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
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 curveResponsivenessAdministrationMinutesPatients
2015
Substantial Discrepancy Between Fluid and Weight Loss During Acute Decompensated Heart Failure Treatment
Testani JM, Brisco MA, Kociol RD, Jacoby D, Bellumkonda L, Parikh CR, Coca SG, Tang WH. Substantial Discrepancy Between Fluid and Weight Loss During Acute Decompensated Heart Failure Treatment. The American Journal Of Medicine 2015, 128: 776-783.e4. PMID: 25595470, PMCID: PMC4475432, DOI: 10.1016/j.amjmed.2014.12.020.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAge FactorsAgedAged, 80 and overBody FluidsCohort StudiesDiureticsDose-Response Relationship, DrugDouble-Blind MethodDrug Administration ScheduleFemaleFollow-Up StudiesHeart FailureHumansInfusions, IntravenousMaleMiddle AgedRandomized Controlled Trials as TopicRisk AssessmentSeverity of Illness IndexSex FactorsStatistics, NonparametricSurvival RateTreatment OutcomeWeight LossConceptsAcute decompensated heart failureDecompensated heart failureDiuretic Optimization Strategies EvaluationHeart failureWeight lossAcute Decompensated Heart Failure (CARRESS-HF) trialPatient careDecompensated Heart Failure (ASCEND-HF) trialPulmonary Artery Catheterization EffectivenessAcute decompensated heartHeart Failure TrialCongestive heart failureHeart failure researchBaseline characteristicsDiuretic responseFailure TrialLimits of agreementFailure treatmentFluid balanceDecompensated heartNet fluidGreater fluidPatientsCareTreatment
2013
Loop Diuretic Efficiency
Testani JM, Brisco MA, Turner JM, Spatz ES, Bellumkonda L, Parikh CR, Tang WH. Loop Diuretic Efficiency. Circulation Heart Failure 2013, 7: 261-270. PMID: 24379278, PMCID: PMC4386906, DOI: 10.1161/circheartfailure.113.000895.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseCause of DeathDiuresisDose-Response Relationship, DrugFemaleFollow-Up StudiesGlomerular Filtration RateHeart FailureHospital MortalityHumansInjections, IntravenousMaleMiddle AgedPatient DischargePennsylvaniaPrognosisProspective StudiesSodium Potassium Chloride Symporter InhibitorsSurvival RateTreatment OutcomeConceptsLower diuretic efficiencyDiuretic efficiencyNet fluid outputDiuretic doseHeart failureFluid outputBaseline characteristicsPoor long-term outcomesDecompensated heart failureDistinct prognostic informationDose of diureticsPrimary discharge diagnosisCongestive heart failureTraditional prognostic factorsLong-term outcomesCatheterization variablesFurosemide equivalentsDiuretic therapyRenal functionWorsened survivalPrognostic factorsUrine outputDecongestive therapyDischarge diagnosisConsecutive admissions
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 nitrogenPatientsMortalityClinical Characteristics and Outcomes of Patients With Improvement in Renal Function During the Treatment of Decompensated Heart Failure
Testani JM, McCauley BD, Chen J, Coca SG, Cappola TP, Kimmel SE. Clinical Characteristics and Outcomes of Patients With Improvement in Renal Function During the Treatment of Decompensated Heart Failure. Journal Of Cardiac Failure 2011, 17: 993-1000. PMID: 22123361, PMCID: PMC3248245, DOI: 10.1016/j.cardfail.2011.08.009.Peer-Reviewed Original ResearchConceptsDecompensated heart failureRenal functionHeart failureRenal dysfunctionAcute decompensated heart failureVolume of diuresisOutcomes of patientsCongestive heart failureGlomerular filtration rateCardiorenal interactionsIRF patientsClinical characteristicsHemodynamic derangementsConsecutive patientsCardiac dysfunctionDischarge diagnosisPoor prognosisFiltration rateMortality riskEligibility criteriaPatientsGreater incidenceDysfunctionUniversity of PennsylvaniaIRFImpact of changes in blood pressure during the treatment of acute decompensated heart failure on renal and clinical outcomes†
Testani JM, Coca SG, McCauley BD, Shannon RP, Kimmel SE. Impact of changes in blood pressure during the treatment of acute decompensated heart failure on renal and clinical outcomes†. European Journal Of Heart Failure 2011, 13: 877-884. PMID: 21693504, PMCID: PMC3143830, DOI: 10.1093/eurjhf/hfr070.Peer-Reviewed Original ResearchConceptsDecompensated heart failureBlood pressure reductionSystolic blood pressureHeart failureBlood pressurePulmonary Artery Catheterization Effectiveness trialAcute decompensated heart failureSignificant blood pressure reductionSystolic blood pressure reductionPressure reductionThiazide diuretic useCongestive heart failureDifferent prognostic implicationsRegional vascular bedsFinal common pathwayGreater weight reductionOral vasodilatorsDiuretic useRenal functionWorsened survivalAdverse prognosisPerfusion pressurePrognostic implicationsPrognostic significanceEffectiveness trialImpact 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 statesPotential Effects of Aggressive Decongestion During the Treatment of Decompensated Heart Failure on Renal Function and Survival
Testani JM, Chen J, McCauley BD, Kimmel SE, Shannon RP. Potential Effects of Aggressive Decongestion During the Treatment of Decompensated Heart Failure on Renal Function and Survival. Circulation 2010, 122: 265-272. PMID: 20606118, PMCID: PMC3025294, DOI: 10.1161/circulationaha.109.933275.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBlood ProteinsBlood VolumeExtracellular FluidFemaleGlomerular Filtration RateHeart FailureHematocritHumansKidneyMaleMiddle AgedPulmonary Wedge PressureSerum AlbuminSodium Chloride Symporter InhibitorsSodium Potassium Chloride Symporter InhibitorsTreatment OutcomeVentricular PressureConceptsDecompensated heart failureRenal functionAggressive decongestionHeart failurePulmonary Artery Catheterization Effectiveness trialPulmonary capillary wedge pressureAggressive fluid removalCapillary wedge pressureIntravascular volume depletionRight atrial pressureCongestive heart failureEvidence of hemoconcentrationAggressive diuresisIntravascular substancesWedge pressureAtrial pressureBaseline characteristicsLoop diureticsTop tertileVolume depletionEffectiveness trialExtravascular fluidFluid removalHemoconcentrationHigh doses