2021
Compensatory post-diuretic renal sodium reabsorption is not a dominant mechanism of diuretic resistance in acute heart failure
Cox ZL, Rao VS, Ivey-Miranda JB, Moreno-Villagomez J, Mahoney D, Ponikowski P, Biegus J, Turner JM, Maulion C, Bellumkonda L, Asher JL, Parise H, Wilson PF, Ellison DH, Wilcox CS, Testani JM. Compensatory post-diuretic renal sodium reabsorption is not a dominant mechanism of diuretic resistance in acute heart failure. European Heart Journal 2021, 42: 4468-4477. PMID: 34529781, PMCID: PMC8599022, DOI: 10.1093/eurheartj/ehab620.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureSpontaneous natriuresisDiuretic resistanceHeart failureSodium reabsorptionUrine collectionSpot urine sodium concentrationsIntravenous loop diureticsNeutral sodium balanceAcute heart failureDecompensated heart failureRenal sodium reabsorptionSubgroup of patientsUrine sodium concentrationSpot urine samplesDiuretic therapySodium aviditySodium excretionUrine sodiumCreatinine ratioLoop diureticsDiuretic administrationSodium balanceNatriuresisHealthy volunteersNatriuretic Equation to Predict Loop Diuretic Response in Patients With Heart Failure
Rao VS, Ivey-Miranda JB, Cox ZL, Riello R, Griffin M, Fleming J, Soucier R, Sangkachand P, O'Brien M, LoRusso F, D'Ambrosi J, Churchwell K, Mahoney D, Bellumkonda L, Asher JL, Maulion C, Turner JM, Wilson FP, Collins SP, Testani JM. Natriuretic Equation to Predict Loop Diuretic Response in Patients With Heart Failure. Journal Of The American College Of Cardiology 2021, 77: 695-708. PMID: 33573739, PMCID: PMC8114781, DOI: 10.1016/j.jacc.2020.12.022.Peer-Reviewed Original ResearchConceptsLoop diuretic administrationDiuretic therapyNatriuretic responseDiuretic administrationSodium outputAcute decompensated heart failureDecompensated heart failureHeart failure admissionsDaily urine outputSpot urine samplesNet fluid outputNet fluid lossPathway cohortHeart failureLoop diureticsUrine outputDiuretic responseResidual congestionFluid outputTherapyCohortWeight lossAdditional studiesUrine samplesExcellent discrimination
2020
Prediction and measurement of diuretic responsiveness after oral administration of furosemide to healthy dogs and dogs with congestive heart failure
Loughran KA, Larouche‐Lebel É, Huh T, Testani JM, Rao VS, Oyama MA. Prediction and measurement of diuretic responsiveness after oral administration of furosemide to healthy dogs and dogs with congestive heart failure. Journal Of Veterinary Internal Medicine 2020, 34: 2253-2264. PMID: 33125814, PMCID: PMC7694836, DOI: 10.1111/jvim.15952.Peer-Reviewed Original ResearchConceptsCongestive heart failureSpot urine samplesDiuretic responsivenessHeart failureHealthy dogsOral administrationUrine samplesCumulative urine volumeUrinary Na excretionProspective interventional studyUrine sodiumNa excretionUrine volumeInterventional studyUvolClinical importanceHuman patientsClinical settingDogsFurosemideCharacteristic curveResponsivenessAdministrationMinutesPatientsSafety and Efficacy of an Automated Nurse-Driven Diuretic Titration Protocol: the Yale Diuretic Pathway
Meegan G, Sangkachand P, O'Brien M, Riello R, Soucier R, Jacoby D, Gleason O, Fleming J, Griffin M, Ivey-Miranda J, Cox Z, Rao V, Testani J. Safety and Efficacy of an Automated Nurse-Driven Diuretic Titration Protocol: the Yale Diuretic Pathway. Journal Of Cardiac Failure 2020, 26: s22. DOI: 10.1016/j.cardfail.2020.09.070.Peer-Reviewed Original ResearchAcute decompensated heart failureDiuretic doseLoop diureticsSodium outputBlood pressureEMR orderTitration protocolDecompensated heart failureSystolic blood pressureDaily urine outputSpot urine samplesNet fluid outputDiuretic resistanceFurosemide equivalentsFirst doseMedian doseSodium excretionHeart failureSerum potassiumSubsequent dosesUrine outputClinical outcomesMedian timeSerum magnesiumSame doseValidation of Natriuretic Response Prediction Equation in Patients with Acute Decompensated Heart Failure
Gleason O, Meegan G, Fleming J, Griffin M, Ivey-Miranda J, Cox Z, Rao V, Testani J. Validation of Natriuretic Response Prediction Equation in Patients with Acute Decompensated Heart Failure. Journal Of Cardiac Failure 2020, 26: s2. DOI: 10.1016/j.cardfail.2020.09.015.Peer-Reviewed Original ResearchNatriuretic responseSodium outputUrine collectionDiuretic administrationAcute decompensated heart failureIntravenous loop diuretic therapyLoop diuretic administrationLoop diuretic therapySpot urine sodiumDecompensated heart failureHeart failure admissionsRoutine clinical practiceSpot urine samplesNet fluid outputTotal sodium excretionUrine spot samplesADHF patientsDiuretic therapySodium excretionUrine sodiumHeart failureLoop diureticsUrine outputClinical practiceFluid output
2019
Rapid and Accurate Assessment of Diuretic Response: Validation of an Equation to Predict Diuretic Induced Sodium Output Using a Spot Urine Sample
Griffin M, Struyk G, Fleming J, Shamlian P, Wycallis E, Pattoli M, Thomas A, Stewart B, Barnett J, Gomez N, Ivey-Miranda J, Rao V, Testani J. Rapid and Accurate Assessment of Diuretic Response: Validation of an Equation to Predict Diuretic Induced Sodium Output Using a Spot Urine Sample. Journal Of Cardiac Failure 2019, 25: s52-s53. DOI: 10.1016/j.cardfail.2019.07.148.Peer-Reviewed Original ResearchPoor diuretic responseSpot urine samplesNet fluid balanceDiuretic responseSodium excretionUrine collectionDiuretic administrationSodium outputValidation cohortWeight lossUrine samplesFluid balanceCumulative sodium excretionTypes of diureticsRoutine clinical practiceNet fluid lossAssessment of responseDiuretic doseDiuretic periodDiuretic therapyBladder dysfunctionLoop diureticsSpot urineMedical recordsClinical trialsSafety and Efficacy of an Auto-Titrating Diuretic Protocol: A Pilot
Griffin M, Flemming J, Pattoli M, Stewart B, Gomez N, Barnett J, Thomas A, Wycallis E, Struyk G, Shamlian P, Mahoney D, Ivey-Miranda J, Ivey-Miranda J, Rao V, Testani J. Safety and Efficacy of an Auto-Titrating Diuretic Protocol: A Pilot. Journal Of Cardiac Failure 2019, 25: s52. DOI: 10.1016/j.cardfail.2019.07.147.Peer-Reviewed Original ResearchDiuretic resistanceFurosemide equivalentsRenal functionBlood pressureHeart failureWeight lossHeart failure physiciansNon-randomized pilotTraditional diuretic therapyMajority of patientsSystolic blood pressureRapid dose escalationMaximum daily doseSpot urine samplesDiuretic doseDiuretic protocolDiuretic therapyDiuretic dosesHF patientsSodium excretionStarting doseElectrolyte abnormalitiesHospital daysDaily doseDose escalation