Registry (JoHFR)
ClinicalTrials.gov Identifier: NCT04829591
( Study protocol )
Principal investigator and study chair : Hadi Abu-Hantash , MD ,MSc ,FACC ,FSCAI .
Principal investigator: Mahmoud Izraiq , MD .
Brief Summary
Heart Failure research registry is a collection of computerized information about
individuals with heart failure. The database in this registry is obtained from several
Jordanian medical centers which will represent an extremely valuable resource for
epidemiological research on heart failure patients.
Detailed Description:
Understanding the cause of Heart Failure (HF) and how the body will respond to it, is
critical for an effective treatment. HF is a global problem with significant morbidity and
mortality, despite improved understanding of the pathophysiology and a growing range
of therapeutic options. Jordanian Heart Failure Registry (JoHFR) will be the first
research project of heart failure prevalence in Jordan. It is undertaken by primary
healthcare professionals with main aim to improve knowledge about the care of patients
with HF. The investigators responsible for conducting this research are physicians and
their teams who deal with heart failure patients in their outpatient and inpatient clinic
centers including the public and private medical sectors in Jordans’ medical community
. Standards in the Hashemite kingdom of Jordan complies with the recognized good
guideline directed medical practices internationally.
Objectives of the registry:
Up to date, there is still a lack of reliable pathology data that summarizes patient cases
with heart failure disease. This research aims to fill this gap and provide the local and
international medical communities with this important set of comparative data in order
to determine our current situation in regards to screening, management, and follow up
of patients. This will have a direct impact on improving Heart Failure patient
outcomes by directing our focus on strengths and weaknesses in our management in
this ongoing high morbidity and mortality syndrome. Furthermore, this registry will
focus on describing the diagnostic and therapeutic approaches undertaken by
cardiologists in their care of patients with HF in order to improve future
management

of patients with high HF risks. The prevalence of the clinical profiles of patients with
acute and chronic HF will also be evaluated.
Study design and methodology:
▪This registry consists of multiple variables including demographics, concomitant diseases, diagnostic
procedures, hemodynamics, laboratory data, and medications used, discharge information and instructions.
The patient information is detailed in the attached questionnaire (appindex1) which will be filled by
participating who will record details of their HF patients and transfer these data for documentation.
▪This study aims to include sufficient number of patients with Heart Failure and is expected to last for
extended time until the study sample is completed by participating healthcare professionals. The data
collected at 12 months will be the basis of the initial statistics, upon which the trial duration will be
determined.
▪The principal research coordinator and his team will train personnel of the participating units on how to
register patients and how to use the registry.
▪Patient safety, security and confidentiality will be retained at all times during the course of the study and
thereafter.
▪Follow up after one year should include data on morbidity (including Heart failure hospitalization) and
mortality with detailed information on medications, quality of life, and functional capacity. ▪The study will
comply with the ethics of research and (IRB) institutional review board approvals and any other required
official organizational requirements.
Inclusion and exclusion criteria:
• Inclusion criteria:
1. Patients who are 18 years or older with Heart Failure diagnosis as defined by internationally recognized
guidelines.
2. Current residents of the Hashemite Kingdom of Jordan.
• Exclusion criteria:
1. Patients who refuse or unable to sign a consent form.
2. Patient inability to follow up with provider
Statistical analysis:
Data will be pooled and descriptive and comparative statistical tests will be used to categorize the patients based on
the disease sub-typing and management quality and to find the prevalence of heart failure disease different types,
classes and stages amongst Jordanians. Furthermore, comparative analysis will be performed to test the efficiency,
accuracy, and the quality of medical practice in Jordan. Statistical analysis will be done using SPSS V21.
See appindex1 below.
Appindex1:
Chronic HF ☐Acute HF ☐
Patient Initials/Site number:
DOB: / / (MM/DD/YYYY) Gender: M F Admission date/ Office visit / / :
Discharge Date/Time / / :

MEDICAL HISTORY
Medical History (Select all that apply):
□H/O ASCVD
□H/O Arrhythmias
□ASCVD risk factor:
೦೦DM
೦೦HTN
೦೦Smoking
೦೦Alcohol
Abuse
೦೦Dyslipidemia
೦೦Obesity
೦೦Positive
family
history of
premature
ASCVD
೦೦CKD
೦೦Others.
□Implanted devices
□History of structural heart disease
□Other relevant medical history
❑Notes :
Heart Failure History
Etiology:
Check if history of :
□Ischemic/CAD
❑Non-Ischemic
□Hypertensive
□Alcohol/Other Drug
□Chemotherapy
□Viral
□Postpartum
□Familial
□Other Etiology
□Unknown/Idiopathic

Known history of HF prior
to this admission?
o Yes
o No
# of hospital admissions in
past 6 mo./office visit for HF:
⚪ 0
⚪ 2
⚪1
⚪ >2
o Unknown
MEDICATIONS AT ADMISSION/Office visit
Medications Used Prior to Admission: [Select all that apply]

❑Patient on no meds
prior to admission
❑ACE Inhibitor
❑Aldosterone
Antagonist
❑Angiotensin receptor
blocker (ARB)
❑Angiotensin
Receptor Neprilysin
Inhibitor (ARNI)
❑Antiarrhythmic
❑Aspirin
❑Antiplatelet agent
(excluding aspirin)
❑Anticoagulation Therapy
⚪Warfarin
⚪Direct Thrombin Inhibitor(
dabigatran)
⚪Factor Xa Inhibitor( apixaban,
rivaroxaban, edoxaban)
⚪Other
❑Anti-hyperglycemic medications:
□DPP-4 Inhibitors( sitagliptin,
vildagliptin, saxagliptin, linagliptin,
alogliptin)
□GLP-1 receptor agonist (
liraglutide, albiglutide, exenatide,
semaglutide)
□Insulin
□Metformin
□SLGT2 Inhibitor (canagliflozin,
dapagliflozin, empagliflozin,
ertuglifluzin)
□Sulfonylurea( glibenclamide,
glimperide, glipizide, tolbutamide)
□Thiazolidinedione( pioglitazone,
rosiglitazone)
□Other Oral Agents
□Other injectable/subcutaneous
agents
❑Beta-Blocker(
metoprolol, propranolol,
bisoprolol, atenolol,
acebutelol, nebivelol,
nadolol)
❑Ca channel blocker(
amlodipine, nefidipine,
nicardipine, verapamil,
diltiazem)
❑Digoxin
❑Diuretic
□Thiazide/Thiazide
like( chlorothalidone,
hydrochlorothiazide,
indapamide,
metolazone)
□Loop( bumetanide,
furosemide,
torsemide)
❑Hydralazine
❑Ivabradine
❑Lipid lowering agent
(Any)
□Statin( rosuvastatin,
atorvastatin,
simvastatin,
fluvastatin,
pravastatin)
□Other Lipid lowering
agent
❑Nitrate( nitroglycerin,
nitroprusside,
isosorbide)
❑Other
EXAMS/LABS AT ADMISSION/Office visit
Admission Tab
Symptoms
(Closest to Admission)
Select all that apply
❑Dyspnea
❑PND
NYHA class
❑Fatigue
(|, ||, |||, |V)
❑Chest pain
❑Orthopnea
❑Palpitations

Vital signs
Height ೦೦cm
(Closest to Admission/Office visit)
Weight BMI ೦೦Kgs.
Heart Rate
Heart Rate bpm
❑Regular
❑irregular
Examination
(Closest to
Admission/Office visit)
JVP: o Yes
o No
Rales: o Yes
o No
Lower Extremity
o Yes
Edema
o No
Lipids
TC:
LDL:
HDL: _
mg/dL
mg/dL
mg/dL
TG:
mg/dL
❑Lipids Not
Available
Labs
Closest to Admission)/ office visit
Na
o mg/dL
❑
Unavailabl e
BNP
o ng/L
❑
Unavailabl e
K
o mg/dL
❑
Unavailabl e
Hb
o g/dL
❑
Unavailabl e
Albumin
o g/dL
❑
Unavailabl e
NT-proBNP
o ng/L
❑
Unavailabl e
SCr
o mg/dL
❑
Unavailabl e

eGFR
o ml/min/
1.73m2
❑MDRD
BUN
o mg/dL
❑
Unavailabl e
Troponin (Peak)
ng/L ೦೦T
quantitative / Hs
೦೦I
೦೦Normal
೦೦
Abnormal
❑
Unavailabl e
Ferritin
ng/mL
Transferrin saturation
HbA1C %
Unavailable
Fasting Blood
Glucose
(mg/dL)
Unavailable
EKG QRS
Unavailable
Duration (ms)
EKG QRS
೦೦
೦೦
Normal
RBB
Morphology
B
೦೦LBBB
೦೦NS
IVCD
೦೦Paced
೦೦Unavailable
IN-HOSPITAL CARE FOR ACUTE HF Pts.
Procedures

❑No Procedures
❑Atrial Fibrillation Ablation or Surgery
❑Cardiac Cath/Coronary Angiography
❑Cardiac Valve Surgery
❑Coronary Artery Bypass Graft
❑Cardioversion
❑CRT-P (cardiac
❑CRT-D (cardiac resynchronization therapy
resynchronizationtherapy pacing only)
with ICD ❑Intra-aortic Balloon Pump
❑Dialysis or Ultrafiltration
❑Left Ventricular Assist Device
❑ICD only
❑Pacemaker
❑Mechanical Ventilation
❑PCI
❑Right Cardiac Catheterization
EF
- By Echo
Obtained:
- By other
means
%
೦೦This Admission
೦೦Within the last year
೦೦> 1 year ago
Added Oral Medications
during hospitalization
Select all that apply
❑None
❑Aldosterone
❑ARNI
Antagonist
❑Hydralazine
❑ARB
Nitrate
❑ACE Inhibitor
❑Beta Blocker
Parenteral Therapies
during hospitalization
Select all that apply
❑None
❑Nitroglycerine
❑Other IV
❑Dopamine
Vasodilator
❑Iron
❑Milrinone
❑Dobutamine
❑Loop Diuretics
□Intermittent
Bolus
□Continuous
Infusion
Was the patient
ambulating at the end of
hospital day
2?
Yes No
Not Documented

Was DVT prophylaxis
initiated by the end of
hospital day 2?
Yes No
Contraindicated
If yes,
❑Low dose unfractionated heparin (LDUH)
❑Low molecular weight heparin
(LMWH)
❑Warfarin
❑Other
❑Factor Xa Inhibitor
❑Direct thrombin inhibitor
❑Intermittent pneumatic
compression devices
(IPC)
DISCHARGE INFORMATION for Acute HF patients Discharge Tab
Discharge Date/Time / / :
❑MM/DD/YYYY only
Primary Cause of Death
o Cardiovascular o Non-Cardiovascular
o Unknown
If Cardiovascular:
o Acute Coronary
o Worsening
Heart Failure
Syndrome
⚪Sudden Death
⚪Other
When is the earliest documentation of comfort
⚪Day 0 or 1
measures only?
⚪Day 2 or after
⚪Timing unclear
⚪Not Documented
Symptoms (closest to discharge)
⚪Worse
⚪Better,
Symptomatic
⚪Unchanged
⚪Better,
Asymptomatic
⚪Unable to determine
Vital Signs (closest to Discharge)
Weight ೦೦Kgs.
❑Not Documented
Heart Rate Bpm regular Irregular
❑Not Documented
BP-Supine _ / _ mmHg (systolic/diastolic)
❑Not Documented
Respiratory Rate breaths per minute
Exam (Closest to Discharge)
JVP: o Yes o No
o
Unknow
n
Rales: o Yes
o No

Lower Extremity
o Yes
Edema
o No
Labs (Closest to Discharge)
Na
o mg/dL
❑Unavailable
BNP
o mg/dL
❑Unavailable
SCr
o mg/dL
❑Unavailable
BUN
o mg/dL
❑Unavailable
NT-BNP (pg/mL)
❑Not Documented
K o mEq/L
o mmol/L
o mg/dL
❑
eGFR
೦೦Ml/min/
❑MDRD
1.73m2
DISCHARGE MEDICATIONS
Discharge Tab
Angiotensin Converting Enzyme Inhibitor (ACEI)
Prescribed?
If Yes,
o Yes o No
Medication: Dosage:
Frequency:
Beta-Blocker
Name:
Dose:
Aldosterone Antagonist
Medication: Dosage:
Frequency:
Anti-hyperglycemic Medications:
Name:
Dose:
Lipid Lowering Medication(s):
Name:
Dose:
Hydralazine Nitrate

Name:
Dose:
Other Medications at Discharge
❑Antiarrhythmic
□Amiodarone
□Sotalol
□Other
❑Ca Channel
❑Nitrate
Blocker
❑Ranolazine
❑Digoxin
❑Other Anti-Hypertensive
❑Diuretic
❑Other
□Loop
Diuretic
□Thiazide
Diuretic
Angiotensin Receptor Blocker (ARB)
Name:
Dose:
Angiotensin Receptor Neprilysin Inhibitor (ARNI)
Name:
Dose:
Acetylsalicylic acid (ASA)
Name:
Dose:
Anticoagulation Therapy
Prescribed?
Yes No
Dosage
If Yes,
Class:
❑Other
❑Warfarin
❑DOAC
Clopidogrel
Prescribed?
o Yes o No

If Yes,
Dosage: Frequency:
Other Antiplatelet(s)
Name:
dose:
Discharge instructions:
Activity
o Yes o No Diet (Salt restricted)
o Yes
o No
Follow-up
Symptoms Worsening
o Yes o No Medications
o Yes o No Weight Monitoring
o Yes
o Yes
o No
o No
Follow-up Visit Scheduled
o Yes o No Date/Time of first follow up
visit:
/ / :
Location of first follow-up visit: ೦೦Office Visit ೦೦Home Health Visit
೦೦Telehealth
೦೦Not Documented
Medical or Patient Reason for no follow-up
o Yes
appointment being scheduled?
o No
Follow up visits form:
Scheduled at:
3 months 6 months
12 months
NYHA class: (|,||,|||,|V)

eGFR:
Loop diuretics (name,dose):
Vital signs
New EF ,method, if any :
CV related hospital admission:
❑Yes:
❑Yes:
□WHF
□WHF
□ACS
□ACS
□Arrhythmia
□Arrhythmia
s
s
□Others
□Others
❑Yes:
□WHF
□ACS
□Arrhythmias
□Others
No
12 months
No
No
3 months 6 months
Labs:
Meds:

Other notes: