2023
In-Hospital Observation on Oral Diuretics After Treatment for Acute Decompensated Heart Failure: Evaluating the Utility
Ivey-Miranda J, Rao V, Cox Z, Moreno-Villagomez J, Mahoney D, Maulion C, Bellumkonda L, Turner J, Collins S, Wilson F, Krumholz H, Testani J. In-Hospital Observation on Oral Diuretics After Treatment for Acute Decompensated Heart Failure: Evaluating the Utility. Circulation Heart Failure 2023, 16: e010206. PMID: 36896716, PMCID: PMC10186250, DOI: 10.1161/circheartfailure.122.010206.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureDiuretic responseDiuretic dosingOral diureticsHeart failureMulticenter cohortHospital observationLower readmission ratesNet fluid balanceDays postdischargeReadmission ratesHospital readmissionUrine outputReadmission riskFluid statusFluid balanceHospital measuresDose selectionCohortProvider decisionsWeight changeReadmissionDiureticsPatients
2022
Inferior Vena Cava Diameter Measurement Provides Distinct and Complementary Information to Right Atrial Pressure in Acute Decompensated Heart Failure
Griffin M, Ivey-Miranda J, McCallum W, Sarnak M, Eder M, Bellumkonda L, Maulion C, Wilson FP, Rao VS, Testani J. Inferior Vena Cava Diameter Measurement Provides Distinct and Complementary Information to Right Atrial Pressure in Acute Decompensated Heart Failure. Journal Of Cardiac Failure 2022, 28: 1217-1221. PMID: 35301109, DOI: 10.1016/j.cardfail.2022.02.014.Peer-Reviewed Original ResearchConceptsRight atrial pressureAcute decompensated heart failureDecompensated heart failureIVC diameterAtrial pressureHeart failureInferior vena cava diameter (IVCD) measurementBaseline right atrial pressureInferior vena cava (IVC) measurementsPulmonary artery catheterVena cava diameter measurementsArtery catheterHemoglobin levelsIntravascular volumeVenous systemESCAPE trialIVC measurementsBlood volumeRAP measurementsSurvival ratePatientsVolume assessmentHigh complianceModest correlationMedian
2021
Natriuretic Equation to Predict Loop Diuretic Response in Patients With Heart Failure
Rao VS, Ivey-Miranda JB, Cox ZL, Riello R, Griffin M, Fleming J, Soucier R, Sangkachand P, O'Brien M, LoRusso F, D'Ambrosi J, Churchwell K, Mahoney D, Bellumkonda L, Asher JL, Maulion C, Turner JM, Wilson FP, Collins SP, Testani JM. Natriuretic Equation to Predict Loop Diuretic Response in Patients With Heart Failure. Journal Of The American College Of Cardiology 2021, 77: 695-708. PMID: 33573739, PMCID: PMC8114781, DOI: 10.1016/j.jacc.2020.12.022.Peer-Reviewed Original ResearchConceptsLoop diuretic administrationDiuretic therapyNatriuretic responseDiuretic administrationSodium outputAcute decompensated heart failureDecompensated heart failureHeart failure admissionsDaily urine outputSpot urine samplesNet fluid outputNet fluid lossPathway cohortHeart failureLoop diureticsUrine outputDiuretic responseResidual congestionFluid outputTherapyCohortWeight lossAdditional studiesUrine samplesExcellent discrimination
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 variablesEffect of Loop Diuretics on the Fractional Excretion of Urea in Decompensated Heart Failure
Cox ZL, Sury K, Rao VS, Ivey-Miranda JB, Griffin M, Mahoney D, Gomez N, Fleming JH, Inker LA, Coca SG, Turner J, Wilson FP, Testani JM. Effect of Loop Diuretics on the Fractional Excretion of Urea in Decompensated Heart Failure. Journal Of Cardiac Failure 2020, 26: 402-409. PMID: 32007554, PMCID: PMC7798124, DOI: 10.1016/j.cardfail.2020.01.019.Peer-Reviewed Original ResearchConceptsAcute kidney injuryFractional excretionHeart failureLoop diureticsDecompensated heart failureFurosemide equivalentsKidney injuryProspective cohortDiuretic administrationDiuretic responsePeak diuresisDiuretic effectFEUreaDiureticsPatientsDiagnostic superiorityHospital systemExcretionMagnitude of changeDegree of changeBaselineDistribution of changesFENaDiuresisFailure
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 reductionTreatmentRenal 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 incidenceNatriuretic Response Is Highly Variable and Associated With 6-Month Survival Insights From the ROSE-AHF Trial
Hodson DZ, Griffin M, Mahoney D, Raghavendra P, Ahmad T, Turner J, Wilson FP, Tang WHW, Rao VS, Collins SP, Mullens W, Testani JM. Natriuretic Response Is Highly Variable and Associated With 6-Month Survival Insights From the ROSE-AHF Trial. JACC Heart Failure 2019, 7: 383-391. PMID: 31047017, PMCID: PMC6501816, DOI: 10.1016/j.jchf.2019.01.007.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureROSE-AHF trialsSodium excretionNet fluid balanceWorse prognosisFluid balanceHigh-dose loop diuretic therapyNegative net fluid balanceGreater sodium excretionLoop diuretic agentsLoop diuretic therapyDecompensated heart failureDietary sodium intakeDiuretic therapyUrinary sodiumNatriuretic responseHeart failureSodium intakeUrine outputSodium retentionVolume overloadFluid retentionSodium balanceDiuretic agentsPrognostic ability
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
2016
Clinical Implications of Cluster Analysis-Based Classification of Acute Decompensated Heart Failure and Correlation with Bedside Hemodynamic Profiles
Ahmad T, Desai N, Wilson F, Schulte P, Dunning A, Jacoby D, Allen L, Fiuzat M, Rogers J, Felker GM, O’Connor C, Patel CB. Clinical Implications of Cluster Analysis-Based Classification of Acute Decompensated Heart Failure and Correlation with Bedside Hemodynamic Profiles. PLOS ONE 2016, 11: e0145881. PMID: 26840410, PMCID: PMC4739604, DOI: 10.1371/journal.pone.0145881.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureHemodynamic profileNon-ischemic cardiomyopathyClinical outcomesADHF patientsHeart failureLower B-type natriuretic peptide levelsB-type natriuretic peptide levelsCox proportional hazards modelConcomitant renal insufficiencyHigher BNP levelsNatriuretic peptide levelsAdverse clinical outcomesBaseline clinical variablesProportional hazards modelBNP levelsAdvanced diseaseCause mortalityMultiple comorbiditiesRenal insufficiencyComorbid conditionsHemodynamic classificationPrognostic valueAdverse outcomesRapid and Highly Accurate Prediction of Poor Loop Diuretic Natriuretic Response in Patients With Heart Failure
Testani JM, Hanberg JS, Cheng S, Rao V, Onyebeke C, Laur O, Kula A, Chen M, Wilson FP, Darlington A, Bellumkonda L, Jacoby D, Tang WH, Parikh CR. Rapid and Highly Accurate Prediction of Poor Loop Diuretic Natriuretic Response in Patients With Heart Failure. Circulation Heart Failure 2016, 9: e002370. PMID: 26721915, PMCID: PMC4741370, DOI: 10.1161/circheartfailure.115.002370.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAdministration, IntravenousAgedBiomarkersBumetanideDrug MonitoringDrug ResistanceFemaleHeart FailureHumansMaleMiddle AgedModels, BiologicalNatriuresisPredictive Value of TestsProspective StudiesReproducibility of ResultsSodiumSodium Potassium Chloride Symporter InhibitorsTime FactorsTreatment OutcomeUrinalysisConceptsAcute decompensated heart failureDecompensated heart failureNatriuretic responseSpot urine samplesSodium outputHeart failureDiuretic administrationAcute decompensated heart failure patientsDecompensated heart failure patientsLoop diuretic administrationPrimary therapeutic objectiveUrine samplesHeart failure patientsPositive sodium balanceNet fluid outputDiuretic dosingIntravenous bumetanideMedian doseFailure patientsDiuretic responseSodium balanceUrine collectionFluid balanceTherapeutic objectivesFluid output
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