2025
Sodium chloride versus glucose solute as a volume replacement therapy for more effective decongestion in acute heart failure (SOLVRED‐AHF): A prospective, randomized, mechanistic study
Biegus J, Iwanek G, Testani J, Zymliński R, Fudim M, Guzik M, Gajewski P, Ponikowski P. Sodium chloride versus glucose solute as a volume replacement therapy for more effective decongestion in acute heart failure (SOLVRED‐AHF): A prospective, randomized, mechanistic study. European Journal Of Heart Failure 2025 PMID: 40455066, DOI: 10.1002/ejhf.3708.Peer-Reviewed Original ResearchAcute heart failureProximal tubular sodium reabsorptionCo-primary endpointsTubular sodium reabsorptionNaCl groupEffective decongestionDiuretic therapyUrine outputSodium reabsorptionHeart failureCumulative dose of furosemideGlucose groupFractional excretion of lithiumDose of furosemideMedian urine outputAbsolute distal reabsorptionVolume replacement therapyExcretion of lithiumSingle-blind studyInfusion of NaClInhibition of proximal tubular sodium reabsorptionFurosemide doseFluid overloadCumulative doseDecongestive effectSerum chloride and the response to combining loop and thiazide diuretics for acute heart failure: the ALCALOTIC study
Núñez J, Miñana G, Villalonga M, Asenjo M, Carrera M, Epelde F, Gil M, Chivite D, Contra A, Pla X, Casado J, Miró Ò, de la Espriella R, Testani J, Trullàs J. Serum chloride and the response to combining loop and thiazide diuretics for acute heart failure: the ALCALOTIC study. Internal And Emergency Medicine 2025, 1-11. PMID: 40379935, DOI: 10.1007/s11739-025-03961-z.Peer-Reviewed Original ResearchAcute heart failureHeart failureDiuretic responseSerum chlorideThiazide diureticsWeight lossAssociated with smaller weight lossPatients admitted with acute heart failurePathophysiology of heart failureIn-hospital weight lossAssociated with higher weight lossObservational cohort studyDiuretic resistanceHF prognosisThiazideCohort studyDiureticsPatientsHyperchloraemiaOverall populationHypochloraemiaClinical sitesSerumSmall weight lossFailureAcute Systemic Sclerosis-Associated Cardiomyopathy That Improved With Glucocorticoids and Cyclophosphamide
Gustafson A, Trinh K, Lomasney J, Shah S, Hinchcliff M. Acute Systemic Sclerosis-Associated Cardiomyopathy That Improved With Glucocorticoids and Cyclophosphamide. JACC Case Reports 2025, 30: 102948. PMID: 39972702, PMCID: PMC11862153, DOI: 10.1016/j.jaccas.2024.102948.Peer-Reviewed Original ResearchSystemic sclerosisEndomyocardial biopsyDiffuse cutaneous systemic sclerosisCutaneous systemic sclerosisAssociated with increased mortalityT lymphocyte infiltrationAcute heart failureIntravenous cyclophosphamideDiagnosing myocarditisDiastolic dysfunctionSystolic dysfunctionT lymphocytesHeart failureProlonged recoveryPatientsCardiomyopathy treatmentCyclophosphamideBiopsyCardiomyopathyGlucocorticoidDysfunctionMyopericarditisMyocarditisFrom Inflammation to Inspiration and Innovation: A New Perspective on the Utility of Anti-inflammatory Therapies for Acute Heart Failure
Sobieraj M, Bansal K, Clark K. From Inflammation to Inspiration and Innovation: A New Perspective on the Utility of Anti-inflammatory Therapies for Acute Heart Failure. Journal Of Cardiac Failure 2025, 31: 367-368. PMID: 39824279, DOI: 10.1016/j.cardfail.2025.01.002.Peer-Reviewed Original ResearchDiuretic Potentiation Strategies in Acute Heart Failure
Siddiqi T, Packer M, Ezekowitz J, Fonarow G, Greene S, Kittleson M, Khan M, Mentz R, Testani J, Voors A, Butler J. Diuretic Potentiation Strategies in Acute Heart Failure. JACC Heart Failure 2025, 13: 14-27. PMID: 39779178, DOI: 10.1016/j.jchf.2024.09.017.Peer-Reviewed Original ResearchConceptsAcute heart failureHeart failureReceptor antagonistSodium-glucose cotransporter 2 inhibitorsLoop diuretic agentsMarkers of congestionMineralocorticoid receptor antagonistsVasopressin receptor antagonistsHeart failure eventsLong-term outcomesShort-term markersCarbonic anhydrase inhibitorsDiuretic strategyThiazide diureticsSerum creatinineDecongestion strategiesClinical outcomesConventional therapyDiuretic agentsImprove symptomsPhysical signsDiureticsCombination strategiesSymptomsAntagonist
2024
Sex differences in proteomics of cardiovascular disease: results from the Yale-CMD registry
Liu Y, Wang Z, Collins S, Testani J, Kleinstein S, Safdar B. Sex differences in proteomics of cardiovascular disease: results from the Yale-CMD registry. European Heart Journal 2024, 45: ehae666.3091. DOI: 10.1093/eurheartj/ehae666.3091.Peer-Reviewed Original ResearchCoronary microvascular dysfunctionCoronary artery diseaseUpregulation of lipidCardiovascular diseaseAcute heart failureCoronary artery disease cohortHistory of diabetesPathophysiology of CVDProximity extension assayBody mass indexSignificant sex differencesRegulation of blood flowSerum proteomic profilesSex differencesProteomic profilingAngiogenesis-related proteinsCardiac PET/CTHemodynamic instabilityIschemic symptomsMicrovascular dysfunctionFalse discovery rateHeart failureFebrile illnessFunctional pathway analysisMass indexTiming of Acute eGFR Declines in Acute Heart Failure and Their Association with Cardiovascular and Kidney Outcomes
McCallum W, Tighiouart H, Tuttle M, Lala-Trindade A, Costanzo M, Bautista I, Oka T, Testani J, Konstam M, Sarnak M. Timing of Acute eGFR Declines in Acute Heart Failure and Their Association with Cardiovascular and Kidney Outcomes. Journal Of The American Society Of Nephrology 2024, 35: 10.1681/asn.2024cax7nzke. DOI: 10.1681/asn.2024cax7nzke.Peer-Reviewed Original ResearchAcute heart failureRacial, ethnic and sex disparity in acute heart failure patients with COVID-19: A nationwide analysis
Hashem A, Khalouf A, Mohamed M, Nayfeh T, Elkhapery A, Zahid S, Altibi A, Thyagaturu H, Kashou A, Anavekar N, Gulati M, Balla S. Racial, ethnic and sex disparity in acute heart failure patients with COVID-19: A nationwide analysis. Heliyon 2024, 10: e34513. PMID: 39157311, PMCID: PMC11327804, DOI: 10.1016/j.heliyon.2024.e34513.Peer-Reviewed Original ResearchAcute heart failureImpact of raceNational Inpatient SampleCOVID-19 infectionWhite malesHispanic malesDiagnosis of acute heart failureOutcomes of acute heart failureOdds of cardiac arrestAcute heart failure patientsCOVID-19Sex disparitiesWhite femalesOdds of in-hospital mortalityEthnicityRaceDisparitiesMultivariate logistic regression modelIn-Hospital MortalityIn-Hospital OutcomesHeart failure patientsLogistic regression modelsHispanic ethnicityHeart failureCardiac arrestIncreased Spironolactone Dosing in Acute Heart Failure Alters Potassium Homeostasis but Does not Enhance Decongestion
Natov P, Ivey-Miranda J, Cox Z, Rao V, Butler J, Konstam M, Kiernan M, Kapur N, Testani J. Increased Spironolactone Dosing in Acute Heart Failure Alters Potassium Homeostasis but Does not Enhance Decongestion. Journal Of Cardiac Failure 2024, 30: 1522-1526. PMID: 38986838, DOI: 10.1016/j.cardfail.2024.06.008.Peer-Reviewed Original ResearchBaseline serum potassiumAcute heart failureSerum potassiumSpironolactone treatmentTreatment armsHeart failureBaseline serum potassium levelsNatriuretic peptide levelsTreated with spironolactoneSerum potassium levelsSpironolactone-treated patientsNet fluid lossRenal potassium handlingPost Hoc AnalysisEnhance decongestionSpironolactone dosePotassium wastingUrine outputClinical congestionTreatment startPotassium handlingPotassium replacementPotassium supplementationPharmacodynamic effectsSurrogate markerAcute Cardiac Events in Hospitalized Older Adults With Respiratory Syncytial Virus Infection
Woodruff R, Melgar M, Pham H, Sperling L, Loustalot F, Kirley P, Austin E, Yousey-Hindes K, Openo K, Ryan P, Brown C, Lynfield R, Davis S, Barney G, Tesini B, Sutton M, Talbot H, Zahid H, Kim L, Havers F, Rowlands J, Spina N, Engesser K, Salazar-Sanchez Y, George A, Staten H, Bleecker M, Leegwater L, Tellez Nunez V, Falkowski A, Felsen C, Licherdell E, St George K, Pacheco F, Desiato J, Labozzo N, Zmek E, Alden N, Strayhorn N, Fawcett E, Surell C, Como-Sabetti K, Mumm E, Bilski K, Markus T, Ndi D, Billings K. Acute Cardiac Events in Hospitalized Older Adults With Respiratory Syncytial Virus Infection. JAMA Internal Medicine 2024, 184: 602-611. PMID: 38619857, PMCID: PMC11019447, DOI: 10.1001/jamainternmed.2024.0212.Peer-Reviewed Original ResearchRespiratory syncytial virus infectionRespiratory syncytial virusRespiratory syncytial virus seasonAcute cardiac eventsCardiac eventsWeighted estimated prevalenceIn-Hospital DeathAdjusted risk ratiosIntensive care unitClassification of diseasesCross-sectional studyHospitalized adultsCardiac complicationsRSV infectionRSV diseaseLaboratory-confirmed RSV infectionOlder adultsCases of RSV infectionReceipt of invasive mechanical ventilationCardiovascular diseaseIntensive care unit admissionSevere outcomesEstimated prevalenceAcute heart failurePotential cardiac complicationsCovid-19 Infection Is Associated With Increased In-hospital Mortality And Complications In Patients With Acute Heart Failure: Insight From National Inpatient Sample (2020)
Hashem A, Khalouf A, Mohamed M, Nayfeh T, Elkhapery A, Elbahnasawy M, Altibi A, Rai D, Deshwal H, Feitell S, Balla S. Covid-19 Infection Is Associated With Increased In-hospital Mortality And Complications In Patients With Acute Heart Failure: Insight From National Inpatient Sample (2020). Journal Of Cardiac Failure 2024, 30: 195. DOI: 10.1016/j.cardfail.2023.10.191.Peer-Reviewed Original ResearchAcute heart failure patientsAcute heart failureAcute kidney injuryIn-Hospital MortalityCOVID-19 infectionPulmonary embolismHeart failureAcute myocardial infarctionSeptic shockAtrial fibrillationBaseline comorbiditiesPatients admitted with acute heart failureDiagnosis of acute heart failureAssociated with increased in-hospital mortalityAcute heart failure exacerbationAcute heart failure hospitalizationClinical outcomes of COVID-19Coronary Artery Bypass GraftingAcute pulmonary embolismAssociated with significantly higher in-hospital mortalityHigher In-Hospital MortalityChronic heart failureHeart failure exacerbationNational Inpatient Sample databaseEnd-stage HF
2023
Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial
Ghazi L, Yamamoto Y, Fuery M, O'Connor K, Sen S, Samsky M, Riello R, Dhar R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial. European Heart Journal 2023, 44: 4233-4242. PMID: 37650264, DOI: 10.1093/eurheartj/ehad512.Peer-Reviewed Original ResearchGuideline-directed medical therapyAcute heart failureMineralocorticoid receptor antagonistsHeart failureElectronic health recordsGDMT prescriptionPrimary outcomeEnzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitorsSodium-glucose cotransporter 2 inhibitorsAngiotensin receptor neprilysin inhibitorElectronic health record alertsEvidence-based regimenProviders of patientsReduced ejection fractionCotransporter 2 inhibitorsRelevant patient characteristicsTime of dischargePre-specified criteriaAHF hospitalizationEligible patientsInpatient initiationPatient characteristicsEjection fractionHospitalized patientsMedian ageOutcomes Associated with Sodium-Glucose Cotransporter-2 Inhibitor Use in Acute Heart Failure Hospitalizations Complicated by AKI
Aklilu A, Kumar S, Yamamoto Y, Moledina D, Sinha F, Testani J, Wilson F. Outcomes Associated with Sodium-Glucose Cotransporter-2 Inhibitor Use in Acute Heart Failure Hospitalizations Complicated by AKI. Kidney360 2023, 4: 1371-1381. PMID: 37644648, PMCID: PMC10615381, DOI: 10.34067/kid.0000000000000250.Peer-Reviewed Original ResearchConceptsAcute kidney injuryHeart failure hospitalizationSodium-glucose cotransporter-2 inhibitor useSodium-glucose cotransporter 2 inhibitorsAcute heart failure hospitalizationCotransporter 2 inhibitorsCox regression analysisRenal recoveryFailure hospitalizationAKI diagnosisKidney injuryInhibitor useLower riskStage 5 chronic kidney diseaseTime-varying Cox regression analysisKidney Disease Improving Global OutcomesInverse probability-weighted analysisMulticenter retrospective cohort studyMultivariable Cox regression analysisStage 5 CKDAcute heart failureRetrospective cohort studyChronic kidney diseaseKidney function recoveryGlomerular filtration ratePrevention and treatment of diuretic resistance in acute heart failure: when to use which combination of diuretics?
Martens P, Testani J, Damman K. Prevention and treatment of diuretic resistance in acute heart failure: when to use which combination of diuretics? European Heart Journal 2023, 44: 2978-2981. PMID: 37572039, DOI: 10.1093/eurheartj/ehad463.Peer-Reviewed Original ResearchConceptsAcute heart failureCombination of diureticsDiuretic resistanceHeart failureDiureticsPreventionRandomized controlled trial of urinE chemiStry guided aCute heArt faiLure treATmEnt (ESCALATE): Rationale and design
Cox Z, Siddiqi H, Stevenson L, Bales B, Han J, Hart K, Imhoff B, Ivey-Miranda J, Jenkins C, Lindenfeld J, Shotwell M, Miller K, Ooi H, Rao V, Schlendorf K, Self W, Siew E, Storrow A, Walsh R, Wrenn J, Testani J, Collins S. Randomized controlled trial of urinE chemiStry guided aCute heArt faiLure treATmEnt (ESCALATE): Rationale and design. American Heart Journal 2023, 265: 121-131. PMID: 37544492, PMCID: PMC10592235, DOI: 10.1016/j.ahj.2023.07.014.Peer-Reviewed Original ResearchAcute decompensated heart failureUrine chemistryDiuretic strategyIntravenous diuresisUsual careAcute heartHeart failureClinical trialsGlobal clinical statusKey exclusion criteriaUsual care strategyAcute heart failureDecompensated heart failureRandomized clinical trialsKey inclusion criteriaMultiple clinical trialsPaucity of evidenceDiuretic dosingDiuretic therapyPrimary outcomePatient's symptomsClinical statusTreatment trialsValvular stenosisClinical stateThe blunted loop diuretic response in acute heart failure is driven by reduced tubular responsiveness rather than insufficient tubular delivery. The role of furosemide urine excretion on diuretic and natriuretic response in acute heart failure
Biegus J, Zymliński R, Testani J, Fudim M, Cox Z, Guzik M, Iwanek G, Hurkacz M, Raj D, Marciniak D, Ponikowska B, Ponikowski P. The blunted loop diuretic response in acute heart failure is driven by reduced tubular responsiveness rather than insufficient tubular delivery. The role of furosemide urine excretion on diuretic and natriuretic response in acute heart failure. European Journal Of Heart Failure 2023, 25: 1323-1333. PMID: 37042083, DOI: 10.1002/ejhf.2852.Peer-Reviewed Original ResearchConceptsAcute heart failureDiuretic responseHeart failureChronic usersTubular deliveryUrine volumeAcute heart failure patientsGlomerular filtration rateHeart failure patientsHigher urine volumeDiuretic exposureFurosemide deliveryFurosemide usersGood diuresisFurosemide doseFailure patientsNatriuretic responseFurosemide useTubular responseFiltration rateObservational studyUrine excretionNaïve groupHealthy individualsBody weightThe importance of forward flow and venous congestion in diuretic response in acute heart failure: Insights from the ESCAPE trial
Eder M, Griffin M, Moreno-Villagomez J, Bellumkonda L, Maulion C, Asher J, Wilson F, Cox Z, Ivey-Miranda J, Rao V, Butler J, Borlaug B, McCallum W, Ramos-Mastache D, Testani J. The importance of forward flow and venous congestion in diuretic response in acute heart failure: Insights from the ESCAPE trial. International Journal Of Cardiology 2023, 381: 57-61. PMID: 37023862, DOI: 10.1016/j.ijcard.2023.04.002.Peer-Reviewed Original ResearchConceptsRight atrial pressureDiuretic efficiencyRight atrial areaDiuretic responseVenous congestionHeart failureCardio-renal interactionsLoop diuretic doseAcute heart failureRenal perfusion pressureLow cardiac outputMean arterial pressureRight ventricular systolicCongestive heart failureVentricular ejection fractionNet fluid outputForward flowDiuretic doseDiuretic resistanceTTE parametersCardiac indexVentricular systolicArterial pressureAtrial pressureEjection fraction
2022
Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial
Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyAcute heart failureHeart failurePragmatic trialElectronic health recordsSubstantial health care costsBest practice advisoryReduced ejection fractionUsual care armHealth recordsTime of dischargeEvidence-based careHealth care costsClinical decision support systemAHF patientsCare armEligible patientsHF hospitalizationInpatient initiationCardiovascular deathMedication classesEjection fractionMedical therapyPrimary outcomePractice advisoryAssociation Between ACEI/ARB Use With Mortality, Heart Failure Admissions, and Kidney Failure Outcomes Among Patients Admitted for Acute Heart Failure Requiring Invasive Hemodynamic Monitoring
Tuttle M, Tighiouart H, Gillberg J, Banlengchit R, Oka T, Testani J, Kiernan M, Sarnak M, McCallum W. Association Between ACEI/ARB Use With Mortality, Heart Failure Admissions, and Kidney Failure Outcomes Among Patients Admitted for Acute Heart Failure Requiring Invasive Hemodynamic Monitoring. Journal Of The American Society Of Nephrology 2022, 33: 218-218. DOI: 10.1681/asn.20223311s1218a.Peer-Reviewed Original ResearchAssociation of Acute eGFR Changes With Mortality and Heart Failure Hospitalizations Among Patients Admitted for Acute Heart Failure Requiring Hemodynamic Monitoring
Banlengchit R, Tighiouart H, Gillberg J, Tuttle M, Testani J, Oka T, Kiernan M, Sarnak M, McCallum W. Association of Acute eGFR Changes With Mortality and Heart Failure Hospitalizations Among Patients Admitted for Acute Heart Failure Requiring Hemodynamic Monitoring. Journal Of The American Society Of Nephrology 2022, 33: 349-349. DOI: 10.1681/asn.20223311s1349c.Peer-Reviewed Original Research
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