2024
Bladder Symptoms Prvoked by Short, Rapid Acting Loop Diuretics: A Frequent But Often Overlooked Problem
Wilcox C, Pourafshar N, Han K, Shah S, Sussman R, Testani J, Packer M, Rossignol P, Zannad F, Pitt B, Shah S. Bladder Symptoms Prvoked by Short, Rapid Acting Loop Diuretics: A Frequent But Often Overlooked Problem. American Journal Of Hypertension 2024, hpae139. PMID: 39485998, DOI: 10.1093/ajh/hpae139.Peer-Reviewed Original ResearchCongestive heart failureChronic kidney diseaseBladder dysfunctionOveractive bladderLoop diureticsCardiovascular diseaseFormulations of loop diureticsSymptoms of overactive bladderSymptoms of urinary urgencyUrinary tract symptomsExtended-release formulationType 2 inhibitorsImpaired quality of lifeWorsening of symptomsPatients seeking careAdult US populationResistant hypertensionUrinary urgencyBladder symptomsReceptor antagonistBladder contractionsSodium-glucoseUrinary incontinenceHeart failureDiureticsDapagliflozin enhances arterial and venous compliance during exercise in heart failure with preserved ejection fraction
Tada A, Burkhoff D, Naser J, Harada T, Pourmussa B, Reddy Y, Jensen M, Carter R, Testani J, Chirinos J, Borlaug B. Dapagliflozin enhances arterial and venous compliance during exercise in heart failure with preserved ejection fraction. European Heart Journal 2024, 45: ehae666.782. DOI: 10.1093/eurheartj/ehae666.782.Peer-Reviewed Original ResearchPulmonary capillary wedge pressureSodium-glucose cotransporter-2 inhibitorsSystemic arterial complianceEffects of dapagliflozinVenous capacitancePeak exerciseArterial complianceHemodynamic congestionHeart failureTotal arterial complianceImproved systemic arterial complianceInvasive hemodynamic exercise testingTime of baseline evaluationSystolic BPBlood volumeHemodynamic exercise testingCapillary wedge pressureCotransporter-2 inhibitorsSystemic vascular resistanceImproving clinical outcomesTotal blood volumeRadial artery pressureFluid-filled catheterWedge pressureStressed blood volumeEffects of dapagliflozin on body composition and its relation to hemodynamics in heart failure with preserved ejection fraction: the CAMEO-DAPA randomized clinical trial
Naser J, Tada A, Harada T, Reddy Y, Carter R, Testani J, Jensen M, Borlaug B. Effects of dapagliflozin on body composition and its relation to hemodynamics in heart failure with preserved ejection fraction: the CAMEO-DAPA randomized clinical trial. European Heart Journal 2024, 45: ehae666.1044. DOI: 10.1093/eurheartj/ehae666.1044.Peer-Reviewed Original ResearchPulmonary capillary wedge pressureFat-free massEffects of dapagliflozinDual-energy X-ray absorptiometryBone mineral contentTrunk fatBody compositionCardiac hemodynamicsHeart failureExercise pulmonary capillary wedge pressureTotal body fat-free massHemodynamic effectsBody fatEnergy X-ray absorptiometryReduced fat-free massWeeks of dapagliflozinDevelopment of heart failureBody fat-free massPlacebo-controlled studyFavorable hemodynamic effectsCapillary wedge pressureX-ray absorptiometryPlasma volumeDecreased risk of hospitalizationTotal body fatSex differences in proteomics of cardiovascular disease: results from the Yale-CMD registry
Liu Y, Wang Z, Collins S, Testani J, Kleinstein S, Safdar B. Sex differences in proteomics of cardiovascular disease: results from the Yale-CMD registry. European Heart Journal 2024, 45: ehae666.3091. DOI: 10.1093/eurheartj/ehae666.3091.Peer-Reviewed Original ResearchCoronary microvascular dysfunctionCoronary artery diseaseUpregulation of lipidCardiovascular diseaseAcute heart failureCoronary artery disease cohortHistory of diabetesPathophysiology of CVDProximity extension assayBody mass indexSignificant sex differencesRegulation of blood flowSerum proteomic profilesSex differencesProteomic profilingAngiogenesis-related proteinsCardiac PET/CTHemodynamic instabilityIschemic symptomsMicrovascular dysfunctionFalse discovery rateHeart failureFebrile illnessFunctional pathway analysisMass indexEarly, Individualized Recommendations for Hospitalized Patients With Acute Kidney Injury
Aklilu A, Menez S, Baker M, Brown D, Dircksen K, Dunkley K, Gaviria S, Farrokh S, Faulkner S, Jones C, Kadhim B, Le D, Li F, Makhijani A, Martin M, Moledina D, Coronel-Moreno C, O’Connor K, Shelton K, Shvets K, Srialluri N, Tan J, Testani J, Corona-Villalobos C, Yamamoto Y, Parikh C, Wilson F, Sundararajan A, Wang A, Schretlen C, Singel D, Moss E, Aune F, Iantosca G, Zou G, Chernova I, Bitzel J, Hernandez J, Lindsley J, Dane K, Orias M, Mehta P, Zassman-Isner S, Wen Y, Freeman N. Early, Individualized Recommendations for Hospitalized Patients With Acute Kidney Injury. JAMA 2024, 332 PMID: 39454050, DOI: 10.1001/jama.2024.22718.Peer-Reviewed Original ResearchElectronic health recordsUsual careHealth recordsAction teamsClinicians of patientsHospitalized patientsFinal follow-upIntervention groupHealth systemStudy pharmacistsStudy physiciansMain OutcomesAssociated with adverse outcomesAcute kidney injuryRandomized clinical trialsPrimary outcomeIndividualized recommendationsNew HavenAdverse outcomesAKI detectionCareRhode IslandComposite outcomeFollow-upInterventionTiming of Acute eGFR Declines in Acute Heart Failure and Their Association with Cardiovascular and Kidney Outcomes
McCallum W, Tighiouart H, Tuttle M, Lala-Trindade A, Costanzo M, Bautista I, Oka T, Testani J, Konstam M, Sarnak M. Timing of Acute eGFR Declines in Acute Heart Failure and Their Association with Cardiovascular and Kidney Outcomes. Journal Of The American Society Of Nephrology 2024, 35: 10.1681/asn.2024cax7nzke. DOI: 10.1681/asn.2024cax7nzke.Peer-Reviewed Original ResearchEffects of Sodium-Glucose Cotransporter-2 Inhibitors on Kidney Outcomes across Baseline Cardiovascular-Kidney-Metabolic Conditions: A Systematic Review and Meta-Analyses.
Siddiqi T, Cherney D, Siddiqui H, Jafar T, Januzzi J, Khan M, Levin A, Marx N, Rangaswami J, Testani J, Usman M, Wanner C, Zannad F, Butler J. Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Kidney Outcomes across Baseline Cardiovascular-Kidney-Metabolic Conditions: A Systematic Review and Meta-Analyses. Journal Of The American Society Of Nephrology 2024 PMID: 39230974, DOI: 10.1681/asn.0000000000000491.Peer-Reviewed Original ResearchSodium-glucose cotransporter-2 inhibitorsType 2 diabetes mellitusChronic kidney diseaseEffects of sodium-glucose cotransporter-2 inhibitorsComposite kidney endpointCotransporter-2 inhibitorsKidney outcomesHeart failureKidney diseaseKidney endpointsHazard ratioDoubling of serum creatinineCombination of heart failureSustained doubling of serum creatininePlacebo-controlled trialReduced ejection fractionBaseline heart failureConfidence intervalsRandom-effects modelAlbuminuria progressionEjection fractionSerum creatinineReview ManagerMellitusPatientsEffects of Sotagliflozin on Health Status in Patients With Worsening Heart Failure Results From SOLOIST-WHF
Bhatt A, Bhatt D, Steg P, Szarek M, Cannon C, Leiter L, McGuire D, Lewis J, Riddle M, Voors A, Metra M, Lund L, Testani J, Wilcox C, Davies M, Pitt B, Kosiborod M. Effects of Sotagliflozin on Health Status in Patients With Worsening Heart Failure Results From SOLOIST-WHF. Journal Of The American College Of Cardiology 2024, 84: 1078-1088. PMID: 39260929, DOI: 10.1016/j.jacc.2024.06.036.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2Effect of sotagliflozinKCCQ-12 scoreKCCQ-12Heart failureSOLOIST-WHFPrimary endpointSodium-glucose cotransporter 2 inhibitionLeft ventricular ejection fractionWorsening heart failureBaseline to monthVentricular ejection fractionHealth statusWorsening HFKansas City Cardiomyopathy Questionnaire-12Ejection fractionSecondary endpointsCotransporter 2Randomized patientsClinical characteristicsHF hospitalizationPlaceboCardiovascular deathHF episodeSotagliflozinInpatient Use of Guideline-Directed Medical Therapy During Heart Failure Hospitalizations Among Community-Based Health Systems
Zheng J, Sandhu A, Bhatt A, Collins S, Flint K, Fonarow G, Fudim M, Greene S, Heidenreich P, Lala A, Testani J, Varshney A, Wi R, Ambrosy A. Inpatient Use of Guideline-Directed Medical Therapy During Heart Failure Hospitalizations Among Community-Based Health Systems. JACC Heart Failure 2024 PMID: 39269395, DOI: 10.1016/j.jchf.2024.08.004.Peer-Reviewed Original ResearchCommunity-based health systemQuality improvement registryHealth systemGuideline-directed medical therapyGuideline-directed medical therapy useEligible hospitalsImprovement registryNational quality improvement registryElectronic health record dataHealth record dataEvidence-based medicationsHF hospitalizationHeart failurePostdischarge strategiesHFrEF patientsFailure hospitalizationMedical therapyCommunity-basedAngiotensin receptor-neprilysin inhibitorSodium-glucose cotransporter 2 inhibitorsInpatient useRecord dataRenin-angiotensin system inhibitorsMineralocorticoid receptor antagonistsWorsening renal functionMechanistic 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 weightThe utility of urine sodium–guided diuresis during acute decompensated heart failure
Siddiqi H, Cox Z, Stevenson L, Damman K, ter Maaten J, Bales B, Han J, Ivey-Miranda J, Lindenfeld J, Miller K, Ooi H, Rao V, Schlendorf K, Storrow A, Walsh R, Wrenn J, Testani J, Collins S. The utility of urine sodium–guided diuresis during acute decompensated heart failure. Heart Failure Reviews 2024, 29: 1161-1173. PMID: 39128947, PMCID: PMC11455821, DOI: 10.1007/s10741-024-10424-8.Peer-Reviewed Original ResearchAcute decompensated heart failureDecompensated heart failureHeart failureClinical trialsUrine sodium excretionObservational cohort studyRandomized clinical trialsAdequate decongestionDiuretic strategySodium excretionUrine chemistryCohort studyTitration strategyUrineDiuretic titrationAdverse effectsDiuresisDecongestionPatientsUsual careEvidence gapsTrialsTherapyFailureDapagliflozin Enhances Arterial and Venous Compliance During Exercise in Heart Failure With Preserved Ejection Fraction: Insights From the CAMEO-DAPA Trial
Tada A, Burkhoff D, Naser J, Harada T, Pourmussa B, Reddy Y, Jensen M, Carter R, Demmer R, Testani J, Chirinos J, Borlaug B. Dapagliflozin Enhances Arterial and Venous Compliance During Exercise in Heart Failure With Preserved Ejection Fraction: Insights From the CAMEO-DAPA Trial. Circulation 2024, 150: 997-1009. PMID: 39101201, PMCID: PMC11433515, DOI: 10.1161/circulationaha.124.068788.Peer-Reviewed Original ResearchConceptsSystemic arterial complianceEffects of dapagliflozinStressed blood volumeVenous capacitanceBlood volumePeak exerciseArterial complianceHemodynamic congestionHeart failureEstimating stressed blood volumeImproved systemic arterial complianceInvasive hemodynamic exercise testingSodium-glucose cotransporter-2 inhibitorsSystolic BPPulmonary capillary wedge pressureHemodynamic exercise testingCapillary wedge pressureCotransporter-2 inhibitorsSystemic vascular resistanceImproving clinical outcomesTotal blood volumeRadial artery pressureSimultaneous echocardiographyEjection fractionFluid-filled catheterPeak Tricuspid Regurgitation Jet Velocity and Kidney Outcomes in Patients With Heart Failure With Preserved Ejection Fraction
Oka T, Tighiouart H, McCallum W, Tuttle M, Testani J, Sarnak M. Peak Tricuspid Regurgitation Jet Velocity and Kidney Outcomes in Patients With Heart Failure With Preserved Ejection Fraction. Kidney International Reports 2024, 9: 3035-3044. PMID: 39430198, PMCID: PMC11489825, DOI: 10.1016/j.ekir.2024.07.009.Peer-Reviewed Original ResearchLeft ventricular ejection fractionPulmonary artery pressureCreatinine doublingEGFR declineEjection fractionKidney outcomesHeart failurePeak tricuspid regurgitant jet velocityDoubling of serum creatinineTricuspid regurgitant jet velocityElevated pulmonary artery pressureAssociated with lower eGFRWorsening kidney functionVentricular ejection fractionRegurgitant jet velocityCox proportional hazards modelsProportional hazards modelPost hoc analysisBaseline eGFRSerum creatinineLow eGFRTOPCAT trialFollow-upKidney functionArterial pressureIncreased Spironolactone Dosing in Acute Heart Failure Alters Potassium Homeostasis but Does Not Enhance Decongestion
Natov P, Ivey-Miranda J, Cox Z, Rao V, Butler J, Konstam M, Kiernan M, Kapur N, Testani J. Increased Spironolactone Dosing in Acute Heart Failure Alters Potassium Homeostasis but Does Not Enhance Decongestion. Journal Of Cardiac Failure 2024 PMID: 38986838, DOI: 10.1016/j.cardfail.2024.06.008.Peer-Reviewed Original ResearchBaseline serum potassiumAcute heart failureSerum potassiumSpironolactone treatmentTreatment armsHeart failureBaseline serum potassium levelsNatriuretic peptide levelsTreated with spironolactoneSerum potassium levelsSpironolactone-treated patientsNet fluid lossRenal potassium handlingPost hoc analysisEnhance decongestionSpironolactone dosePotassium wastingUrine outputClinical congestionTreatment startPotassium handlingPotassium replacementPotassium supplementationPharmacodynamic effectsSurrogate markerEffects of Dapagliflozin on Body Composition and Its Relation to Hemodynamics in Heart Failure With Preserved Ejection Fraction
Naser J, Tada A, Harada T, Reddy Y, Carter R, Testani J, Jensen M, Borlaug B. Effects of Dapagliflozin on Body Composition and Its Relation to Hemodynamics in Heart Failure With Preserved Ejection Fraction. Circulation 2024, 149: 2026-2028. PMID: 38885297, PMCID: PMC11185269, DOI: 10.1161/circulationaha.124.069479.Peer-Reviewed Original ResearchVolenrelaxin (LY3540378) increases renal plasma flow: a randomized Phase 1 trial
San Tham L, Heerspink H, Wang X, Verdino P, Saifan C, Benson E, Goldsmith P, Wang Z, Testani J, Haupt A, Sam F, Cherney D. Volenrelaxin (LY3540378) increases renal plasma flow: a randomized Phase 1 trial. Nephrology Dialysis Transplantation 2024, gfae112. PMID: 38782726, DOI: 10.1093/ndt/gfae112.Peer-Reviewed Original ResearchMeasured glomerular filtration rateEffective renal plasma flowRenal plasma flowKidney perfusionIncreased renal plasma flowPlacebo-adjusted changeMultiple-ascending dosePhase 1 trialGlomerular filtration rateChronic heart failureChronic kidney diseaseDiastolic blood pressureRenal arteriolar resistanceExtended half-lifeCardiorenal functionDouble-blindPlacebo SCRelaxin proteinSC doseAdverse eventsMeasured GFRArteriolar resistanceClinical developmentHeart failureOrthostatic hypotensionSodium Zirconium Cyclosilicate in HFrEF and Hyperkalemia REALIZE-K Design and Baseline Characteristics
Kosiborod M, Cherney D, Connelly K, Desai A, Guimarães P, Kuthi L, Lala A, Madrini V, Merkely B, Villota J, Squire I, Testani J, Vaclavik J, Verma S, Wranicz J, Dahl M, Eudicone J, Friberg L, Petrie M. Sodium Zirconium Cyclosilicate in HFrEF and Hyperkalemia REALIZE-K Design and Baseline Characteristics. JACC Heart Failure 2024, 12: 1707-1716. PMID: 38878009, DOI: 10.1016/j.jchf.2024.05.003.Peer-Reviewed Original ResearchMineralocorticoid receptor antagonistsSodium zirconium cyclosilicateZirconium cyclosilicateBaseline characteristicsOpen-label run-inN-terminal pro B-type natriuretic peptideMineralocorticoid receptor antagonist useRun-inPro B-type natriuretic peptideB-type natriuretic peptidePlacebo-controlled trialRisk of hyperkalemiaReduced ejection fractionPrimary composite endpointDouble-blindEjection fractionReceptor antagonistLowered potassiumOptimal therapyNatriuretic peptideIncident hyperkalemiaProportion of participantsTherapy useHFrEFComposite endpointDietary sodium and fluid intake in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC
Mullens W, Damman K, Dhont S, Banerjee D, Bayes‐Genis A, Cannata A, Chioncel O, Cikes M, Ezekowitz J, Flammer A, Martens P, Mebazaa A, Mentz R, Miró Ò, Moura B, Nunez J, Maaten J, Testani J, van Kimmenade R, Verbrugge F, Metra M, Rosano G, Filippatos G. Dietary sodium and fluid intake in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC. European Journal Of Heart Failure 2024, 26: 730-741. PMID: 38606657, DOI: 10.1002/ejhf.3244.Peer-Reviewed Original ResearchConceptsHeart failureClinical consensus statementFluid restrictionDietary sodiumConsensus statementEuropean Society of Cardiology HF guidelinesUntreated patient cohortLimitation of salt intakeHeart Failure AssociationSodium handlingSodium intakePatient cohortSalt intakeHF guidelinesFluid intakeFailure AssociationFluid homeostasisPatientsAvidity stateEuropean SocietyIntakeHeartContemporary evidenceExpert opinionData challengeContemporary Decongestion Strategies in Patients Hospitalized for Heart Failure A National Community-Based Cohort Study
Zheng J, Ambrosy A, Bhatt A, Collins S, Flint K, Fonarow G, Fudim M, Greene S, Lala A, Testani J, Varshney A, Wi R, Sandhu A. Contemporary Decongestion Strategies in Patients Hospitalized for Heart Failure A National Community-Based Cohort Study. JACC Heart Failure 2024, 12: 1381-1392. PMID: 38678466, DOI: 10.1016/j.jchf.2024.04.002.Peer-Reviewed Original ResearchPredictors of weight lossHeart failureWeight lossHF hospitalizationPatient-level electronic health record dataCommunity-based health systemAssociated with less weight lossContinuous diuretic infusionsElectronic health record dataCommunity-based cohort studyAssociated with greater weight lossHealth record dataGreater weight lossBackground Heart failureEstimated weight lossLess weight lossAdjunctive diureticsDiuretic infusionAcute HFSerum creatinineClinical predictorsDecongestion strategiesAdmission weightStudy cohortDischarge weightCONTEMPORARY DECONGESTION STRATEGIES AND WEIGHT LOSS IN PATIENTS HOSPITALIZED FOR HEART FAILURE: A NATIONAL COMMUNITY-BASED COHORT STUDY
Zheng J, Ambrosy A, Bhatt A, Collins S, Flint K, Fonarow G, Fudim M, Greene S, Lala A, Testani J, Varshney A, Wi R, Sandhu A. CONTEMPORARY DECONGESTION STRATEGIES AND WEIGHT LOSS IN PATIENTS HOSPITALIZED FOR HEART FAILURE: A NATIONAL COMMUNITY-BASED COHORT STUDY. Journal Of The American College Of Cardiology 2024, 83: 339. DOI: 10.1016/s0735-1097(24)02329-5.Peer-Reviewed Original Research