2024
The utility of urine sodium–guided diuresis during acute decompensated heart failure
Siddiqi H, Cox Z, Stevenson L, Damman K, ter Maaten J, Bales B, Han J, Ivey-Miranda J, Lindenfeld J, Miller K, Ooi H, Rao V, Schlendorf K, Storrow A, Walsh R, Wrenn J, Testani J, Collins S. The utility of urine sodium–guided diuresis during acute decompensated heart failure. Heart Failure Reviews 2024, 29: 1161-1173. PMID: 39128947, PMCID: PMC11455821, DOI: 10.1007/s10741-024-10424-8.Peer-Reviewed Original ResearchAcute decompensated heart failureDecompensated heart failureHeart failureClinical trialsUrine sodium excretionObservational cohort studyRandomized clinical trialsAdequate decongestionDiuretic strategySodium excretionUrine chemistryCohort studyTitration strategyUrineDiuretic titrationAdverse effectsDiuresisDecongestionPatientsUsual careEvidence gapsTrialsTherapyFailure
2023
In-Hospital Observation on Oral Diuretics After Treatment for Acute Decompensated Heart Failure: Evaluating the Utility
Ivey-Miranda J, Rao V, Cox Z, Moreno-Villagomez J, Mahoney D, Maulion C, Bellumkonda L, Turner J, Collins S, Wilson F, Krumholz H, Testani J. In-Hospital Observation on Oral Diuretics After Treatment for Acute Decompensated Heart Failure: Evaluating the Utility. Circulation Heart Failure 2023, 16: e010206. PMID: 36896716, PMCID: PMC10186250, DOI: 10.1161/circheartfailure.122.010206.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureDiuretic responseDiuretic dosingOral diureticsHeart failureMulticenter cohortHospital observationLower readmission ratesNet fluid balanceDays postdischargeReadmission ratesHospital readmissionUrine outputReadmission riskFluid statusFluid balanceHospital measuresDose selectionCohortProvider decisionsWeight changeReadmissionDiureticsPatientsImprovement in Renal Function During the Treatment of Acute Decompensated Heart Failure: Relationship With Markers of Renal Tubular Injury and Prognostic Importance
Natov P, Ivey-Miranda J, Cox Z, Moreno-Villagomez J, Maulion C, Bellumkonda L, Shlipak M, Estrella M, Borlaug B, Rao V, Testani J. Improvement in Renal Function During the Treatment of Acute Decompensated Heart Failure: Relationship With Markers of Renal Tubular Injury and Prognostic Importance. Circulation Heart Failure 2023, 16: e009776. PMID: 36700431, PMCID: PMC10150783, DOI: 10.1161/circheartfailure.122.009776.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureStable renal functionGlomerular filtration rateRenal functionRenal tubular injuryHeart failureTubular injuryKIM-1Filtration rateRenal tubular injury markersTubular injury markersRenal function groupCumulative urine outputCardiorenal dysfunctionDiuretic dosesInjury markersWorse survivalWorsened survivalUrine outputDecongestive therapyPrognostic importanceAdverse outcomesLower admissionPatients
2022
Changes in the Inferior Vena Cava Are More Sensitive Than Venous Pressure During Fluid Removal: A Proof-of-Concept Study
Posada-Martinez EL, Cox ZL, Cano-Nieto MM, Ibarra-Marquez ND, Moreno-Villagomez J, Gudiño-Bravo P, Arias-Godinez JA, Lopez-Gil S, Madero M, Rao VS, Mebazaa A, Burkhoff D, Cowie MR, Fudim M, Damman K, Borlaug BA, Testani JM, Ivey-Miranda JB. Changes in the Inferior Vena Cava Are More Sensitive Than Venous Pressure During Fluid Removal: A Proof-of-Concept Study. Journal Of Cardiac Failure 2022, 29: 463-472. PMID: 36243338, DOI: 10.1016/j.cardfail.2022.09.012.Peer-Reviewed Original ResearchConceptsInferior vena cava diameterPeripheral venous pressureCentral venous pressureVenous pressureUltrafiltration volumeHeart failureVolume statusMean ultrafiltration volumeManagement of patientsVena cava diameterInferior vena cavaDiastolic dysfunctionCardiac dysfunctionStable hemodialysisVena cavaHemodialysis sessionFluid removalPatientsDialysisHemodialysisDysfunctionConcept studyGreater magnitudeStatusCavaInferior Vena Cava Diameter Measurement Provides Distinct and Complementary Information to Right Atrial Pressure in Acute Decompensated Heart Failure
Griffin M, Ivey-Miranda J, McCallum W, Sarnak M, Eder M, Bellumkonda L, Maulion C, Wilson FP, Rao VS, Testani J. Inferior Vena Cava Diameter Measurement Provides Distinct and Complementary Information to Right Atrial Pressure in Acute Decompensated Heart Failure. Journal Of Cardiac Failure 2022, 28: 1217-1221. PMID: 35301109, DOI: 10.1016/j.cardfail.2022.02.014.Peer-Reviewed Original ResearchConceptsRight atrial pressureAcute decompensated heart failureDecompensated heart failureIVC diameterAtrial pressureHeart failureInferior vena cava diameter (IVCD) measurementBaseline right atrial pressureInferior vena cava (IVC) measurementsPulmonary artery catheterVena cava diameter measurementsArtery catheterHemoglobin levelsIntravascular volumeVenous systemESCAPE trialIVC measurementsBlood volumeRAP measurementsSurvival ratePatientsVolume assessmentHigh complianceModest correlationMedian
2020
Prediction and measurement of diuretic responsiveness after oral administration of furosemide to healthy dogs and dogs with congestive heart failure
Loughran KA, Larouche‐Lebel É, Huh T, Testani JM, Rao VS, Oyama MA. Prediction and measurement of diuretic responsiveness after oral administration of furosemide to healthy dogs and dogs with congestive heart failure. Journal Of Veterinary Internal Medicine 2020, 34: 2253-2264. PMID: 33125814, PMCID: PMC7694836, DOI: 10.1111/jvim.15952.Peer-Reviewed Original ResearchConceptsCongestive heart failureSpot urine samplesDiuretic responsivenessHeart failureHealthy dogsOral administrationUrine samplesCumulative urine volumeUrinary Na excretionProspective interventional studyUrine sodiumNa excretionUrine volumeInterventional studyUvolClinical importanceHuman patientsClinical settingDogsFurosemideCharacteristic curveResponsivenessAdministrationMinutesPatientsCystatin C and Muscle Mass in Patients With Heart Failure
Ivey-Miranda JB, Inker LA, Griffin M, Rao V, Maulion C, Turner JM, Wilson FP, Tang WHW, Levey AS, Testani JM. Cystatin C and Muscle Mass in Patients With Heart Failure. Journal Of Cardiac Failure 2020, 27: 48-56. PMID: 32750487, PMCID: PMC8672303, DOI: 10.1016/j.cardfail.2020.07.013.Peer-Reviewed Original ResearchConceptsHeart failureCreatinine clearanceMuscle massCystatin CHigher muscle massAssociation of eGFRcysGlomerular filtration rateLow muscle massCystatin C levelsAccurate GFR estimationMultivariable analysisFiltration rateEGFRcysEGFRcrBody compositionGFR estimationPatientsCreatinineC levelsClearanceMortalityAssociationEffect of Loop Diuretics on the Fractional Excretion of Urea in Decompensated Heart Failure
Cox ZL, Sury K, Rao VS, Ivey-Miranda JB, Griffin M, Mahoney D, Gomez N, Fleming JH, Inker LA, Coca SG, Turner J, Wilson FP, Testani JM. Effect of Loop Diuretics on the Fractional Excretion of Urea in Decompensated Heart Failure. Journal Of Cardiac Failure 2020, 26: 402-409. PMID: 32007554, PMCID: PMC7798124, DOI: 10.1016/j.cardfail.2020.01.019.Peer-Reviewed Original ResearchConceptsAcute kidney injuryFractional excretionHeart failureLoop diureticsDecompensated heart failureFurosemide equivalentsKidney injuryProspective cohortDiuretic administrationDiuretic responsePeak diuresisDiuretic effectFEUreaDiureticsPatientsDiagnostic superiorityHospital systemExcretionMagnitude of changeDegree of changeBaselineDistribution of changesFENaDiuresisFailure
2019
Effect on Survival of Concurrent Hemoconcentration and Increase in Creatinine During Treatment of Acute Decompensated Heart Failure
Griffin M, Rao VS, Fleming J, Raghavendra P, Turner J, Mahoney D, Wettersten N, Maisel A, Ivey-Miranda JB, Inker L, Tang WHW, Wilson FP, Testani JM. Effect on Survival of Concurrent Hemoconcentration and Increase in Creatinine During Treatment of Acute Decompensated Heart Failure. The American Journal Of Cardiology 2019, 124: 1707-1711. PMID: 31601358, PMCID: PMC6959849, DOI: 10.1016/j.amjcard.2019.08.034.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureHeart failureImproved survivalHigher loop diuretic dosesLoop diuretic dosesNet fluid lossPlasma volume reductionAggressive decongestionAggressive diuresisPostdischarge survivalDiuretic dosesPostdischarge outcomesSerum creatinineHospital treatmentHospital parametersBetter survivalCreatinineHemoconcentrationPatient carePatientsSurvivalLonger lengthVolume reductionTreatmentRelationship between “Dry Weight” and Actual Weight Loss in Patients Hospitalized for Heart Failure
Fleming J, Griffin M, Ivey-Miranda J, Raghavendra P, Struyk G, Shamlian P, Gomez N, Barnett J, Stewart B, Wycallis E, Thomas A, Mahoney D, Pattoli M, Rao V, Testani J. Relationship between “Dry Weight” and Actual Weight Loss in Patients Hospitalized for Heart Failure. Journal Of Cardiac Failure 2019, 25: s51-s52. DOI: 10.1016/j.cardfail.2019.07.145.Peer-Reviewed Original ResearchElectronic medical recordsActual weight lossWeight lossDiuretic therapyVolume overloadHigher body mass indexHospital weight lossBody mass indexTreatment of patientsADHF hospitalizationsAdmission weightMethods PatientsHeart failureFluid excessMass indexPatient assessmentEqual incidencePatient's estimationMedical recordsPatients' estimatesPatientsHospitalizationYounger ageIdeal weightPrimary comparison
2018
The Renal Effects of Aggressive Volume Removal in Heart Failure Patients with Preexisting Worsening Renal Function
Mahoney D, Ahmad T, Rao V, Brisco-Bacik M, Wilson F, Siew E, Felker G, Anstrom K, Bart B, Tang W, O'Connor C, Velazquez E, Testani J. The Renal Effects of Aggressive Volume Removal in Heart Failure Patients with Preexisting Worsening Renal Function. Journal Of Cardiac Failure 2018, 24: s26. DOI: 10.1016/j.cardfail.2018.07.074.Peer-Reviewed Original ResearchRenal tubular injury biomarkersTubular injury biomarkersRenal tubular injuryHeart failure patientsInjury biomarkersTubular injuryFailure patientsRenal functionAcute decompensated heart failure patientsDecompensated heart failure patientsVolume removalCARRESS-HF trialRenal function recoveryTubular injury markersWorsening Renal FunctionHalf of patientsADHF patientsEffective decongestionRenal effectsInjury markersPharmacologic therapyTransient findingFunction recoveryHigh incidencePatients
2017
010 Urine Sodium Content is Highly Variable in Hospitalized Acute Heart Failure Patients: Lasix Urine is Not Necessarily “Half-Normal Saline”
Chunara Z, Jackson K, Rao V, Mahoney D, Thomas D, Tarleton C, Hodson D, Chen M, Jacoby D, Riello R, Ahmad T, Testani J. 010 Urine Sodium Content is Highly Variable in Hospitalized Acute Heart Failure Patients: Lasix Urine is Not Necessarily “Half-Normal Saline”. Journal Of Cardiac Failure 2017, 23: s7. DOI: 10.1016/j.cardfail.2017.07.013.Peer-Reviewed Original Research007 Acute Tubular Injury is Not a Major Mechanism for Worsening Renal Function in Patients Treated for Acute Heart Failure
Hodson D, Jackson K, Ahmad T, Rao V, Mahoney D, Tarleton C, Chunara Z, Thomas D, Chen M, Jacoby D, Riello R, Testani J. 007 Acute Tubular Injury is Not a Major Mechanism for Worsening Renal Function in Patients Treated for Acute Heart Failure. Journal Of Cardiac Failure 2017, 23: s6. DOI: 10.1016/j.cardfail.2017.07.010.Peer-Reviewed Original Research
2016
090 Aspirin Does Not Have a Significant Impact on Loop Diuretic Response or Renin Release in Heart Failure Patients
Broughton J, Hanberg J, Assefa M, Rao V, Testani J. 090 Aspirin Does Not Have a Significant Impact on Loop Diuretic Response or Renin Release in Heart Failure Patients. Journal Of Cardiac Failure 2016, 22: s34-s35. DOI: 10.1016/j.cardfail.2016.06.108.Peer-Reviewed Original Research029 Differential Effect of Diuretic Efficiency on Survival in Acute Heart Failure Patients with Preserved Versus Reduced Ejection Fraction
Assefa M, Hanberg J, Maaten J, Broughton J, Rao V, Testani J. 029 Differential Effect of Diuretic Efficiency on Survival in Acute Heart Failure Patients with Preserved Versus Reduced Ejection Fraction. Journal Of Cardiac Failure 2016, 22: s13. DOI: 10.1016/j.cardfail.2016.06.046.Peer-Reviewed Original ResearchRENAL TUBULAR RESISTANCE, RATHER THAN DIURETIC DELIVERY, IS THE PRIMARY DRIVER FOR DIURETIC RESISTANCE IN ACUTE HEART FAILURE PATIENTS
Maaten J, Rao V, Simon J, Assefa M, Broughton S, Modesto K, Damman K, Voors A, Tang W, Testani J. RENAL TUBULAR RESISTANCE, RATHER THAN DIURETIC DELIVERY, IS THE PRIMARY DRIVER FOR DIURETIC RESISTANCE IN ACUTE HEART FAILURE PATIENTS. Journal Of The American College Of Cardiology 2016, 67: 1544. DOI: 10.1016/s0735-1097(16)31545-5.Peer-Reviewed Original Research