2023
Improvement 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
2019
Effect on Survival of Concurrent Hemoconcentration and Increase in Creatinine During Treatment of Acute Decompensated Heart Failure
Griffin M, Rao VS, Fleming J, Raghavendra P, Turner J, Mahoney D, Wettersten N, Maisel A, Ivey-Miranda JB, Inker L, Tang WHW, Wilson FP, Testani JM. Effect on Survival of Concurrent Hemoconcentration and Increase in Creatinine During Treatment of Acute Decompensated Heart Failure. The American Journal Of Cardiology 2019, 124: 1707-1711. PMID: 31601358, PMCID: PMC6959849, DOI: 10.1016/j.amjcard.2019.08.034.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureHeart failureImproved survivalHigher loop diuretic dosesLoop diuretic dosesNet fluid lossPlasma volume reductionAggressive decongestionAggressive diuresisPostdischarge survivalDiuretic dosesPostdischarge outcomesSerum creatinineHospital treatmentHospital parametersBetter survivalCreatinineHemoconcentrationPatient carePatientsSurvivalLonger lengthVolume reductionTreatment
2016
Efficacy of Intravenous Chlorothiazide for Refractory Acute Decompensated Heart Failure Unresponsive to Adjunct Metolazone
Cardinale M, Altshuler J, Testani JM. Efficacy of Intravenous Chlorothiazide for Refractory Acute Decompensated Heart Failure Unresponsive to Adjunct Metolazone. Pharmacotherapy The Journal Of Human Pharmacology And Drug Therapy 2016, 36: 843-851. PMID: 27321568, DOI: 10.1002/phar.1787.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureIntravenous chlorothiazideUrine outputIndex doseOral metolazoneLoop diureticsHigh-dose loop diureticsAdministration of chlorothiazideDecompensated heart failurePrimary end pointRetrospective cohort studyTertiary care hospitalFurosemide equivalentsHospital mortalityImproved diuresisDiuretic dosesLast doseMedian doseCohort studyCare hospitalHeart failureMultiple dosesInstitutional protocolInadequate responseOwn controlHypochloraemia is strongly and independently associated with mortality in patients with chronic heart failure
Testani JM, Hanberg JS, Arroyo JP, Brisco MA, Ter Maaten JM, Wilson FP, Bellumkonda L, Jacoby D, Tang WH, Parikh CR. Hypochloraemia is strongly and independently associated with mortality in patients with chronic heart failure. European Journal Of Heart Failure 2016, 18: 660-668. PMID: 26763893, PMCID: PMC5471359, DOI: 10.1002/ejhf.477.Peer-Reviewed Original ResearchConceptsChronic heart failureHeart failureSerum chlorideSerum sodiumLow serum sodiumHeart failure pathophysiologyGreater disease severityBEST trialDiuretic dosesSerum chloride valuesRenal functionWorsened survivalPrognostic importanceAdverse outcomesUnivariate analysisHyponatraemiaHypochloraemiaPatientsDisease severityMortalityAdditional researchFailureChloride valuesCritical roleSodium
2013
Timing of Hemoconcentration During Treatment of Acute Decompensated Heart Failure and Subsequent Survival Importance of Sustained Decongestion
Testani JM, Brisco MA, Chen J, McCauley BD, Parikh CR, Tang WH. Timing of Hemoconcentration During Treatment of Acute Decompensated Heart Failure and Subsequent Survival Importance of Sustained Decongestion. Journal Of The American College Of Cardiology 2013, 62: 516-524. PMID: 23747773, PMCID: PMC3892152, DOI: 10.1016/j.jacc.2013.05.027.Peer-Reviewed Original ResearchConceptsDecompensated heart failureHeart failureEarly hemoconcentrationIntravascular volumeSurvival advantageAcute decompensated heart failureLoop diuretic dosesSignificant mortality benefitPrimary discharge diagnosisSimilar baseline characteristicsSignificant survival advantageGreater weight lossDiuretic dosesOral diureticsBaseline characteristicsMortality benefitRenal functionImproved survivalLoop diureticsSingle centerDischarge diagnosisHealthy patientsConsecutive admissionsDiuretic responsivenessRapid diuresis