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 ureaHospitalizationBUNOutcomes
2016
Implications of Serum Chloride Homeostasis in Acute Heart Failure (from ROSE-AHF)
Grodin JL, Sun JL, Anstrom KJ, Chen HH, Starling RC, Testani JM, Tang WH. Implications of Serum Chloride Homeostasis in Acute Heart Failure (from ROSE-AHF). The American Journal Of Cardiology 2016, 119: 78-83. PMID: 27816115, PMCID: PMC5161696, DOI: 10.1016/j.amjcard.2016.09.014.Peer-Reviewed Original ResearchConceptsAcute heart failureSerum Cl levelsHeart failureClinical outcomesDiuretic responseAcute heart failure trialsRenal Optimization Strategies EvaluationShort-term clinical responseCumulative sodium excretionLoop diuretic doseHeart Failure TrialLong-term mortalitySerum chloride levelsCystatin C changesDiuretic dosePostdischarge outcomesSodium excretionCl levelsClinical responseRenal functionDiuretic efficiencyFailure TrialAdditional adjustmentCystatin CTherapeutic implicationsRenal dysfunction and chronic mechanical circulatory support
Brisco MA, Testani JM, Cook JL. Renal dysfunction and chronic mechanical circulatory support. Current Opinion In Cardiology 2016, 31: 277-286. PMID: 27022890, PMCID: PMC6176489, DOI: 10.1097/hco.0000000000000278.Peer-Reviewed Original ResearchMeSH KeywordsAssisted CirculationHeart FailureHumansPatient SelectionPrognosisRenal DialysisRenal InsufficiencyConceptsMechanical circulatory supportRenal dysfunctionRenal functionCirculatory supportChronic mechanical circulatory supportPostoperative acute kidney injuryIrreversible renal dysfunctionAcute kidney injuryRight ventricular dysfunctionAdvanced heart failureCardiogenic shockKidney injuryNeurohormonal activationVentricular dysfunctionMost patientsHeart failureKidney functionSubsequent recurrenceVolume overloadVenous congestionEarly improvementDysfunctionDevice-related effectsReversible formDiagnostic testsReduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure
Hanberg JS, Sury K, Wilson FP, Brisco MA, Ahmad T, Maaten J, Broughton JS, Assefa M, Tang WH, Parikh CR, Testani JM. Reduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure. Journal Of The American College Of Cardiology 2016, 67: 2199-2208. PMID: 27173030, PMCID: PMC4867078, DOI: 10.1016/j.jacc.2016.02.058.Peer-Reviewed Original ResearchConceptsPulmonary artery catheterizationBlood urea nitrogenCardiac indexRenal functionHeart failureRenal dysfunctionGood renal functionReduced cardiac indexHigher cardiac indexGlomerular filtration rateSignificant inverse correlationMultiple subgroupsMulticenter populationWorse eGFRHF patientsCreatinine ratioArtery catheterizationPatient subgroupsFiltration rateSerial assessmentLinear mixed modelingESCAPE trialPatientsUrea nitrogenDysfunctionThe risk of death associated with proteinuria in heart failure is restricted to patients with an elevated blood urea nitrogen to creatinine ratio
Brisco MA, Zile MR, Maaten J, Hanberg JS, Wilson FP, Parikh C, Testani JM. The risk of death associated with proteinuria in heart failure is restricted to patients with an elevated blood urea nitrogen to creatinine ratio. International Journal Of Cardiology 2016, 215: 521-526. PMID: 27153048, PMCID: PMC4986924, DOI: 10.1016/j.ijcard.2016.04.100.Peer-Reviewed Original ResearchConceptsElevated blood urea nitrogenBUN/CrRenal dysfunctionBlood urea nitrogenCreatinine ratioUrea nitrogenLeft Ventricular Dysfunction (SOLVD) trialVentricular Dysfunction trialsGlomerular filtration rateRisk of deathBaseline characteristicsWorsened survivalAdverse eventsHeart failureTop tertileFiltration rateBottom tertileProteinuriaSurvival disadvantagePatientsMortalityTertileDysfunctionSurvivalSurvival modelsHypochloraemia is strongly and independently associated with mortality in patients with chronic heart failure
Testani JM, Hanberg JS, Arroyo JP, Brisco MA, Ter Maaten JM, Wilson FP, Bellumkonda L, Jacoby D, Tang WH, Parikh CR. Hypochloraemia is strongly and independently associated with mortality in patients with chronic heart failure. European Journal Of Heart Failure 2016, 18: 660-668. PMID: 26763893, PMCID: PMC5471359, DOI: 10.1002/ejhf.477.Peer-Reviewed Original ResearchConceptsChronic heart failureHeart failureSerum chlorideSerum sodiumLow serum sodiumHeart failure pathophysiologyGreater disease severityBEST trialDiuretic dosesSerum chloride valuesRenal functionWorsened survivalPrognostic importanceAdverse outcomesUnivariate analysisHyponatraemiaHypochloraemiaPatientsDisease severityMortalityAdditional researchFailureChloride valuesCritical roleSodium
2015
The Impact of Donor and Recipient Renal Dysfunction on Cardiac Allograft Survival: Insights Into Reno-Cardiac Interactions
Laur O, Brisco MA, Kula AJ, Cheng SJ, Mangi AA, Bellumkonda L, Jacoby DL, Coca S, Tang WH, Parikh CR, Testani JM. The Impact of Donor and Recipient Renal Dysfunction on Cardiac Allograft Survival: Insights Into Reno-Cardiac Interactions. Journal Of Cardiac Failure 2015, 22: 368-375. PMID: 26616578, PMCID: PMC4904299, DOI: 10.1016/j.cardfail.2015.11.009.Peer-Reviewed Original ResearchConceptsRenal dysfunctionCardiac transplantationAdverse recipient outcomesCardiac allograft survivalOrgan Sharing registryGlomerular filtration ratePotent risk factorImpact of donorAllograft survivalCardiac allograftsRecipient deathRecipient outcomesUnited NetworkAdverse outcomesFiltration rateMyocardial necrosisRisk factorsCardiovascular diseaseHigh riskDonor characteristicsOlder ageRetransplantationDeathTransplantationDysfunctionBlood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunction
Parrinello G, Torres D, Testani JM, Almasio PL, Bellanca M, Pizzo G, Cuttitta F, Pinto A, Butler J, Paterna S. Blood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunction. Internal And Emergency Medicine 2015, 10: 965-972. PMID: 26037394, DOI: 10.1007/s11739-015-1261-1.Peer-Reviewed Original ResearchConceptsBUN/CrInferior vena cavaRenal dysfunctionHeart failureVenous congestionBUN/Cr ratioMultiple logistic regression modelNYHA class 3Independent risk factorLong-term mortalityHeart failure patientsGlomerular filtration rateBlood urea nitrogenReceiver-operating characteristic analysisLogistic regression modelsCause deathHF outpatientsHF severityLower eGFRRenal functionAmbulatory visitsFailure patientsCreatinine ratioSingle centerRenal biomarkers
2014
A Combined-Biomarker Approach to Clinical Phenotyping Renal Dysfunction in Heart Failure
Testani JM, Damman K, Brisco MA, Chen S, Laur O, Kula AJ, Tang WH, Parikh C. A Combined-Biomarker Approach to Clinical Phenotyping Renal Dysfunction in Heart Failure. Journal Of Cardiac Failure 2014, 20: 912-919. PMID: 25152498, PMCID: PMC4292792, DOI: 10.1016/j.cardfail.2014.08.008.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBiomarkersBlood Urea NitrogenCardio-Renal SyndromeCohort StudiesConfidence IntervalsCreatinineFemaleGlomerular Filtration RateHeart FailureHospitals, UniversityHumansMaleMiddle AgedPhenotypePrognosisRenal InsufficiencyRetrospective StudiesSensitivity and SpecificityStatistics, NonparametricSurvival RateConceptsB-type natriuretic peptideElevated B-type natriuretic peptideRenal dysfunctionHeart failureLower B-type natriuretic peptideUse of BNPCombined biomarker approachDecompensated heart failureIntrinsic kidney diseaseBlood urea nitrogenDifferent clinical phenotypesBUN/Diuretic resistanceInotrope useWorse survivalCreatinine ratioRisk stratificationDischarge diagnosisNatriuretic peptideVenous congestionKidney diseaseStratify patientsClinical phenotypingPatientsUrea nitrogen
2013
Influence of Age-Related Versus Non–Age-Related Renal Dysfunction on Survival in Patients With Left Ventricular Dysfunction
Testani JM, Brisco MA, Han G, Laur O, Kula AJ, Cheng SJ, Tang WH, Parikh CR. Influence of Age-Related Versus Non–Age-Related Renal Dysfunction on Survival in Patients With Left Ventricular Dysfunction. The American Journal Of Cardiology 2013, 113: 127-131. PMID: 24216124, PMCID: PMC3915785, DOI: 10.1016/j.amjcard.2013.09.029.Peer-Reviewed Original ResearchConceptsLow glomerular filtration rateGlomerular filtration rateVentricular dysfunctionRenal dysfunctionNormal agingLeft ventricular dysfunctionRisk of deathNormal aging resultsAge-related decreaseInfluence of ageBaseline eGFRMean eGFRLower eGFRWorsened survivalPrognostic importanceFiltration rateSurvival disadvantagePrimary analysisDysfunctionEGFRSignificant riskPatientsUnderlying mechanismRiskMortality
2011
Influence of renal dysfunction phenotype on mortality in the setting of cardiac dysfunction: analysis of three randomized controlled trials
Testani JM, Coca SG, Shannon RP, Kimmel SE, Cappola TP. Influence of renal dysfunction phenotype on mortality in the setting of cardiac dysfunction: analysis of three randomized controlled trials. European Journal Of Heart Failure 2011, 13: 1224-1230. PMID: 21926073, PMCID: PMC3200208, DOI: 10.1093/eurjhf/hfr123.Peer-Reviewed Original ResearchConceptsGlomerular filtration rateBUN/creatinineRenal insufficiencyNeurohormonal activationRisk of mortalityHeart failurePulmonary Artery Catheterization Effectiveness trialLeft Ventricular Dysfunction (SOLVD) trialBaseline renal insufficiencyBeta-Blocker EvaluationVentricular Dysfunction trialsHeart failure populationCongestive heart failureBlood urea nitrogenCreatinine ratioPrimary outcomeCardiac dysfunctionFailure populationFiltration rateEffectiveness trialPoor survivalStudy populationUrea nitrogenPatientsMortalityImpact of worsening renal function during the treatment of decompensated heart failure on changes in renal function during subsequent hospitalization
Testani JM, Cappola TP, McCauley BD, Chen J, Shen J, Shannon RP, Kimmel SE. Impact of worsening renal function during the treatment of decompensated heart failure on changes in renal function during subsequent hospitalization. American Heart Journal 2011, 161: 944-949. PMID: 21570527, PMCID: PMC3095914, DOI: 10.1016/j.ahj.2011.02.005.Peer-Reviewed Original ResearchConceptsDecompensated heart failureSubsequent hospitalizationRenal functionHeart failureCardiorenal pathophysiologyIndex hospitalizationAcute decompensated heart failureBaseline patient characteristicsCongestive heart failurePatient-related factorsTreatment-related parametersBaseline characteristicsBaseline factorsPatient characteristicsDischarge diagnosisHospital treatmentConsecutive admissionsInclusion criteriaHospitalizationPrior historySubsequent episodesPrimary hypothesisMinimal associationPatientsSignificant correlation
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