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©2013 UpToDate ® Print Email ACC/AHA guideline summary: Serial clinical assessment of patients with heart failure (HF) Class I - There is evidence and/or general agreement that the following serial clinical assessments should be performed at each visit in patients with HF: •  The ability to perform routine and desired activities of daily living. •  Volume status and weight. •  Careful history of current use of alcohol, tobacco, illicit drugs, "alternative therapies," and chemotherapy drugs. •  Diet and sodium intake. Class IIa - The weight of evidence or opinion is in favor of the usefulness of the following serial clinical assessment in patients with HF: •  Repeat measurements of left ventricular ejection fraction and the severity of structural remodeling in patients who have had a change in clinical status or who have experienced or recovered from a clinical event or received treatment that might have had a significant effect on cardiac function. Class IIb - The weight of evidence or opinion is less well established for the usefulness of the following serial clinical assessment of patients with HF: •  Serial measurements of serum B-type natriuretic peptide (BNP) to guide therapy. Data from Hunt SA, Abraham WT, Chin MH, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 2005; 112:e154.