Christopher Maulion, MD
Assistant Professor of Cardiovascular MedicineCards
About
Research
Publications
2024
Serial direct sodium removal in patients with heart failure and diuretic resistance
Rao V, Ivey‐Miranda J, Cox Z, Moreno‐Villagomez J, Ramos‐Mastache D, Neville D, Balkcom N, Asher J, Bellumkonda L, Bigvava T, Shaburishvili T, Bartunek J, Wilson F, Finkelstein F, Maulion C, Turner J, Testani J. Serial direct sodium removal in patients with heart failure and diuretic resistance. European Journal Of Heart Failure 2024, 26: 1215-1230. PMID: 38556717, DOI: 10.1002/ejhf.3196.Peer-Reviewed Original ResearchConceptsDiuretic resistanceCardiorenal syndromeHeart failureLoop diureticsDiuretic withdrawalHigh-dose loop diureticsN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideGrowth differentiation factor 15Carbohydrate antigen 125Differentiation factor 15Sodium removalRandomized controlled studyCardiorenal parametersDiuretic doseSoluble ST2Natriuretic peptideMedian timeDiuretic responseKidney injuryPeritoneal membraneElectrolyte handlingKidney functionDiureticsInterleukin-6
2023
Empagliflozin in Heart Failure: Regional Nephron Sodium Handling Effects
Rao V, Ivey-Miranda J, Cox Z, Moreno-Villagomez J, Maulion C, Bellumkonda L, Chang J, Field M, Wiederin D, Butler J, Collins S, Turner J, Wilson F, Inzucchi S, Wilcox C, Ellison D, Testani J. Empagliflozin in Heart Failure: Regional Nephron Sodium Handling Effects. Journal Of The American Society Of Nephrology 2023, 35: 189-201. PMID: 38073038, PMCID: PMC10843196, DOI: 10.1681/asn.0000000000000269.Peer-Reviewed Original ResearchThe 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 fractionUtilization of an Independent Procurement Team for Direct Procurement and Machine Perfusion of Cardiac Allografts Following Donation after Cardiac Death
Ragnarsson S, Morrison A, Higaki A, Mullan C, Sen S, Ahmad T, Anwer M, Geirsson A, Maulion C, Davis R. Utilization of an Independent Procurement Team for Direct Procurement and Machine Perfusion of Cardiac Allografts Following Donation after Cardiac Death. The Journal Of Heart And Lung Transplantation 2023, 42: s279-s280. DOI: 10.1016/j.healun.2023.02.638.Peer-Reviewed Original ResearchDCD heart transplantationCST groupCardiac allograftsHeart transplantationMachine perfusionNPS groupCardiac deathMedian warm ischemia timeExcellent short-term survivalMedian recipient agePostoperative mechanical supportSingle-center reviewMean donor ageWarm ischemia timeManual chart reviewShort-term survivalProcurement teamRecipient ageChart reviewCirculatory deathIschemia timeDonor ageOrgan recoveryHeartMate 3Group 52In-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
Clinical implications of Type 2 diabetes on outcomes after cardiac transplantation
Chouairi F, Mullan C, Ahmed A, Bhinder J, Guha A, Miller P, Jastreboff A, Fuery M, Chiravuri M, Geirsson A, Desai N, Maulion C, Sen S, Ahmad T, Anwer M. Clinical implications of Type 2 diabetes on outcomes after cardiac transplantation. PLOS ONE 2022, 17: e0273111. PMID: 36516178, PMCID: PMC9750001, DOI: 10.1371/journal.pone.0273111.Peer-Reviewed Original ResearchConceptsPost-transplant mortalityType 2 diabetesAllocation system changeOld allocation systemsHeart transplant recipientsOutcomes of patientsOrgan Sharing databaseProportion of patientsHeart transplantation outcomesLower likelihoodLikelihood of transplantationHigher likelihoodNew allocation systemCardiac transplantationHeart transplantationTransplant recipientsT2D patientsHeart failureSharing databaseCox regressionTransplantation outcomesUnited NetworkWorse outcomesT2DPatientsHemoconcentration of Creatinine Minimally Contributes to Changes in Creatinine during the Treatment of Decompensated Heart Failure
Maulion C, Chen S, Rao VS, Ivey-Miranda JB, Cox ZL, Mahoney D, Coca SG, Negoianu D, Asher JL, Turner JM, Inker LA, Wilson FP, Testani JM. Hemoconcentration of Creatinine Minimally Contributes to Changes in Creatinine during the Treatment of Decompensated Heart Failure. Kidney360 2022, 3: 1003-1010. PMID: 35845336, PMCID: PMC9255871, DOI: 10.34067/kid.0007582021.Peer-Reviewed Original ResearchDefibrillators in heart transplant patients: Not always a shockingly good choice
Rosenfeld LE, Maulion C. Defibrillators in heart transplant patients: Not always a shockingly good choice. Journal Of Cardiovascular Electrophysiology 2022, 33: 1823-1825. PMID: 35671360, DOI: 10.1111/jce.15587.Peer-Reviewed Original ResearchInferior 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
Clinical Trials
Current Trials
Mechanisms Underlying Hypotensive Response to ARB/NEP Inhibition - Aim 3
HIC ID2000028712RoleSub InvestigatorPrimary Completion Date12/31/2025Recruiting ParticipantsErtugliflozin in Acute Heart Failure
HIC ID2000027951RoleSub InvestigatorPrimary Completion Date01/31/2022Recruiting ParticipantsGenderBothAge18+ years
Academic Achievements & Community Involvement
Clinical Care
Overview
Christopher Maulion, MD, is a cardiologist who specializes in advanced heart failure and transplant. He treats critically ill patients with cardiomyopathy, a spectrum of diseases of the heart muscle that lead to diminished heart function, potentially requiring advanced therapies including heart transplantation and left ventricular assist devices.
Dr. Maulion also is working with heart transplant surgeons to spearhead a multi-site clinical trial at Yale involving DCD (donation after cardiac death). Utilization of DCD organs is relatively new in the U.S., where the vast majority of donor hearts are retrieved as “donation after brain death.” Dr. Maulion reports, “DCD is the likely next chapter in cardiac transplantation,” and the trial may be the first step toward expanding the number of available organs and providing lifesaving opportunities for patients.
The heart failure and transplant field attracted Dr. Maulion because of its complexity and the opportunities it provides to help very sick patients get their lives back. “Advanced heart failure cardiology requires a broad knowledge base of not only cardiology but also internal medicine,” he says. “In addition, it is a field that is innovating in multiple fronts, spanning from the medical treatment of heart failure to mechanical circulatory support devices and heart transplant.” The work has also shaped his research interests in DCD heart transplantation, medical treatments in chronic heart failure, and cardiorenal syndrome, which involves both the heart and kidneys.
But Dr. Maulion says he is most grateful for the incredible patients he has met. “Overcoming the odds and being able to give a person a new lease on life is an amazing feeling,” he says. “Dealing with such a sick population has taught me how resilient a patient can be.”
Clinical Specialties
Fact Sheets
Ventricular Assist Device (VAD)
Learn More on Yale MedicineCongestive Heart Failure (CHF)
Learn More on Yale MedicineHeart Transplant
Learn More on Yale MedicineHeart Failure Surgery
Learn More on Yale Medicine
Board Certifications
Cardiovascular Disease
- Certification Organization
- AB of Internal Medicine
- Original Certification Date
- 2018
Internal Medicine
- Certification Organization
- AB of Internal Medicine
- Original Certification Date
- 2015
Yale Medicine News
News
News
- July 27, 2022
New Appointments & Promotions Within Department of Internal Medicine
- July 08, 2022
Incoming faculty join Yale Cardiovascular Medicine
- October 05, 2020Source: LMT online
Yale docs ‘doing it for the heart’: Technology brings more transplants with shorter wait
- September 16, 2019
2019 Department of Internal Medicine Faculty Appointments and Promotions