2024
Impact of baseline kidney dysfunction on oral diuretic efficacy following hospitalization for heart failure – insights from TRANSFORM‐HF
Martens P, Greene S, Mentz R, Li S, Wojdyla D, Kapelios C, Mullens W, Hall M, Ketema F, Kim D, Eisenstein E, Anstrom K, Fang J, Pitt B, Velazquez E, Tang W. Impact of baseline kidney dysfunction on oral diuretic efficacy following hospitalization for heart failure – insights from TRANSFORM‐HF. European Journal Of Heart Failure 2024, 26: 1242-1250. PMID: 38558520, DOI: 10.1002/ejhf.3207.Peer-Reviewed Original ResearchEffect of torsemideBaseline renal functionRenal functionHeart failureKCCQ-CSSRandomized patientsKansas City Cardiomyopathy Questionnaire Clinical Summary ScoreSpectrum of renal functionBaseline kidney dysfunctionCategories of estimated glomerular filtration rateTrial randomized patientsClinical summary scoreAdverse clinical outcomesGlomerular filtration rateAll-cause mortalityTreatment effect modificationModify treatment effectsPost hoc analysisPatient-reported outcomesDiuretic efficacyBaseline eGFRNo significant differenceClinical outcomesKidney dysfunctionFiltration rateEfficacy And Safety Of Sacubitril/valsartan In Patients Hospitalized With Heart Failure: A Prespecified, Pooled Individual Patient-level Analysis Of PIONEER-HF And PARAGLIDE-HF
Morrow D, Velazquez E, Desai A, DeVore A, Lepage S, Park J, Sharma K, Solomon S, Starling R, Ward J, Williamson K, Zieroth S, Hernandez A, Mentz R, Braunwald E. Efficacy And Safety Of Sacubitril/valsartan In Patients Hospitalized With Heart Failure: A Prespecified, Pooled Individual Patient-level Analysis Of PIONEER-HF And PARAGLIDE-HF. Journal Of Cardiac Failure 2024, 30: 312-313. DOI: 10.1016/j.cardfail.2023.10.467.Peer-Reviewed Original ResearchSacubitril/valsartanPIONEER-HFHeart failurePooled analysisNT-proBNPControl therapyDe novo heart failurePlasma NT-proBNP levelsIndependent clinical events committeeIndividual patient-level analysisNovo heart failureNT-proBNP levelsClinical events committeePatient-level analysisCardiovascular deathHemodynamic stabilizationPrimary endpointSymptomatic hypotensionRenal functionMedian ageClinical outcomesRandomized trialsClinical effectsEvents committeeHF events
2023
Angiotensin-Neprilysin Inhibition in Patients With Mildly Reduced or Preserved Ejection Fraction and Worsening Heart Failure
Mentz R, Ward J, Hernandez A, Lepage S, Morrow D, Sarwat S, Sharma K, Starling R, Velazquez E, Williamson K, Desai A, Zieroth S, Solomon S, Braunwald E, Investigators P. Angiotensin-Neprilysin Inhibition in Patients With Mildly Reduced or Preserved Ejection Fraction and Worsening Heart Failure. Journal Of The American College Of Cardiology 2023, 82: 1-12. PMID: 37212758, DOI: 10.1016/j.jacc.2023.04.019.Peer-Reviewed Original ResearchConceptsSacubitril/valsartanEjection fractionWHF eventNT-proBNPSymptomatic hypotensionHeart failureAmino-terminal pro-B-type natriuretic peptideTerminal pro-B-type natriuretic peptidePro-B-type natriuretic peptidePlasma NT-proBNP levelsAngiotensin-Neprilysin InhibitionNT-proBNP changesNT-proBNP levelsUrgent HF visitsChronic heart failureHeart failure eventsLarge treatment effectsHF hospitalizationHF visitsCardiovascular deathPrimary endpointRenal functionClinical benefitNatriuretic peptideWeek 4Rationale, Design and Baseline Characteristics of the PARAGLIDE-HF Trial: Sacubitril/Valsartan vs Valsartan in HFmrEF and HFpEF With a Worsening Heart Failure Event
Mentz R, Ward J, Hernandez A, Lepage S, Morrow D, Sarwat S, Sharma K, Solomon S, Starling R, Velazquez E, Williamson K, Zieroth S, Braunwald E. Rationale, Design and Baseline Characteristics of the PARAGLIDE-HF Trial: Sacubitril/Valsartan vs Valsartan in HFmrEF and HFpEF With a Worsening Heart Failure Event. Journal Of Cardiac Failure 2023, 29: 922-930. PMID: 36796671, DOI: 10.1016/j.cardfail.2023.02.001.Peer-Reviewed Original ResearchConceptsSac/ValSacubitril/valsartanHeart failure eventsPARAGON-HF trialWHF eventNT-proBNPEjection fractionHeart failureClinical outcomesAmino-terminal pro-B-type natriuretic peptide levelsTerminal pro-B-type natriuretic peptide levelsB-type natriuretic peptide levelsDe novo HFChronic heart failureNatriuretic peptide levelsPrimary efficacy endpointPg/mLEfficacy endpointSafety endpointSecondary endpointsSymptomatic hypotensionBaseline characteristicsRenal functionStable patientsBlack patients
2019
Sacubitril/Valsartan Initiated in Black Patients Admitted for Acute Decompensated Heart Failure Reduced NT-proBNP, was Safe and Led to Improved Clinical Outcomes- A Secondary Analysis of the PIONEER-HF Trial
Velazquez E, Ambrosy A, Morrow D, McCague K, Duffy C, O'Brien T, Rocha R, DeVore A, Braunwald E. Sacubitril/Valsartan Initiated in Black Patients Admitted for Acute Decompensated Heart Failure Reduced NT-proBNP, was Safe and Led to Improved Clinical Outcomes- A Secondary Analysis of the PIONEER-HF Trial. Journal Of Cardiac Failure 2019, 25: s80. DOI: 10.1016/j.cardfail.2019.07.227.Peer-Reviewed Original ResearchAcute decompensated HFPIONEER-HF trialHeart failureNT-proBNPBlack patientsPg/mLAngioedema eventsHospital initiationClinical outcomesAcute decompensated heart failureAngiotensin receptor neprilysin inhibitorPre-specified subgroup analysisPrior heart failureACEI/ARBDecompensated heart failureNatriuretic peptide levelsSacubitril/valsartanImproved clinical outcomesSelf-reported raceCV deathEnalapril armHemodynamic stabilizationSymptomatic hypotensionRenal functionNeprilysin inhibitorRenal Effects of Intensive Volume Removal in Heart Failure Patients With Preexisting Worsening Renal Function
Rao VS, Ahmad T, Brisco-Bacik MA, Bonventre JV, Wilson FP, Siew ED, Felker GM, Anstrom KK, Mahoney DD, Bart BA, Tang WHW, Velazquez EJ, Testani JM. Renal Effects of Intensive Volume Removal in Heart Failure Patients With Preexisting Worsening Renal Function. Circulation Heart Failure 2019, 12: e005552. PMID: 31163974, PMCID: PMC6585463, DOI: 10.1161/circheartfailure.118.005552.Peer-Reviewed Original ResearchConceptsRenal tubular injury biomarkersTubular injury biomarkersHeart failure patientsAcute decompensated heart failure patientsDecompensated heart failure patientsTubular injury markersInjury biomarkersFailure patientsRenal functionInjury markersAcute decompensated heart failureVolume removalCARRESS-HF trialRenal function recoveryDecompensated heart failureRenal tubular injuryRenal effectsSerum creatinineTubular injuryBiomarker substudyHeart failurePharmacological therapyClinical outcomesFunction recoveryHigh incidence
2018
Angiotensin–Neprilysin Inhibition in Acute Decompensated Heart Failure
Velazquez EJ, Morrow DA, DeVore AD, Duffy CI, Ambrosy AP, McCague K, Rocha R, Braunwald E. Angiotensin–Neprilysin Inhibition in Acute Decompensated Heart Failure. New England Journal Of Medicine 2018, 380: 539-548. PMID: 30415601, DOI: 10.1056/nejmoa1812851.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAminobutyratesAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsBiphenyl CompoundsCardiac Output, LowDose-Response Relationship, DrugDouble-Blind MethodDrug CombinationsEnalaprilFemaleHeart FailureHumansMaleMiddle AgedNatriuretic Peptide, BrainNeprilysinPeptide FragmentsStroke VolumeTetrazolesValsartanConceptsAcute decompensated heart failureDecompensated heart failureNT-proBNP concentrationsSacubitril-valsartan groupSacubitril-valsartan therapyReduced ejection fractionHeart failureSymptomatic hypotensionRenal functionEnalapril groupEjection fractionWeek 4N-terminal pro-B-type natriuretic peptide concentrationsAngiotensin-Neprilysin InhibitionKey safety outcomePrimary efficacy outcomeNatriuretic peptide concentrationsGreater reductionEnalapril therapyEfficacy outcomesHemodynamic stabilizationSafety outcomesBaseline valuesWeek 1PatientsThe 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
2013
Low-Dose Dopamine or Low-Dose Nesiritide in Acute Heart Failure With Renal Dysfunction: The ROSE Acute Heart Failure Randomized Trial
Chen HH, Anstrom KJ, Givertz MM, Stevenson LW, Semigran MJ, Goldsmith SR, Bart B, Bull DA, Stehlik J, LeWinter MM, Konstam MA, Huggins GS, Rouleau JL, O'Meara E, Tang WH, Starling RC, Butler J, Deswal A, Felker GM, O'Connor CM, Bonita RE, Margulies KB, Cappola TP, Ofili EO, Mann DL, Dávila-Román VG, McNulty SE, Borlaug BA, Velazquez EJ, Lee KL, Shah MR, Hernandez AF, Braunwald E, Redfield MM. Low-Dose Dopamine or Low-Dose Nesiritide in Acute Heart Failure With Renal Dysfunction: The ROSE Acute Heart Failure Randomized Trial. JAMA 2013, 310: 2533-2543. PMID: 24247300, PMCID: PMC3934929, DOI: 10.1001/jama.2013.282190.Peer-Reviewed Original ResearchConceptsLow-dose dopamineAcute heart failureCumulative urine volumeRenal dysfunctionCystatin C levelsHeart failureRenal functionUrine volumeDiuretic therapyPlacebo-controlled clinical trialEnd pointPooled placebo groupCoprimary end pointsSecondary end pointsHours of admissionC levelsSerum cystatin CDose dopaminePlacebo groupActive treatmentClinical outcomesRandomized trialsClinical trialsCystatin CMAIN OUTCOME
2012
Ultrafiltration in Decompensated Heart Failure with Cardiorenal Syndrome
Bart B, Goldsmith SR, Lee KL, Givertz MM, O'Connor CM, Bull DA, Redfield MM, Deswal A, Rouleau JL, LeWinter MM, Ofili EO, Stevenson LW, Semigran MJ, Felker GM, Chen HH, Hernandez AF, Anstrom KJ, McNulty SE, Velazquez EJ, Ibarra JC, Mascette AM, Braunwald E. Ultrafiltration in Decompensated Heart Failure with Cardiorenal Syndrome. New England Journal Of Medicine 2012, 367: 2296-2304. PMID: 23131078, PMCID: PMC3690472, DOI: 10.1056/nejmoa1210357.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureSerum creatinine levelsHeart failureUltrafiltration groupRenal functionCreatinine levelsPharmacologic therapyAdverse eventsEnd pointSafety of ultrafiltrationPrimary end pointSerious adverse eventsTreatment of patientsPersistent congestionDiuretic therapyCardiorenal syndromeRandomized trialsMean changePatientsBody weightWeight lossTherapySignificant differencesHigh rate
2011
Diuretic Strategies in Patients with Acute Decompensated Heart Failure
Felker GM, Lee KL, Bull DA, Redfield MM, Stevenson LW, Goldsmith SR, LeWinter MM, Deswal A, Rouleau JL, Ofili EO, Anstrom KJ, Hernandez AF, McNulty SE, Velazquez EJ, Kfoury AG, Chen HH, Givertz MM, Semigran MJ, Bart B, Mascette AM, Braunwald E, O'Connor CM. Diuretic Strategies in Patients with Acute Decompensated Heart Failure. New England Journal Of Medicine 2011, 364: 797-805. PMID: 21366472, PMCID: PMC3412356, DOI: 10.1056/nejmoa1005419.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedArea Under CurveCreatinineDiureticsDouble-Blind MethodDrug Administration ScheduleDyspneaFemaleFurosemideHeart FailureHumansInfusions, IntravenousInjections, IntravenousIntention to Treat AnalysisKaplan-Meier EstimateMaleMiddle AgedSodium Potassium Chloride Symporter InhibitorsConceptsAcute decompensated heart failureDecompensated heart failurePatient global assessmentHeart failureCreatinine levelsContinuous infusionHigh-dose strategyGlobal assessmentRenal functionMean changeLow doseHigh doseSignificant differencesCoprimary end pointsSerum creatinine levelsHigh-dose groupLow-dose strategyVisual analog scaleComparison of BolusDiuretic strategyDiuretic therapyTransient worseningGreater diuresisDose adjustmentLoop diuretics
2008
Comparison of Renal Function and Cardiovascular Risk Following Acute Myocardial Infarction in Patients With and Without Diabetes Mellitus
Anavekar NS, Solomon SD, McMurray JJ, Maggioni A, Rouleau JL, Califf R, White H, Kober L, Velazquez E, Pfeffer MA. Comparison of Renal Function and Cardiovascular Risk Following Acute Myocardial Infarction in Patients With and Without Diabetes Mellitus. The American Journal Of Cardiology 2008, 101: 925-929. PMID: 18359309, DOI: 10.1016/j.amjcard.2007.11.037.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRenal dysfunctionRenal functionMyocardial infarctionCV outcomesDiabetes mellitusHigh-risk acute myocardial infarctionCox proportional modelingAdverse CV outcomesComposite cardiovascular eventsComposite end pointIndependent risk factorRenal Disease equationGlomerular filtration rateReduced renal functionBaseline creatinineCV eventsMean eGFRCardiovascular eventsCV diseaseCV riskVentricular dysfunctionCardiovascular riskHeart failureOverall mortalityPredictors of the first heart failure hospitalization in patients who are stable survivors of myocardial infarction complicated by pulmonary congestion and/or left ventricular dysfunction: a VALIANT study
Lewis EF, Velazquez EJ, Solomon SD, Hellkamp AS, McMurray JJ, Mathias J, Rouleau JL, Maggioni AP, Swedberg K, Kober L, White H, Dalby AJ, Francis GS, Zannad F, Califf RM, Pfeffer MA. Predictors of the first heart failure hospitalization in patients who are stable survivors of myocardial infarction complicated by pulmonary congestion and/or left ventricular dysfunction: a VALIANT study. European Heart Journal 2008, 29: 748-756. PMID: 18308687, DOI: 10.1093/eurheartj/ehn062.Peer-Reviewed Original ResearchConceptsHeart failure hospitalizationMyocardial infarctionFailure hospitalizationHigh-risk acute myocardial infarctionFirst heart failure hospitalizationHigh-risk myocardial infarctionStable post-MI patientsIndex myocardial infarctionRecurrent myocardial infarctionPrior myocardial infarctionLong-term survivorsPost-MI patientsRisk of deathAcute myocardial infarctionOnset of HFAntecedent diabetesTime-dependent fashionVALIANT studyCardiovascular deathInitial hospitalizationVentricular dysfunctionMost patientsRenal functionIndependent predictorsPrognostic factors
2007
The Relationship Between Renal Function and Cardiac Structure, Function, and Prognosis After Myocardial Infarction The VALIANT Echo Study
Verma A, Anavekar NS, Meris A, Thune JJ, Arnold JM, Ghali JK, Velazquez EJ, McMurray JJ, Pfeffer MA, Solomon SD. The Relationship Between Renal Function and Cardiac Structure, Function, and Prognosis After Myocardial Infarction The VALIANT Echo Study. Journal Of The American College Of Cardiology 2007, 50: 1238-1245. PMID: 17888840, DOI: 10.1016/j.jacc.2007.06.018.Peer-Reviewed Original ResearchConceptsLeft ventricular mass indexRenal impairmentHeart failureMyocardial infarctionRenal functionCardiac structureReduced eGFRSystolic functionLA volumeSmaller LVHigher left ventricular mass indexLarger left atrial volumeInfarct segment lengthMitral deceleration timeVALIANT Echo studyMultivariable Cox regressionAdverse cardiovascular outcomesLeft ventricular dysfunctionNormal renal functionOutcome of deathRight ventricular functionVentricular mass indexGlomerular filtration rateAdditional prognostic informationLarger LA volumes