2024
Effects of Sotagliflozin on Health Status in Patients With Worsening Heart Failure Results From SOLOIST-WHF
Bhatt A, Bhatt D, Steg P, Szarek M, Cannon C, Leiter L, McGuire D, Lewis J, Riddle M, Voors A, Metra M, Lund L, Testani J, Wilcox C, Davies M, Pitt B, Kosiborod M. Effects of Sotagliflozin on Health Status in Patients With Worsening Heart Failure Results From SOLOIST-WHF. Journal Of The American College Of Cardiology 2024, 84: 1078-1088. PMID: 39260929, DOI: 10.1016/j.jacc.2024.06.036.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2Effect of sotagliflozinKCCQ-12 scoreKCCQ-12Heart failureSOLOIST-WHFPrimary endpointSodium-glucose cotransporter 2 inhibitionLeft ventricular ejection fractionWorsening heart failureBaseline to monthVentricular ejection fractionHealth statusWorsening HFKansas City Cardiomyopathy Questionnaire-12Ejection fractionSecondary endpointsCotransporter 2Randomized patientsClinical characteristicsHF hospitalizationPlaceboCardiovascular deathHF episodeSotagliflozinEffects of Dapagliflozin on Body Composition and Its Relation to Hemodynamics in Heart Failure With Preserved Ejection Fraction
Naser J, Tada A, Harada T, Reddy Y, Carter R, Testani J, Jensen M, Borlaug B. Effects of Dapagliflozin on Body Composition and Its Relation to Hemodynamics in Heart Failure With Preserved Ejection Fraction. Circulation 2024, 149: 2026-2028. PMID: 38885297, PMCID: PMC11185269, DOI: 10.1161/circulationaha.124.069479.Peer-Reviewed Original Research
2023
Sodium restriction in patients with chronic heart failure and reduced ejection fraction: A randomized controlled trial
Ivey-Miranda J, Almeida-Gutierrez E, Herrera-Saucedo R, Posada-Martinez E, Chavez-Mendoza A, Mendoza-Zavala G, Cigarroa-Lopez J, Magaña-Serrano J, Rivera-Leaños R, Treviño-Mejia A, Revilla-Monsalve C, Flores-Umanzor E, Espinola-Zavaleta N, Orea-Tejeda A, Garduño-Espinosa J, Saturno-Chiu G, Rao VS, Testani J, Borrayo-Sanchez G. Sodium restriction in patients with chronic heart failure and reduced ejection fraction: A randomized controlled trial. Cardiology Journal 2023, 30: 411-421. PMID: 34490604, PMCID: PMC10287066, DOI: 10.5603/cj.a2021.0098.Peer-Reviewed Original ResearchConceptsQuality of lifeSodium restrictionAdverse safety eventsNT-proBNPHeart failureSodium intakeEjection fractionSafety eventsN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideStable HF patientsChronic heart failureNT-proBNP levelsReduced ejection fractionLow sodium intakeBeneficial cardiac effectsAdverse safety signalsSolid clinical evidenceGOV IDENTIFIERUrinary sodiumHF patientsSymptomatic hypotensionCardiac effectsSecondary outcomesBlood pressureThe 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 ResearchMeSH KeywordsHeart FailureHumansHyperemiaSodium Potassium Chloride Symporter InhibitorsStroke VolumeVentricular Function, LeftConceptsRight 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
Renal effects of guideline‐directed medical therapies in heart failure: a consensus document from the Heart Failure Association of the European Society of Cardiology
Mullens W, Martens P, Testani JM, Tang WHW, Skouri H, Verbrugge FH, Fudim M, Iacoviello M, Franke J, Flammer AJ, Palazzuoli A, Barragan PM, Thum T, Marcos MC, Miró Ò, Rossignol P, Metra M, Lassus J, Orso F, Jankowska EA, Chioncel O, Milicic D, Hill L, Seferovic P, Rosano G, Coats A, Damman K. Renal effects of guideline‐directed medical therapies in heart failure: a consensus document from the Heart Failure Association of the European Society of Cardiology. European Journal Of Heart Failure 2022, 24: 603-619. PMID: 35239201, DOI: 10.1002/ejhf.2471.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsChronic heart failureHeart failureRenal functionEjection fractionClinical practiceConsensus documentSodium-glucose cotransporter 2 inhibitorsGuideline-directed medical therapyReduced ejection fraction patientsEjection fraction patientsHeart Failure AssociationCotransporter 2 inhibitorsEuropean SocietyPharmacologic treatment optionsPoor renal functionDisease-modifying therapiesGood clinical practiceTreatment-induced changesDrug implementationHF drugsCardiology guidelinesESC guidelinesRenal effectsMedical therapyLifesaving therapy
2020
Acute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Acute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure. JACC Heart Failure 2020, 8: 537-547. PMID: 32535124, PMCID: PMC9027677, DOI: 10.1016/j.jchf.2020.03.009.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptideAcute decompensated heart failureDecompensated heart failureHeart failureKidney functionAdverse outcomesAcute declineNT-proBNPComposite outcomeNatriuretic peptideHigh riskMultivariable Cox regression modelsTotal proteinAcute kidney functionMarkers of decongestionN-terminal prohormoneGlomerular filtration rateCox regression modelEGFR declineCardiovascular deathVolume overloadFiltration rateEGFRHospital changesDecongestionImproved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study
Akiyama E, Cinotti R, Čerlinskaitė K, Van Aelst LNL, Arrigo M, Placido R, Chouihed T, Girerd N, Zannad F, Rossignol P, Badoz M, Launay J, Gayat E, Cohen‐Solal A, Lam CSP, Testani J, Mullens W, Cotter G, Seronde M, Mebazaa A. Improved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study. ESC Heart Failure 2020, 7: 996-1006. PMID: 32277607, PMCID: PMC7261539, DOI: 10.1002/ehf2.12645.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionTricuspid annular plane systolic excursionNeutrophil Gelatinase-Associated LipocalinVenous pressureAHF patientsHFrEF patientsCardiac chamber dimensionsEchocardiographic parametersDyspnea patientsHeart failureNatriuretic peptidePlasma volumeMid-regional pro-atrial natriuretic peptideAcute heart failure patientsDiastolic Heart Failure StudyAnnular plane systolic excursionPro-atrial natriuretic peptideB-type natriuretic peptideE-wave deceleration timeInferior vena cava diameterAcute heart failureDiastolic heart failureGelatinase-Associated LipocalinGlomerular filtration rateHeart failure patientsExtending Behavioral Medicine to Heart Failure With Preserved Ejection Fraction.
Harris KM, Testani JM, Burg MM. Extending Behavioral Medicine to Heart Failure With Preserved Ejection Fraction. Psychosomatic Medicine 2020, 82: 345-346. PMID: 32150010, PMCID: PMC7138745, DOI: 10.1097/psy.0000000000000783.Commentaries, Editorials and LettersReal World Use of Hypertonic Saline in Refractory Acute Decompensated Heart Failure A U.S. Center’s Experience
Griffin M, Soufer A, Goljo E, Colna M, Rao VS, Jeon S, Raghavendra P, D'Ambrosi J, Riello R, Coca SG, Mahoney D, Jacoby D, Ahmad T, Chen M, Tang WHW, Turner J, Mullens W, Wilson FP, Testani JM. Real World Use of Hypertonic Saline in Refractory Acute Decompensated Heart Failure A U.S. Center’s Experience. JACC Heart Failure 2020, 8: 199-208. PMID: 32035891, PMCID: PMC7814403, DOI: 10.1016/j.jchf.2019.10.012.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureHypertonic saline administrationHypertonic saline therapyHypertonic salineSaline administrationSaline therapyDiuretic efficiencyUrine outputSerum sodiumWeight lossAcute decompensated heartDecompensated heart failureCohort of patientsTotal urine outputReal-world safetyU.S. academic medical centersAcademic medical centerLarge U.S. academic medical centerDiuretic doseCenter experienceHeart failureMetabolic derangementsPrimary analytic approachRespiratory statusClinical variables
2019
Adverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction
Reddy YNV, Obokata M, Testani JM, Felker GM, Tang WHW, Abou-Ezzeddine OF, Sun JL, Chakrabothy H, McNulty S, Shah SJ, Lewis GD, Stevenson LW, Redfield MM, Borlaug BA. Adverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction. Journal Of Cardiac Failure 2019, 26: 101-107. PMID: 31618698, PMCID: PMC7036022, DOI: 10.1016/j.cardfail.2019.09.015.Peer-Reviewed Original ResearchConceptsRenal functionNonobese patientsHeart failureObese HFpEFObese patientsEjection fractionRenal responseAdverse renal responsesRight ventricular remodelingGlomerular filtration rateBody mass indexPlasma volume expansionSimilar weight lossCardiorenal hemodynamicsRenal dysfunctionPathophysiologic featuresMass indexAtrial fibrillationDecongestive therapyVentricular remodelingPericardial restraintFiltration rateHFpEFObese phenotypeSevere worseningUrinary Sodium Profiling in Chronic Heart Failure to Detect Development of Acute Decompensated Heart Failure
Martens P, Dupont M, Verbrugge FH, Damman K, Degryse N, Nijst P, Reynders C, Penders J, Tang WHW, Testani J, Mullens W. Urinary Sodium Profiling in Chronic Heart Failure to Detect Development of Acute Decompensated Heart Failure. JACC Heart Failure 2019, 7: 404-414. PMID: 31047021, DOI: 10.1016/j.jchf.2019.02.011.Peer-Reviewed Original ResearchConceptsChronic HF patientsHF patientsHeart failureSodium excretionAcute decompensated heart failureAcute heart failure hospitalizationLongitudinal changesChronic heart failureDecompensated heart failureHeart failure hospitalizationHigher sodium excretionUrinary sodium concentrationGlomerular filtration rate measurementInterindividual differencesLarge interindividual differencesFiltration rate measurementAHF hospitalizationDyspnea scoreFailure hospitalizationNT-proBNPChronic heartEjection fractionIndependent predictorsClinical endpointsPathophysiologic interactionsThe use of diuretics in heart failure with congestion — a position statement from the Heart Failure Association of the European Society of Cardiology
Mullens W, Damman K, Harjola V, Mebazaa A, Rocca H, Martens P, Testani JM, Tang WHW, Orso F, Rossignol P, Metra M, Filippatos G, Seferovic PM, Ruschitzka F, Coats AJ. The use of diuretics in heart failure with congestion — a position statement from the Heart Failure Association of the European Society of Cardiology. European Journal Of Heart Failure 2019, 21: 137-155. PMID: 30600580, DOI: 10.1002/ejhf.1369.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsUse of diureticsHeart failureElectrolyte disturbancesAcute heart failure episodeAcute heart failureHeart Failure AssociationCommon electrolyte disturbanceHeart failure episodesGoal of therapyResponse/resistanceRelief of congestionSigns of congestionDiuretic resistanceDiuretic strategyDiuretic therapyRenal functionVolume overloadDiuretic responseAvailable guidelinesDiureticsEuropean SocietyFailure episodesPosition statementEuvolaemiaEvaluation of congestion
2018
The prognostic role of different renal function phenotypes in patients with acute heart failure
Palazzuoli A, Ruocco G, Pellicori P, Incampo E, Di Tommaso C, Favilli R, Evangelista I, Nuti R, Testani JM. The prognostic role of different renal function phenotypes in patients with acute heart failure. International Journal Of Cardiology 2018, 276: 198-203. PMID: 30503187, DOI: 10.1016/j.ijcard.2018.11.108.Peer-Reviewed Original ResearchConceptsAcute heart failureBUN increaseHeart failureIndependent predictorsPrognostic roleAdverse outcomesGlomerular filtration rate reductionBlood nitrogen ureaSigns of HFRenal function deteriorationBUN changeClinical congestionEffective decongestionFunction deteriorationRenal functionSerum creatininePoor outcomePrognostic relevanceComplete resolutionClinical signsPatientsNitrogen ureaHospitalizationBUNOutcomesEarly urine electrolyte patterns in patients with acute heart failure
Collins SP, Jenkins CA, Baughman A, Miller KF, Storrow AB, Han JH, Brown NJ, Liu D, Luther JM, McNaughton CD, Self WH, Peng D, Testani JM, Lindenfeld J. Early urine electrolyte patterns in patients with acute heart failure. ESC Heart Failure 2018, 6: 80-88. PMID: 30295437, PMCID: PMC6351901, DOI: 10.1002/ehf2.12368.Peer-Reviewed Original ResearchConceptsAcute heart failureDiuretic administrationDiuretic resistanceHeart failureLoop diureticsLow urinary sodiumEscalation of therapyUrine sodium excretionSubset of patientsSystolic blood pressureEmergency department patientsUrine sodium concentrationAHF diagnosisAHF patientsIntravenous diureticsUrinary sodiumED staySodium excretionUrinary electrolytesUrine sodiumNatriuretic responseStandard therapyBlood pressureDepartment patientsUrine outputOutcomes Associated With a Strategy of Adjuvant Metolazone or High‐Dose Loop Diuretics in Acute Decompensated Heart Failure: A Propensity Analysis
Brisco‐Bacik M, Maaten J, Houser SR, Vedage NA, Rao V, Ahmad T, Wilson FP, Testani JM. Outcomes Associated With a Strategy of Adjuvant Metolazone or High‐Dose Loop Diuretics in Acute Decompensated Heart Failure: A Propensity Analysis. Journal Of The American Heart Association 2018, 7: e009149. PMID: 30371181, PMCID: PMC6222930, DOI: 10.1161/jaha.118.009149.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedCause of DeathDose-Response Relationship, DrugFemaleFollow-Up StudiesGuideline AdherenceHeart FailureHumansInjections, IntravenousMaleMetolazonePropensity ScoreRetrospective StudiesSodium Chloride Symporter InhibitorsSodium Potassium Chloride Symporter InhibitorsStroke VolumeSurvival RateTreatment OutcomeUnited StatesConceptsHigh-dose loop diureticsAcute decompensated heart failureDecompensated heart failureLoop diureticsRenal functionPropensity adjustmentHeart failureCommon electronic medical recordIntravenous loop diureticsLoop diuretic dosePropensity-adjusted analysisThiazide-type diureticsControl trial dataElectronic medical recordsDiuretic doseDiuretic strategyCause mortalityAdverse eventsBaseline characteristicsSecondary outcomesThiazide diureticsResults PatientsDischarge diagnosisMedical recordsDiureticsPerturbations in serum chloride homeostasis in heart failure with preserved ejection fraction: insights from TOPCAT
Grodin JL, Testani JM, Pandey A, Sambandam K, Drazner MH, Fang JC, Tang WHW. Perturbations in serum chloride homeostasis in heart failure with preserved ejection fraction: insights from TOPCAT. European Journal Of Heart Failure 2018, 20: 1436-1443. PMID: 29893446, DOI: 10.1002/ejhf.1229.Peer-Reviewed Original ResearchConceptsSerum chloride levelsLoop diuretic useHeart failureSerum chlorideCause deathDiuretic useEjection fractionMultivariable Cox proportional hazards modelsCardiac Function Heart FailureCox proportional hazards modelAldosterone Antagonist TrialHeart failure hospitalizationPrimary composite endpointLower serum chlorideProportional hazards modelSerum chloride concentrationChloride levelsSpironolactone useCardiovascular deathFailure hospitalizationMultivariable adjustmentComposite endpointLoop diureticsClinical outcomesHazards model
2017
Inflammation and cardio‐renal interactions in heart failure: a potential role for interleukin‐6
Hanberg JS, Rao VS, Ahmad T, Chunara Z, Mahoney D, Jackson K, Jacoby D, Chen M, Wilson FP, Tang WHW, Kakkar R, Testani JM. Inflammation and cardio‐renal interactions in heart failure: a potential role for interleukin‐6. European Journal Of Heart Failure 2017, 20: 933-934. PMID: 29024287, PMCID: PMC5895540, DOI: 10.1002/ejhf.963.Peer-Reviewed Original ResearchNovel Biomarkers for the Risk Stratification of Heart Failure with Preserved Ejection Fraction
Cypen J, Ahmad T, Testani JM, DeVore AD. Novel Biomarkers for the Risk Stratification of Heart Failure with Preserved Ejection Fraction. Current Heart Failure Reports 2017, 14: 434-443. PMID: 28803400, DOI: 10.1007/s11897-017-0358-4.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsHeart failureEjection fractionHF biomarkersRisk stratificationReduced ejection fractionTreatment of HFpEFBrain natriuretic peptideValuable prognostic markerKey pathophysiologic componentUse of biomarkersSignificant therapeutic targetSystemic inflammationPathophysiologic componentsNatriuretic peptidePrognostic valueMyocardial fibrosisPrognostic markerNovel biomarkersCurrent evidenceTherapeutic targetHFpEFReviewThe useSummaryFurther investigationBiomarkersInflammationSerum Chloride and Sodium Interplay in Patients With Acute Myocardial Infarction and Heart Failure With Reduced Ejection Fraction
Ferreira JP, Girerd N, Duarte K, Coiro S, McMurray JJ, Dargie HJ, Pitt B, Dickstein K, Testani JM, Zannad F, Rossignol P. Serum Chloride and Sodium Interplay in Patients With Acute Myocardial Infarction and Heart Failure With Reduced Ejection Fraction. Circulation Heart Failure 2017, 10: e003500. PMID: 28159825, DOI: 10.1161/circheartfailure.116.003500.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedBiomarkersChloridesComorbidityDatabases, FactualFemaleHeart FailureHumansKaplan-Meier EstimateLinear ModelsMaleMiddle AgedMyocardial InfarctionNonlinear DynamicsPrognosisProportional Hazards ModelsRandomized Controlled Trials as TopicRetrospective StudiesRisk AssessmentRisk FactorsSodiumStroke VolumeVentricular Dysfunction, LeftVentricular Function, LeftConceptsHeart failureAcute myocardial infarctionSerum chlorideMyocardial infarctionPrognostic informationPrognostic variablesSodium levelsReduced left ventricular functionLow sodiumReduced ejection fractionLeft ventricular functionLower serum chlorideSignificant prognostic informationRelevant prognostic informationSerum chloride levelsPost-myocardial infarctionLow sodium levelsMore comorbiditiesCause mortalitySystolic dysfunctionCardiovascular mortalityEjection fractionVentricular functionClinical outcomesMortality rate
2010
Characteristics of Patients With Improvement or Worsening in Renal Function During Treatment of Acute Decompensated Heart Failure
Testani JM, McCauley BD, Kimmel SE, Shannon RP. Characteristics of Patients With Improvement or Worsening in Renal Function During Treatment of Acute Decompensated Heart Failure. The American Journal Of Cardiology 2010, 106: 1763-1769. PMID: 21055713, PMCID: PMC2997119, DOI: 10.1016/j.amjcard.2010.07.050.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseCardiotonic AgentsCatheterization, Swan-GanzCreatinineDisease ProgressionFemaleFollow-Up StudiesGlomerular Filtration RateHeart FailureHumansInfusions, IntravenousMaleMiddle AgedPrognosisPulmonary Wedge PressureRecovery of FunctionRenal InsufficiencyRetrospective StudiesStroke VolumeVasodilator AgentsConceptsDecompensated heart failureRenal functionStable renal functionCardiac indexHeart failureVasodilator usePulmonary Artery Catheterization Effectiveness trialAcute decompensated heart failureSimilar hemodynamic parametersCharacteristics of patientsCongestive heart failureComparison of patientsAdvanced disease stateCardiorenal interactionsIntravenous inotropesCause mortalityWorse survivalHemodynamic variablesPoor prognosisCreatinine valuesEffectiveness trialHemodynamic parametersHemodynamic differencesPatientsDisease states