2024
Mechanistic Differences between Torsemide and Furosemide.
Rao V, Cox Z, Ivey-Miranda J, Neville D, Balkcom N, Moreno-Villagomez J, Ramos-Mastache D, Maulion C, Bellumkonda L, Tang W, Collins S, Velazquez E, Mentz R, Wilson F, Turner J, Wilcox C, Ellison D, Fang J, Testani J. Mechanistic Differences between Torsemide and Furosemide. Journal Of The American Society Of Nephrology 2024 PMID: 39196651, DOI: 10.1681/asn.0000000000000481.Peer-Reviewed Original ResearchTorsemide groupDiuretic doseTubular site of actionHigher diuretic dosesDose of furosemideProportion of dosesOral furosemideSite of actionPrescribed doseNeurohormonal activationMechanistic substudyClinical outcomesPharmacodynamic advantagesKidney dysfunctionPharmacodynamic parametersKidney functionRandomized trialsNatriuresisTubular sitesFurosemideTorsemideDoseTRANSFORM-HFPlasma volumeBody weightSerial direct sodium removal in patients with heart failure and diuretic resistance
Rao V, Ivey‐Miranda J, Cox Z, Moreno‐Villagomez J, Ramos‐Mastache D, Neville D, Balkcom N, Asher J, Bellumkonda L, Bigvava T, Shaburishvili T, Bartunek J, Wilson F, Finkelstein F, Maulion C, Turner J, Testani J. Serial direct sodium removal in patients with heart failure and diuretic resistance. European Journal Of Heart Failure 2024, 26: 1215-1230. PMID: 38556717, DOI: 10.1002/ejhf.3196.Peer-Reviewed Original ResearchConceptsDiuretic resistanceCardiorenal syndromeHeart failureLoop diureticsDiuretic withdrawalHigh-dose loop diureticsN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideGrowth differentiation factor 15Carbohydrate antigen 125Differentiation factor 15Sodium removalRandomized controlled studyCardiorenal parametersDiuretic doseSoluble ST2Natriuretic peptideMedian timeDiuretic responseKidney injuryPeritoneal membraneElectrolyte handlingKidney functionDiureticsInterleukin-6
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
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
Real World Use of Hypertonic Saline in Refractory Acute Decompensated Heart Failure A U.S. Center’s Experience
Griffin M, Soufer A, Goljo E, Colna M, Rao VS, Jeon S, Raghavendra P, D'Ambrosi J, Riello R, Coca SG, Mahoney D, Jacoby D, Ahmad T, Chen M, Tang WHW, Turner J, Mullens W, Wilson FP, Testani JM. Real World Use of Hypertonic Saline in Refractory Acute Decompensated Heart Failure A U.S. Center’s Experience. JACC Heart Failure 2020, 8: 199-208. PMID: 32035891, PMCID: PMC7814403, DOI: 10.1016/j.jchf.2019.10.012.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureHypertonic saline administrationHypertonic saline therapyHypertonic salineSaline administrationSaline therapyDiuretic efficiencyUrine outputSerum sodiumWeight lossAcute decompensated heartDecompensated heart failureCohort of patientsTotal urine outputReal-world safetyU.S. academic medical centersAcademic medical centerLarge U.S. academic medical centerDiuretic doseCenter experienceHeart failureMetabolic derangementsPrimary analytic approachRespiratory statusClinical variables
2019
Serum and Urine Albumin and Response to Loop Diuretics in Heart Failure
Charokopos A, Griffin M, Rao VS, Inker L, Sury K, Asher J, Turner J, Mahoney D, Cox ZL, Wilson FP, Testani JM. Serum and Urine Albumin and Response to Loop Diuretics in Heart Failure. Clinical Journal Of The American Society Of Nephrology 2019, 14: cjn.11600918. PMID: 31010938, PMCID: PMC6500945, DOI: 10.2215/cjn.11600918.Peer-Reviewed Original ResearchConceptsDiuretic efficiencyHeart failureAlbumin levelsDiuretic excretionDiuretic doseInpatient cohortUrine albuminOutpatient cohortLoop diureticsIL-6Higher urine albuminLoop diuretic doseUrinary albumin levelsLow serum albuminPlasma IL-6Heart failure cohortHuman heart failureDiuretic resistanceSuccessful decongestionDiuretic treatmentSystemic inflammationKidney functionSite of actionSerum albuminSodium output
2018
Outcomes Associated With a Strategy of Adjuvant Metolazone or High‐Dose Loop Diuretics in Acute Decompensated Heart Failure: A Propensity Analysis
Brisco‐Bacik M, Maaten J, Houser SR, Vedage NA, Rao V, Ahmad T, Wilson FP, Testani JM. Outcomes Associated With a Strategy of Adjuvant Metolazone or High‐Dose Loop Diuretics in Acute Decompensated Heart Failure: A Propensity Analysis. Journal Of The American Heart Association 2018, 7: e009149. PMID: 30371181, PMCID: PMC6222930, DOI: 10.1161/jaha.118.009149.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedCause of DeathDose-Response Relationship, DrugFemaleFollow-Up StudiesGuideline AdherenceHeart FailureHumansInjections, IntravenousMaleMetolazonePropensity ScoreRetrospective StudiesSodium Chloride Symporter InhibitorsSodium Potassium Chloride Symporter InhibitorsStroke VolumeSurvival RateTreatment OutcomeUnited StatesConceptsHigh-dose loop diureticsAcute decompensated heart failureDecompensated heart failureLoop diureticsRenal functionPropensity adjustmentHeart failureCommon electronic medical recordIntravenous loop diureticsLoop diuretic dosePropensity-adjusted analysisThiazide-type diureticsControl trial dataElectronic medical recordsDiuretic doseDiuretic strategyCause mortalityAdverse eventsBaseline characteristicsSecondary outcomesThiazide diureticsResults PatientsDischarge diagnosisMedical recordsDiuretics
2017
An exploratory analysis of the competing effects of aggressive decongestion and high-dose loop diuretic therapy in the DOSE trial
Hanberg JS, Tang WH, Wilson FP, Coca SG, Ahmad T, Brisco MA, Testani JM. An exploratory analysis of the competing effects of aggressive decongestion and high-dose loop diuretic therapy in the DOSE trial. International Journal Of Cardiology 2017, 241: 277-282. PMID: 28392080, PMCID: PMC5471358, DOI: 10.1016/j.ijcard.2017.03.114.Peer-Reviewed Original ResearchConceptsHigh-dose loop diureticsDiuretic doseAggressive decongestionDose trialFluid outputLoop diureticsHigh-dose loop diuretic therapyDose-related adverse effectsAdverse effectsLoop diuretic doseLoop diuretic therapyHeart failure patientsNet fluid balanceNet fluid outputRate of deathEmergency department (ED) visitationPotential beneficial effectsHypothesis-generating observationsEffective decongestionDiuretic therapyFailure patientsAdverse outcomesDecongestive effectImproved outcomesFluid balance
2015
Influence of Titration of Neurohormonal Antagonists and Blood Pressure Reduction on Renal Function and Decongestion in Decompensated Heart Failure
Kula AJ, Hanberg JS, Wilson FP, Brisco MA, Bellumkonda L, Jacoby D, Coca SG, Parikh CR, Tang WHW, Testani JM. Influence of Titration of Neurohormonal Antagonists and Blood Pressure Reduction on Renal Function and Decongestion in Decompensated Heart Failure. Circulation Heart Failure 2015, 9: e002333. PMID: 26699390, PMCID: PMC4741376, DOI: 10.1161/circheartfailure.115.002333.Peer-Reviewed Original ResearchConceptsBlood pressure reductionDecompensated heart failureNeurohormonal antagonistsRenal functionSBP reductionBlood pressureDiuretic efficiencyHeart failureAcute decompensated heart failure hospitalizationAcute decompensated heart failure treatmentAcute decompensated heart failurePressure reductionChronic oral medicationHeart failure admissionsHeart failure hospitalizationHeart failure treatmentSystolic blood pressureDiuretic doseImproved diuresisFailure hospitalizationOral medicationsFailure treatmentDiuresisFluid outputAdmission