2023
Kidney and heart failure events are bidirectionally associated in patients with type 2 diabetes and cardiovascular disease
Sharma A, Inzucchi S, Testani J, Ofstad A, Fitchett D, Mattheus M, Verma S, Zannad F, Wanner C, Kraus B. Kidney and heart failure events are bidirectionally associated in patients with type 2 diabetes and cardiovascular disease. ESC Heart Failure 2023, 11: 737-747. PMID: 38155446, PMCID: PMC10966270, DOI: 10.1002/ehf2.14601.Peer-Reviewed Original ResearchPlacebo-treated participantsKidney eventsType 2 diabetesHeart failureCV eventsBaseline factorsLow-density lipoprotein cholesterol levelsMajor adverse CV eventsEMPA-REG OUTCOMEPrior heart failureAdverse CV eventsHeart failure eventsGlomerular filtration rateLipoprotein cholesterol levelsCoronary artery diseaseCox regression modelHigh uric acidUse of therapiesCardiovascular eventsCV diseaseHF outcomesArtery diseaseCholesterol levelsFiltration rateSubsequent riskEffect 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 modelThe 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 weightImprovement 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
2021
FGF-23 (Fibroblast Growth Factor-23) and Cardiorenal Interactions
Ivey-Miranda JB, Stewart B, Cox ZL, McCallum W, Maulion C, Gleason O, Meegan G, Amatruda JG, Moreno-Villagomez J, Mahoney D, Turner JM, Wilson FP, Estrella MM, Shlipak MG, Rao VS, Testani JM. FGF-23 (Fibroblast Growth Factor-23) and Cardiorenal Interactions. Circulation Heart Failure 2021, 14: e008385. PMID: 34689571, PMCID: PMC8782627, DOI: 10.1161/circheartfailure.121.008385.Peer-Reviewed Original ResearchConceptsFGF-23Cardiorenal interactionsHeart failureDiuretic resistanceSodium avidityNeurohormonal activationMultivariable analysisDistal tubular sodium reabsorptionLoop diuretic doseTubular sodium reabsorptionGlomerular filtration rateCardiorenal dysfunctionDiuretic doseDiuretic treatmentNT-proBNPFractional excretionDiuretic administrationSodium reabsorptionPeak diuresisFiltration rateCare centerUrine samplingAnimal modelsSerum chlorideDisease severity
2020
Renal profiling based on estimated glomerular filtration rate and spot urine sodium identifies high‐risk acute heart failure patients
Biegus J, Zymliński R, Testani J, Marciniak D, Zdanowicz A, Jankowska EA, Banasiak W, Ponikowski P. Renal profiling based on estimated glomerular filtration rate and spot urine sodium identifies high‐risk acute heart failure patients. European Journal Of Heart Failure 2020, 23: 729-739. PMID: 33190378, DOI: 10.1002/ejhf.2053.Peer-Reviewed Original ResearchConceptsAcute heart failureGlomerular filtration rateHeart failureFiltration rateDay 1Acute heart failure patientsHospital heart failureSpot urine sodiumHeart failure patientsUrinary sodium concentrationAHF patientsInotrope useTherapeutic profilingUrine sodiumFailure patientsIndependent prognosticatorRenal functionDay 2PatientsEGFRConcomitant assessmentWater handlingSodium concentrationPrognosticatorExcretersCystatin C and Muscle Mass in Patients With Heart Failure
Ivey-Miranda JB, Inker LA, Griffin M, Rao V, Maulion C, Turner JM, Wilson FP, Tang WHW, Levey AS, Testani JM. Cystatin C and Muscle Mass in Patients With Heart Failure. Journal Of Cardiac Failure 2020, 27: 48-56. PMID: 32750487, PMCID: PMC8672303, DOI: 10.1016/j.cardfail.2020.07.013.Peer-Reviewed Original ResearchConceptsHeart failureCreatinine clearanceMuscle massCystatin CHigher muscle massAssociation of eGFRcysGlomerular filtration rateLow muscle massCystatin C levelsAccurate GFR estimationMultivariable analysisFiltration rateEGFRcysEGFRcrBody compositionGFR estimationPatientsCreatinineC levelsClearanceMortalityAssociationAcute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Acute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure. JACC Heart Failure 2020, 8: 537-547. PMID: 32535124, PMCID: PMC9027677, DOI: 10.1016/j.jchf.2020.03.009.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptideAcute decompensated heart failureDecompensated heart failureHeart failureKidney functionAdverse outcomesAcute declineNT-proBNPComposite outcomeNatriuretic peptideHigh riskMultivariable Cox regression modelsTotal proteinAcute kidney functionMarkers of decongestionN-terminal prohormoneGlomerular filtration rateCox regression modelEGFR declineCardiovascular deathVolume overloadFiltration rateEGFRHospital changesDecongestionEvaluation of kidney function throughout the heart failure trajectory – a position statement from the Heart Failure Association of the European Society of Cardiology
Mullens W, Damman K, Testani JM, Martens P, Mueller C, Lassus J, Tang WHW, Skouri H, Verbrugge FH, Orso F, Hill L, Ural D, Lainscak M, Rossignol P, Metra M, Mebazaa A, Seferovic P, Ruschitzka F, Coats A. Evaluation of kidney function throughout the heart failure trajectory – a position statement from the Heart Failure Association of the European Society of Cardiology. European Journal Of Heart Failure 2020, 22: 584-603. PMID: 31908120, DOI: 10.1002/ejhf.1697.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsGlomerular filtration rateHeart failureKidney functionFiltration rateRenal functionSerum creatinineAcute heart failure episodeGuideline-directed medical therapyImproved long-term outcomesCardio-renal dysfunctionCardio-renal interactionsAcute heart failureChronic heart failureHeart Failure AssociationHeart failure careHeart failure stateHeart failure episodesAppropriate clinical contextLong-term outcomesRenal function assessmentFurther treatment strategiesNeurohumoral blockersLoop diureticsMedical therapyWorse outcomes
2019
Adverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction
Reddy YNV, Obokata M, Testani JM, Felker GM, Tang WHW, Abou-Ezzeddine OF, Sun JL, Chakrabothy H, McNulty S, Shah SJ, Lewis GD, Stevenson LW, Redfield MM, Borlaug BA. Adverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction. Journal Of Cardiac Failure 2019, 26: 101-107. PMID: 31618698, PMCID: PMC7036022, DOI: 10.1016/j.cardfail.2019.09.015.Peer-Reviewed Original ResearchConceptsRenal functionNonobese patientsHeart failureObese HFpEFObese patientsEjection fractionRenal responseAdverse renal responsesRight ventricular remodelingGlomerular filtration rateBody mass indexPlasma volume expansionSimilar weight lossCardiorenal hemodynamicsRenal dysfunctionPathophysiologic featuresMass indexAtrial fibrillationDecongestive therapyVentricular remodelingPericardial restraintFiltration rateHFpEFObese phenotypeSevere worsening
2018
Chronic kidney disease, worsening renal function and outcomes in a heart failure community setting: A UK national study
Lawson CA, Testani JM, Mamas M, Damman K, Jones PW, Teece L, Kadam UT. Chronic kidney disease, worsening renal function and outcomes in a heart failure community setting: A UK national study. International Journal Of Cardiology 2018, 267: 120-127. PMID: 29957251, PMCID: PMC6024224, DOI: 10.1016/j.ijcard.2018.04.090.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseRenal functionKidney diseasePrevalence of CKDModerate chronic kidney diseaseSevere chronic kidney diseasePresence of diabetesAdjusted risk estimatesGlomerular filtration rateCase-control studyHeart failure monitoringUK national studyHF prognosisFirst hospitalisationHF patientsRenal declineHF cohortRelated comorbiditiesHF settingFiltration rateNatural courseHospitalisationHigh riskRisk associationCommunity population
2016
Reduced 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 models
2015
Amino-Terminal Pro-B-Type Natriuretic Peptide for Diagnosis and Prognosis in Patients With Renal Dysfunction A Systematic Review and Meta-Analysis
Schaub JA, Coca SG, Moledina DG, Gentry M, Testani JM, Parikh CR. Amino-Terminal Pro-B-Type Natriuretic Peptide for Diagnosis and Prognosis in Patients With Renal Dysfunction A Systematic Review and Meta-Analysis. JACC Heart Failure 2015, 3: 977-989. PMID: 26671676, PMCID: PMC4683413, DOI: 10.1016/j.jchf.2015.07.014.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureNT-proBNPRenal dysfunctionRenal functionHeart failureNatriuretic peptideDiagnosis of ADHFAmino-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptidePg/B-type natriuretic peptideAmino-Terminal ProElevated NT-proBNPHigher NT-proBNPDecompensated heart failurePooled risk ratioGlomerular filtration rateCoronary artery diseaseA Systematic ReviewADHF eventsArtery diseasePrognostic utilityWorse prognosisFiltration rateRisk ratioThe 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 ageRetransplantationDeathTransplantationDysfunctionEvidence of Mild Liver Dysfunction Identifies Stable Heart Failure Outpatients with Reversible Renal Dysfunction
Brisco MA, Cheng SJ, Laur O, Kula AJ, Testani JM. Evidence of Mild Liver Dysfunction Identifies Stable Heart Failure Outpatients with Reversible Renal Dysfunction. Cardiorenal Medicine 2015, 5: 229-236. PMID: 26195975, PMCID: PMC4478303, DOI: 10.1159/000430505.Peer-Reviewed Original ResearchReversible renal dysfunctionStable HF outpatientsMild liver dysfunctionAlanine aminotransferaseAspartate aminotransferaseHF outpatientsRenal dysfunctionElevated bilirubinLiver dysfunctionHeart failurePoor perfusionBeta-Blocker EvaluationDecompensated heart failureHeart failure outpatientsGlomerular filtration rateSigns of congestionBaseline characteristicsRenal functionPathophysiologic factorsLiver parametersFiltration ratePatientsDysfunctionOutpatientsBilirubin
2014
Novel Renal Biomarkers to Assess Cardiorenal Syndrome
Brisco MA, Testani JM. Novel Renal Biomarkers to Assess Cardiorenal Syndrome. Current Heart Failure Reports 2014, 11: 485-499. PMID: 25239434, PMCID: PMC4224613, DOI: 10.1007/s11897-014-0226-4.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsRenal dysfunctionCardiorenal syndromeHeart failureRenal biomarkersNormal glomerular filtration rateIrreversible nephron lossSignificant renal impairmentHypertensive kidney diseaseGlomerular filtration rateNovel renal biomarkersCardiorenal interactionsRenal impairmentNephron lossDecongestive therapyAdverse outcomesKidney diseaseFiltration rateHigh prevalenceRenal performanceSyndromeBiomarkersFailurePrognosisDysfunctionTherapy
2013
Prevalence and Prognostic Importance of Changes in Renal Function After Mechanical Circulatory Support
Brisco MA, Kimmel SE, Coca SG, Putt ME, Jessup M, Tang WW, Parikh CR, Testani JM. Prevalence and Prognostic Importance of Changes in Renal Function After Mechanical Circulatory Support. Circulation Heart Failure 2013, 7: 68-75. PMID: 24214901, PMCID: PMC4067252, DOI: 10.1161/circheartfailure.113.000507.Peer-Reviewed Original ResearchConceptsMechanical circulatory supportRenal functionCirculatory supportEarly improvementContinuous-flow devicesMechanically Assisted Circulatory SupportLarge multicenter populationSerial creatinine levelsGlomerular filtration rateMajority of patientsMulticenter populationCause mortalityInteragency RegistryAdult patientsCreatinine levelsPrognostic importancePrognostic significanceImproved prognosisFiltration ratePoor survivalSurvival disadvantageEGFRPatientsAdditional researchMechanistic basisInfluence 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 mechanismRiskMortalityPotential Effects of Digoxin on Long-Term Renal and Clinical Outcomes in Chronic Heart Failure
Testani JM, Brisco MA, Tang WH, Kimmel SE, Tiku-Owens A, Forfia PR, Coca SG. Potential Effects of Digoxin on Long-Term Renal and Clinical Outcomes in Chronic Heart Failure. Journal Of Cardiac Failure 2013, 19: 295-302. PMID: 23663810, PMCID: PMC3694335, DOI: 10.1016/j.cardfail.2013.03.002.Peer-Reviewed Original ResearchConceptsDigitalis Investigation GroupRenal dysfunctionHeart failureClinical outcomesFavorable renal responseHospitalization-free survivalLong-Term RenalChronic heart failureSerum creatinine levelsGlomerular filtration rateHypothesis-generating findingsLong-term improvementDIG trialCreatinine levelsRenal functionKidney functionRenal responseFiltration rateDigitalis glycosidesPatientsDigoxinHospitalizationDeathAdditional researchInvestigation group