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 weight
2023
Association of Aortic Pulsatility Index with Clinical Outcomes and In-Hospital eGFR Slope Among Patients Admitted for Acute Decompensated Heart Failure Requiring Hemodynamic Monitoring
Banlengchit R, Tighiouart H, Tuttle M, Moises A, Sarnak H, Testani J, Oka T, Kiernan M, Sarnak M, McCallum W. Association of Aortic Pulsatility Index with Clinical Outcomes and In-Hospital eGFR Slope Among Patients Admitted for Acute Decompensated Heart Failure Requiring Hemodynamic Monitoring. Journal Of The American Society Of Nephrology 2023, 34: 761-761. DOI: 10.1681/asn.20233411s1761b.Peer-Reviewed Original Research
2021
Distinct renin/aldosterone activity profiles correlate with renal function, natriuretic response, decongestive ability and prognosis in acute heart failure
Biegus J, Nawrocka-Millward S, Zymliński R, Fudim M, Testani J, Marciniak D, Rosiek-Biegus M, Ponikowska B, Guzik M, Garus M, Ponikowski P. Distinct renin/aldosterone activity profiles correlate with renal function, natriuretic response, decongestive ability and prognosis in acute heart failure. International Journal Of Cardiology 2021, 345: 54-60. PMID: 34728260, DOI: 10.1016/j.ijcard.2021.10.149.Peer-Reviewed Original ResearchConceptsAcute heart failureHeart failureRenal functionDay 1Development of AHFAldosterone system activationSingle cardiology centreAdverse clinical outcomesLower blood pressureAldosterone changesHF rehospitalizationLow natriuresisRAAS overactivitySerum reninNatriuretic responseBlood pressureClinical courseCardiology centersClinical outcomesSerum sodiumYear mortalityStudy populationHigh doseSystem activationClinical relevance
2020
Altered Hemodynamics and End-Organ Damage in Heart Failure
Verbrugge FH, Guazzi M, Testani JM, Borlaug BA. Altered Hemodynamics and End-Organ Damage in Heart Failure. Circulation 2020, 142: 998-1012. PMID: 32897746, PMCID: PMC7482031, DOI: 10.1161/circulationaha.119.045409.Peer-Reviewed Original ResearchConceptsHeart failureHemodynamic derangementsHemodynamic perturbationsElevated cardiac filling pressuresReduced cardiac outputCardiac filling pressuresEnd-organ damagePulmonary vascular diseaseHeart failure phenotypeMultiple organ systemsCapillary stress failureDevelopment of abnormalitiesCardiogenic shockHemodynamic abnormalitiesRenal functionEjection fractionClinical outcomesPulmonary congestionVenous capacityCardiac outputPericardial constraintVascular diseaseChronic diseasesFilling pressureVentilatory control
2019
Renal Effects of Intensive Volume Removal in Heart Failure Patients With Preexisting Worsening Renal Function
Rao VS, Ahmad T, Brisco-Bacik MA, Bonventre JV, Wilson FP, Siew ED, Felker GM, Anstrom KK, Mahoney DD, Bart BA, Tang WHW, Velazquez EJ, Testani JM. Renal Effects of Intensive Volume Removal in Heart Failure Patients With Preexisting Worsening Renal Function. Circulation Heart Failure 2019, 12: e005552. PMID: 31163974, PMCID: PMC6585463, DOI: 10.1161/circheartfailure.118.005552.Peer-Reviewed Original ResearchConceptsRenal tubular injury biomarkersTubular injury biomarkersHeart failure patientsAcute decompensated heart failure patientsDecompensated heart failure patientsTubular injury markersInjury biomarkersFailure patientsRenal functionInjury markersAcute decompensated heart failureVolume removalCARRESS-HF trialRenal function recoveryDecompensated heart failureRenal tubular injuryRenal effectsSerum creatinineTubular injuryBiomarker substudyHeart failurePharmacological therapyClinical outcomesFunction recoveryHigh incidence
2018
Perturbations in serum chloride homeostasis in heart failure with preserved ejection fraction: insights from TOPCAT
Grodin JL, Testani JM, Pandey A, Sambandam K, Drazner MH, Fang JC, Tang WHW. Perturbations in serum chloride homeostasis in heart failure with preserved ejection fraction: insights from TOPCAT. European Journal Of Heart Failure 2018, 20: 1436-1443. PMID: 29893446, DOI: 10.1002/ejhf.1229.Peer-Reviewed Original ResearchConceptsSerum chloride levelsLoop diuretic useHeart failureSerum chlorideCause deathDiuretic useEjection fractionMultivariable Cox proportional hazards modelsCardiac Function Heart FailureCox proportional hazards modelAldosterone Antagonist TrialHeart failure hospitalizationPrimary composite endpointLower serum chlorideProportional hazards modelSerum chloride concentrationChloride levelsSpironolactone useCardiovascular deathFailure hospitalizationMultivariable adjustmentComposite endpointLoop diureticsClinical outcomesHazards model
2017
Serum Chloride and Sodium Interplay in Patients With Acute Myocardial Infarction and Heart Failure With Reduced Ejection Fraction
Ferreira JP, Girerd N, Duarte K, Coiro S, McMurray JJ, Dargie HJ, Pitt B, Dickstein K, Testani JM, Zannad F, Rossignol P. Serum Chloride and Sodium Interplay in Patients With Acute Myocardial Infarction and Heart Failure With Reduced Ejection Fraction. Circulation Heart Failure 2017, 10: e003500. PMID: 28159825, DOI: 10.1161/circheartfailure.116.003500.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedBiomarkersChloridesComorbidityDatabases, FactualFemaleHeart FailureHumansKaplan-Meier EstimateLinear ModelsMaleMiddle AgedMyocardial InfarctionNonlinear DynamicsPrognosisProportional Hazards ModelsRandomized Controlled Trials as TopicRetrospective StudiesRisk AssessmentRisk FactorsSodiumStroke VolumeVentricular Dysfunction, LeftVentricular Function, LeftConceptsHeart failureAcute myocardial infarctionSerum chlorideMyocardial infarctionPrognostic informationPrognostic variablesSodium levelsReduced left ventricular functionLow sodiumReduced ejection fractionLeft ventricular functionLower serum chlorideSignificant prognostic informationRelevant prognostic informationSerum chloride levelsPost-myocardial infarctionLow sodium levelsMore comorbiditiesCause mortalitySystolic dysfunctionCardiovascular mortalityEjection fractionVentricular functionClinical outcomesMortality rate
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 implicationsPrognostic Implications of Long-Chain Acylcarnitines in Heart Failure and Reversibility With Mechanical Circulatory Support
Ahmad T, Kelly JP, McGarrah RW, Hellkamp AS, Fiuzat M, Testani JM, Wang TS, Verma A, Samsky MD, Donahue MP, Ilkayeva OR, Bowles DE, Patel CB, Milano CA, Rogers JG, Felker GM, O’Connor C, Shah SH, Kraus WE. Prognostic Implications of Long-Chain Acylcarnitines in Heart Failure and Reversibility With Mechanical Circulatory Support. Journal Of The American College Of Cardiology 2016, 67: 291-299. PMID: 26796394, PMCID: PMC5429585, DOI: 10.1016/j.jacc.2015.10.079.Peer-Reviewed Original ResearchMeSH KeywordsAgedCarnitineDisease ProgressionEnergy MetabolismExercise TherapyFemaleHeart Failure, SystolicHeart-Assist DevicesHospital MortalityHumansMaleMass SpectrometryMiddle AgedNorth CarolinaOutcome Assessment, Health CarePrognosisReproducibility of ResultsSeverity of Illness IndexStatistics as TopicConceptsEnd-stage heart failureSystolic heart failureHeart failureMechanical circulatory supportHF patientsClinical outcomesCirculatory supportEnd-stage systolic heart failureChronic systolic HF patientsLeft ventricular assist device placementLong-term mechanical circulatory supportVentricular assist device placementPeak VO2 levelsChronic HF patientsSystolic HF patientsAdverse clinical outcomesClinical trial outcomesLong-chain acylcarnitinesAssociations of metabolitesFrozen plasma samplesMechanical circulatoryCardiovascular deathCause hospitalizationCause mortalityLVAD group
2015
Evaluation of Short-Term Changes in Serum Creatinine Level as a Meaningful End Point in Randomized Clinical Trials
Coca SG, Zabetian A, Ferket BS, Zhou J, Testani JM, Garg AX, Parikh CR. Evaluation of Short-Term Changes in Serum Creatinine Level as a Meaningful End Point in Randomized Clinical Trials. Journal Of The American Society Of Nephrology 2015, 27: 2529-2542. PMID: 26712525, PMCID: PMC4978048, DOI: 10.1681/asn.2015060642.Peer-Reviewed Original ResearchConceptsSerum creatinine levelsCreatinine levelsClinical trialsEnd pointAcute elevationRandomized trialsAcute changesPlacebo-controlled randomized trialSafety end pointRandomized clinical trialsStrong risk factorMeaningful clinical outcomesMeaningful end pointsClinical outcomesKidney functionPoor outcomeAcute increaseRisk factorsThorough literature searchObservational studyTemporary elevationMortality rateShort-term effectsPlaceboCKDAutomated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial
Wilson FP, Shashaty M, Testani J, Aqeel I, Borovskiy Y, Ellenberg SS, Feldman HI, Fernandez H, Gitelman Y, Lin J, Negoianu D, Parikh CR, Reese PP, Urbani R, Fuchs B. Automated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial. The Lancet 2015, 385: 1966-1974. PMID: 25726515, PMCID: PMC4475457, DOI: 10.1016/s0140-6736(15)60266-5.Peer-Reviewed Original ResearchConceptsAcute kidney injuryUsual care groupKidney injuryCare groupAlert groupClinical outcomesElectronic alertsEligible participantsKidney Disease Improving Global OutcomesEnd-stage renal diseaseAcute kidney injury alertsEffective treatment optionIntensive care unitElectronic alert systemComputer-generated sequenceRandomisation strataSurgical admissionsUsual carePrimary outcomeRenal diseaseCare unitTreatment optionsCreatinine valuesCreatinine concentrationSuch injuries
2014
Insufficient Natriuretic Response to Continuous Intravenous Furosemide Is Associated With Poor Long-Term Outcomes in Acute Decompensated Heart Failure
Singh D, Shrestha K, Testani JM, Verbrugge FH, Dupont M, Mullens W, Tang WH. Insufficient Natriuretic Response to Continuous Intravenous Furosemide Is Associated With Poor Long-Term Outcomes in Acute Decompensated Heart Failure. Journal Of Cardiac Failure 2014, 20: 392-399. PMID: 24704538, PMCID: PMC4067259, DOI: 10.1016/j.cardfail.2014.03.006.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureContinuous intravenous furosemideDecompensated heart failureLong-term outcomesIntravenous furosemideNatriuretic responseRenal functionUrine sodiumHeart failureClinical outcomesUrine creatinineAdverse long-term clinical outcomesAdverse long-term outcomesLong-term clinical outcomesPoor long-term outcomesAdverse long-term eventsWeight lossContinuous furosemide infusionNet urine outputUrine sodium excretionAdverse clinical outcomesGlomerular filtration rateNet fluid outputGreater likelihoodLow urine sodium
2013
Potential 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