2023
The 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
Inferior 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
2020
First-in-Human Experience With Peritoneal Direct Sodium Removal Using a Zero-Sodium Solution
Rao VS, Turner JM, Griffin M, Mahoney D, Asher J, Jeon S, Yoo PS, Boutagy N, Feher A, Sinusas A, Wilson FP, Finkelstein F, Testani JM. First-in-Human Experience With Peritoneal Direct Sodium Removal Using a Zero-Sodium Solution. Circulation 2020, 141: 1043-1053. PMID: 31910658, PMCID: PMC7331276, DOI: 10.1161/circulationaha.119.043062.Peer-Reviewed Original ResearchConceptsStandard PD solutionExperimental heart failureHeart failurePD solutionsAdverse eventsPeritoneal dialysisSignificant discomfortSodium removalEnd-stage renal diseaseEnd pointElevated right atrial pressureMaintenance of euvolemiaPrimary end pointSecondary end pointsRight atrial pressureHuman proofLoss of responseSolute removalPorcine experimentsAtrial pressureRenal diseaseLoop diureticsSerum electrolytesHuman studiesPeritoneal membrane
2018
Hemodynamic factors associated with serum chloride in ambulatory patients with advanced heart failure
Grodin JL, Mullens W, Dupont M, Taylor DO, McKie PM, Starling RC, Testani JM, Tang WHW. Hemodynamic factors associated with serum chloride in ambulatory patients with advanced heart failure. International Journal Of Cardiology 2018, 252: 112-116. PMID: 29249420, DOI: 10.1016/j.ijcard.2017.11.024.Peer-Reviewed Original ResearchConceptsPulmonary capillary wedge pressureAdvanced chronic heart failureFick cardiac indexPulmonary artery systolic pressureRight atrial pressureVentricular assist device placementHeart transplantHeart rateHeart failureSerum chlorideHigher cardiac filling pressuresPoor long-term outcomesSerum Cl levelsCapillary wedge pressureCardiac filling pressuresChronic heart failureAdvanced heart failureInvasive hemodynamic assessmentHeart failure patientsRisk of deathLong-term outcomesLower serum chlorideConventional clinical parametersBackward regression modelAssociation of hemodynamics
2010
Potential Effects of Aggressive Decongestion During the Treatment of Decompensated Heart Failure on Renal Function and Survival
Testani JM, Chen J, McCauley BD, Kimmel SE, Shannon RP. Potential Effects of Aggressive Decongestion During the Treatment of Decompensated Heart Failure on Renal Function and Survival. Circulation 2010, 122: 265-272. PMID: 20606118, PMCID: PMC3025294, DOI: 10.1161/circulationaha.109.933275.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBlood ProteinsBlood VolumeExtracellular FluidFemaleGlomerular Filtration RateHeart FailureHematocritHumansKidneyMaleMiddle AgedPulmonary Wedge PressureSerum AlbuminSodium Chloride Symporter InhibitorsSodium Potassium Chloride Symporter InhibitorsTreatment OutcomeVentricular PressureConceptsDecompensated heart failureRenal functionAggressive decongestionHeart failurePulmonary Artery Catheterization Effectiveness trialPulmonary capillary wedge pressureAggressive fluid removalCapillary wedge pressureIntravascular volume depletionRight atrial pressureCongestive heart failureEvidence of hemoconcentrationAggressive diuresisIntravascular substancesWedge pressureAtrial pressureBaseline characteristicsLoop diureticsTop tertileVolume depletionEffectiveness trialExtravascular fluidFluid removalHemoconcentrationHigh doses