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 episodeSotagliflozinDapagliflozin Enhances Arterial and Venous Compliance During Exercise in Heart Failure With Preserved Ejection Fraction: Insights From the CAMEO-DAPA Trial
Tada A, Burkhoff D, Naser J, Harada T, Pourmussa B, Reddy Y, Jensen M, Carter R, Demmer R, Testani J, Chirinos J, Borlaug B. Dapagliflozin Enhances Arterial and Venous Compliance During Exercise in Heart Failure With Preserved Ejection Fraction: Insights From the CAMEO-DAPA Trial. Circulation 2024, 150: 997-1009. PMID: 39101201, PMCID: PMC11433515, DOI: 10.1161/circulationaha.124.068788.Peer-Reviewed Original ResearchConceptsSystemic arterial complianceEffects of dapagliflozinStressed blood volumeVenous capacitanceBlood volumePeak exerciseArterial complianceHemodynamic congestionHeart failureEstimating stressed blood volumeImproved systemic arterial complianceInvasive hemodynamic exercise testingSodium-glucose cotransporter-2 inhibitorsSystolic BPPulmonary capillary wedge pressureHemodynamic exercise testingCapillary wedge pressureCotransporter-2 inhibitorsSystemic vascular resistanceImproving clinical outcomesTotal blood volumeRadial artery pressureSimultaneous echocardiographyEjection fractionFluid-filled catheterEffects 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 ResearchDietary sodium and fluid intake in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC
Mullens W, Damman K, Dhont S, Banerjee D, Bayes‐Genis A, Cannata A, Chioncel O, Cikes M, Ezekowitz J, Flammer A, Martens P, Mebazaa A, Mentz R, Miró Ò, Moura B, Nunez J, Maaten J, Testani J, van Kimmenade R, Verbrugge F, Metra M, Rosano G, Filippatos G. Dietary sodium and fluid intake in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC. European Journal Of Heart Failure 2024, 26: 730-741. PMID: 38606657, DOI: 10.1002/ejhf.3244.Peer-Reviewed Original ResearchConceptsHeart failureClinical consensus statementFluid restrictionDietary sodiumConsensus statementEuropean Society of Cardiology HF guidelinesUntreated patient cohortLimitation of salt intakeHeart Failure AssociationSodium handlingSodium intakePatient cohortSalt intakeHF guidelinesFluid intakeFailure AssociationFluid homeostasisPatientsAvidity stateEuropean SocietyIntakeHeartContemporary evidenceExpert opinionData challengeSerial 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
Improved Decongestion With Devices in Decompensated Heart Failure Does the End Justify the Means? ∗
Testani J, Butler J, Packer M. Improved Decongestion With Devices in Decompensated Heart Failure Does the End Justify the Means? ∗. JACC Heart Failure 2023, 11: 1576-1578. PMID: 37940218, DOI: 10.1016/j.jchf.2023.07.006.Peer-Reviewed Original ResearchOutcomes 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 ResearchEffect of Sotagliflozin on Early Mortality and Heart Failure-Related Events A Post Hoc Analysis of SOLOIST-WHF
Pitt B, Bhatt D, Szarek M, Cannon C, Leiter L, McGuire D, Lewis J, Riddle M, Voors A, Metra M, Lund L, Komajda M, Testani J, Wilcox C, Ponikowski P, Lopes R, Ezekowitz J, Sun F, Davies M, Verma S, Kosiborod M, Steg P, Investigators S. Effect of Sotagliflozin on Early Mortality and Heart Failure-Related Events A Post Hoc Analysis of SOLOIST-WHF. JACC Heart Failure 2023, 11: 879-889. PMID: 37558385, DOI: 10.1016/j.jchf.2023.05.026.Peer-Reviewed Original ResearchConceptsMain endpointCardiovascular deathHeart failureN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideEffect of sotagliflozinDate of dischargeGlomerular filtration rateVentricular ejection fractionType 2 diabetesProportional hazards modelPost Hoc AnalysisAgonist useCause mortalityIndex hospitalizationStudy drugEjection fractionEarly mortalityNatriuretic peptideStudy treatmentHF eventsSubgroup analysisFiltration rateHoc AnalysisHazards modelCongestion and Decongestion Assessment in Heart Failure Pressure, Volume, or Both? ∗
Biegus J, Borlaug B, Testani J. Congestion and Decongestion Assessment in Heart Failure Pressure, Volume, or Both? ∗. JACC Heart Failure 2023, 11: 1152-1156. PMID: 37611991, DOI: 10.1016/j.jchf.2023.05.034.Peer-Reviewed Original ResearchHeart FailureHumansCritical Analysis of the Effects of SGLT2 Inhibitors on Renal Tubular Sodium, Water and Chloride Homeostasis and Their Role in Influencing Heart Failure Outcomes
Packer M, Wilcox C, Testani J. Critical Analysis of the Effects of SGLT2 Inhibitors on Renal Tubular Sodium, Water and Chloride Homeostasis and Their Role in Influencing Heart Failure Outcomes. Circulation 2023, 148: 354-372. PMID: 37486998, PMCID: PMC10358443, DOI: 10.1161/circulationaha.123.064346.Peer-Reviewed Original ResearchConceptsSGLT2 inhibitorsProximal renal tubulesRenal tubulesProximal tubular effectHeart failure outcomesHeart failure eventsSodium-hydrogen exchanger 3Renal tubular sodiumProgressive volume lossLong-term treatmentReabsorption of glucoseTreatment-related changesChronic diuresisPharmacological toleranceTubular effectsClinical courseFractional excretionHeart failureTubular sodiumCardioprotective effectsRenal compensationDiuretic effectIndividual patientsDurable improvementDegree of upregulationSodium 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 pressure“Pouring Salt in the Wound”: Sodium Restriction in Acute Heart Failure
Cox Z, Testani J. “Pouring Salt in the Wound”: Sodium Restriction in Acute Heart Failure. Journal Of Cardiac Failure 2023, 29: 997-999. PMID: 37236502, DOI: 10.1016/j.cardfail.2023.05.007.Commentaries, Editorials and LettersSGLT2 inhibitors and diuretics in heart failure: clicking reset on the renal volume setpoint?
Borlaug B, Testani J. SGLT2 inhibitors and diuretics in heart failure: clicking reset on the renal volume setpoint? European Heart Journal 2023, 44: 2944-2946. PMID: 37220086, DOI: 10.1093/eurheartj/ehad345.Commentaries, Editorials and LettersA randomized clinical trial assessing the effect of automated medication-targeted alerts on acute kidney injury outcomes
Wilson F, Yamamoto Y, Martin M, Coronel-Moreno C, Li F, Cheng C, Aklilu A, Ghazi L, Greenberg J, Latham S, Melchinger H, Mansour S, Moledina D, Parikh C, Partridge C, Testani J, Ugwuowo U. A randomized clinical trial assessing the effect of automated medication-targeted alerts on acute kidney injury outcomes. Nature Communications 2023, 14: 2826. PMID: 37198160, PMCID: PMC10192367, DOI: 10.1038/s41467-023-38532-3.Peer-Reviewed Original ResearchConceptsAcute kidney injuryUsual care groupKidney injuryCare groupAcute Kidney Injury OutcomesAlert groupNon-steroidal anti-inflammatory drugsComposite of progressionHours of randomizationMedications of interestAldosterone system inhibitorsClasses of medicationsProton pump inhibitorsRandomized clinical trialsAnti-inflammatory drugsClinical decision support systemNephrotoxic medicationsHospitalized adultsDiscontinuation ratesCertain medicationsPrimary outcomeSubstantial morbiditySystem inhibitorsPump inhibitorsParallel groupThe 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 weightUpdates in Cardiorenal Syndrome
McCallum W, Testani J. Updates in Cardiorenal Syndrome. Medical Clinics Of North America 2023, 107: 763-780. PMID: 37258013, PMCID: PMC10756136, DOI: 10.1016/j.mcna.2023.03.011.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsThe 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 fractionIn-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