Featured Publications
Electronic Alerts to Improve Heart Failure Therapy in Outpatient Practice A Cluster Randomized Trial
Ghazi L, Yamamoto Y, Riello RJ, Coronel-Moreno C, Martin M, O'Connor KD, Simonov M, Huang J, Olufade T, McDermott J, Dhar R, Inzucchi SE, Velazquez EJ, Wilson FP, Desai NR, Ahmad T. Electronic Alerts to Improve Heart Failure Therapy in Outpatient Practice A Cluster Randomized Trial. Journal Of The American College Of Cardiology 2022, 79: 2203-2213. PMID: 35385798, DOI: 10.1016/j.jacc.2022.03.338.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyUsual careEjection fractionHeart failureMedical therapyPrimary outcomeCluster-randomized comparative effectiveness trialSodium-glucose cotransporter 2 inhibitorsElectronic health record alertsAldosterone system inhibitorsReduced ejection fractionUsual care armCotransporter 2 inhibitorsMineralocorticoid receptor antagonistsVentricular ejection fractionComparative effectiveness trialNumber of patientsKnowledge of guidelinesLow-cost interventionCare armDays postrandomizationEligible patientsGDMT useFailure therapyPatient characteristicsImpact Of Digital Health Interventions In The Quality Of Life Of Patients With Heart Failure: A Randomized Trial
Castro A, Martin M, Desai N, Ahmad T, Yamamoto Y, Melchinger H, Lee K, Gerber B, Nguyen A, Weinstein J, Subair L, Lee V, Williams A, Shaw M, Arora T, Wilson F. Impact Of Digital Health Interventions In The Quality Of Life Of Patients With Heart Failure: A Randomized Trial. Journal Of Cardiac Failure 2023, 29: 662. DOI: 10.1016/j.cardfail.2022.10.284.Peer-Reviewed Original ResearchQuality of lifeUsual careClinical summary scoreTotal symptom scoreHeart failureSymptom scoresSummary scoresKansas City Cardiomyopathy Questionnaire overall scoreYale New Haven Health SystemDigital health toolsHealth toolsReduced ejection fractionResults One hundred fiftyUsual care groupMethods One hundred eightyNon-Hispanic blacksDigital health interventionsHF clinicSecondary outcomesEjection fractionEmergency visitsMedian agePrimary outcomeClinical outcomesRandomization groupPragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial
Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyAcute heart failureHeart failurePragmatic trialElectronic health recordsSubstantial health care costsBest practice advisoryReduced ejection fractionUsual care armHealth recordsTime of dischargeEvidence-based careHealth care costsClinical decision support systemAHF patientsCare armEligible patientsHF hospitalizationInpatient initiationCardiovascular deathMedication classesEjection fractionMedical therapyPrimary outcomePractice advisoryAlerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure
Ahmad T, Desai NR, Yamamoto Y, Biswas A, Ghazi L, Martin M, Simonov M, Dhar R, Hsiao A, Kashyap N, Allen L, Velazquez EJ, Wilson FP. Alerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure. JAMA Cardiology 2022, 7: 905-912. PMID: 35947362, PMCID: PMC9366654, DOI: 10.1001/jamacardio.2022.2496.Peer-Reviewed Original ResearchConceptsUsual care groupElectronic health recordsHeart failureAlert groupMedian agePrimary outcomeFemale patientsTerminal pro-brain natriuretic peptide levelsYale New Haven Health SystemPro-brain natriuretic peptide levelsMedian NT-proBNP levelLeft ventricular ejection fractionLarge tertiary care centerHeart failure hospitalizationHeart failure medicationsNatriuretic peptide levelsNT-proBNP levelsHealth recordsHours of admissionTertiary care centerVentricular ejection fractionRate of hospitalizationIntensive care unitEthnicity groupsSmall community hospital
2024
ELECTRONIC ALERTS TO IMPROVE MINERALOCORTICOID RECEPTOR ANTAGONIST USE AND HYPERKALEMIA MANAGEMENT IN AMBULATORY PATIENTS WITH HEART FAILURE: A CLUSTER RANDOMIZED TRIAL
Clark K, Victoria-Castro A, Ghazi, Yamamoto Y, Coronel-Moreno C, Kadhim B, Riello R, O'Connor K, Ahmad T, Wilson F, Desai N. ELECTRONIC ALERTS TO IMPROVE MINERALOCORTICOID RECEPTOR ANTAGONIST USE AND HYPERKALEMIA MANAGEMENT IN AMBULATORY PATIENTS WITH HEART FAILURE: A CLUSTER RANDOMIZED TRIAL. Journal Of The American College Of Cardiology 2024, 83: 2395. DOI: 10.1016/s0735-1097(24)04385-7.Peer-Reviewed Original ResearchSerial direct sodium removal in patients with heart failure and diuretic resistance
Rao V, Ivey‐Miranda J, Cox Z, Moreno‐Villagomez J, Ramos‐Mastache D, Neville D, Balkcom N, Asher J, Bellumkonda L, Bigvava T, Shaburishvili T, Bartunek J, Wilson F, Finkelstein F, Maulion C, Turner J, Testani J. Serial direct sodium removal in patients with heart failure and diuretic resistance. European Journal Of Heart Failure 2024, 26: 1215-1230. PMID: 38556717, DOI: 10.1002/ejhf.3196.Peer-Reviewed Original ResearchConceptsDiuretic resistanceCardiorenal syndromeHeart failureLoop diureticsDiuretic withdrawalHigh-dose loop diureticsN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideGrowth differentiation factor 15Carbohydrate antigen 125Differentiation factor 15Sodium removalRandomized controlled studyCardiorenal parametersDiuretic doseSoluble ST2Natriuretic peptideMedian timeDiuretic responseKidney injuryPeritoneal membraneElectrolyte handlingKidney functionDiureticsInterleukin-6
2023
Rationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use
Clark K, Victoria-Castro A, Ghazi L, Yamamoto Y, Coronel-Moreno C, Kadhim B, Riello R, O'Connor K, Ahmad T, Wilson F, Desai N. Rationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use. JACC Heart Failure 2023, 12: 322-332. PMID: 37943221, DOI: 10.1016/j.jchf.2023.08.025.Peer-Reviewed Original ResearchBest practice alertMineralocorticoid receptor antagonistsNovel potassium bindersPotassium bindersEligible patientsUsual careEjection fractionSerum potassiumHistory of hyperkalemiaIncidence of hyperkalemiaStrong guideline recommendationsHeart failure hospitalizationReduced ejection fractionLaboratory test valuesPopulation health outcomesHyperkalemia treatmentMRA prescriptionAntagonist useFailure hospitalizationPatient characteristicsSecondary outcomesHeart failurePrimary outcomeGuideline recommendationsOutpatient visitsImpact of Digital Health Technology on Quality of Life in Patients With Heart Failure
Victoria-Castro A, Martin M, Yamamoto Y, Melchinger H, Weinstein J, Nguyen A, Lee K, Gerber B, Calderon F, Subair L, Lee V, Williams A, Shaw M, Arora T, Garcez A, Desai N, Ahmad T, Wilson F. Impact of Digital Health Technology on Quality of Life in Patients With Heart Failure. JACC Heart Failure 2023, 12: 336-348. PMID: 37943227, DOI: 10.1016/j.jchf.2023.09.022.Peer-Reviewed Original ResearchOverall summary scoreClinical summary scoreTotal symptom scoreKCCQ overall summary scoreUsual careHeart failureQuality of lifeMedian changeKansas City Cardiomyopathy Questionnaire overall summary scoreSummary scoresMedian agePrimary outcomeSymptom scoresPhysical functionLongitudinal carePatientsDigital health toolsLarger studyDigital health technologiesHealth toolsQoLCareDigital interventionsIndependent effectsHealth technologiesElectronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial
Ghazi L, Yamamoto Y, Fuery M, O'Connor K, Sen S, Samsky M, Riello R, Dhar R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial. European Heart Journal 2023, 44: 4233-4242. PMID: 37650264, DOI: 10.1093/eurheartj/ehad512.Peer-Reviewed Original ResearchGuideline-directed medical therapyAcute heart failureMineralocorticoid receptor antagonistsHeart failureElectronic health recordsGDMT prescriptionPrimary outcomeEnzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitorsSodium-glucose cotransporter 2 inhibitorsAngiotensin receptor neprilysin inhibitorElectronic health record alertsEvidence-based regimenProviders of patientsReduced ejection fractionCotransporter 2 inhibitorsRelevant patient characteristicsTime of dischargePre-specified criteriaAHF hospitalizationEligible patientsInpatient initiationPatient characteristicsEjection fractionHospitalized patientsMedian ageElectronic Health Record Embedded Strategies for Improving Care of Patients With Heart Failure
Fuery M, Kadhim B, Samsky M, Freeman J, Clark K, Desai N, Wilson F, Ahmed T, Ahmad T. Electronic Health Record Embedded Strategies for Improving Care of Patients With Heart Failure. Current Heart Failure Reports 2023, 20: 280-286. PMID: 37552356, DOI: 10.1007/s11897-023-00614-0.Peer-Reviewed Original ResearchConceptsHeart failure patientsFailure patientsElectronic health recordsEHR alertClinical trialsRandomized clinical trialsCare of patientsQuality of careHeart failureClinician satisfactionRandomized fashionRecent FindingsTherePatientsUnmet needPatient careClinical decisionEvidence-based decisionsFuture interventionsCareHealth recordsTrialsCliniciansInterventionFindingsThereThe 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 fractionIn-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
Pragmatic randomized trial assessing the impact of digital health technology on quality of life in patients with heart failure: Design, rationale and implementation
Victoria‐Castro A, Martin M, Yamamoto Y, Ahmad T, Arora T, Calderon F, Desai N, Gerber B, Lee KA, Jacoby D, Melchinger H, Nguyen A, Shaw M, Simonov M, Williams A, Weinstein J, Wilson FP. Pragmatic randomized trial assessing the impact of digital health technology on quality of life in patients with heart failure: Design, rationale and implementation. Clinical Cardiology 2022, 45: 839-849. PMID: 35822275, PMCID: PMC9346973, DOI: 10.1002/clc.23848.Peer-Reviewed Original ResearchConceptsQuality of lifeHF patientsYale New Haven Health SystemKansas City Cardiomyopathy QuestionnaireDigital health technologiesHeart failure careHealth technologiesDigital health interventionsDisease exacerbationHF clinicUsual carePrimary outcomeClinical outcomesHeart failurePatient engagementPatientsHealth interventionsDigital health toolsPatient empowermentHealth systemPatient usabilityHealth toolsEarly detectionFirst enrollmentHealthcare systemInferior 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 correlationMedianAngiopoietins as Prognostic Markers for Future Kidney Disease and Heart Failure Events after Acute Kidney Injury
Mansour SG, Bhatraju PK, Coca SG, Obeid W, Wilson FP, Stanaway IB, Jia Y, Thiessen-Philbrook H, Go AS, Ikizler TA, Siew ED, Chinchilli VM, Hsu CY, Garg AX, Reeves WB, Liu KD, Kimmel PL, Kaufman JS, Wurfel MM, Himmelfarb J, Parikh SM, Parikh CR. Angiopoietins as Prognostic Markers for Future Kidney Disease and Heart Failure Events after Acute Kidney Injury. Journal Of The American Society Of Nephrology 2022, 33: 613-627. PMID: 35017169, PMCID: PMC8975075, DOI: 10.1681/asn.2021060757.Peer-Reviewed Original ResearchConceptsCKD progressionHeart failureLower riskAngpt-1Highest quartileFuture kidney diseaseSetting of AKIAcute kidney injuryHeart failure admissionsHeart failure eventsProspective cohort studyMortality 3 monthsPlasma angiopoietinsKidney injuryCohort studySecondary outcomesEndothelial injuryMedian agePrimary outcomeKidney diseasePrognostic markerAngiopoietin-2AKIAngiopoietin-1Vessel destabilization
2021
Rationale and design of a cluster-randomized pragmatic trial aimed at improving use of guideline directed medical therapy in outpatients with heart failure: PRagmatic trial of messaging to providers about treatment of heart failure (PROMPT-HF)
Ghazi L, Desai NR, Simonov M, Yamamoto Y, O'Connor KD, Riello RJ, Huang J, Olufade T, McDermott J, Inzucchi SE, Velazquez EJ, Wilson FP, Ahmad T. Rationale and design of a cluster-randomized pragmatic trial aimed at improving use of guideline directed medical therapy in outpatients with heart failure: PRagmatic trial of messaging to providers about treatment of heart failure (PROMPT-HF). American Heart Journal 2021, 244: 107-115. PMID: 34808104, DOI: 10.1016/j.ahj.2021.11.010.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyBest practice alertLeft ventricular ejection fractionHeart failureUsual careMedical therapyPragmatic trialElectronic health recordsEjection fractionCluster-randomized pragmatic trialLarge integrated healthcare systemDays post randomizationAppropriate medical therapyHeart Failure TrialReduced ejection fractionUsual care groupCommon chronic illnessGlomerular filtration rateVentricular ejection fractionRecent blood pressureIntegrated healthcare systemUse of guidelinesLow-cost interventionCreatinine levelsReal-world practiceFGF-23 (Fibroblast Growth Factor-23) and Cardiorenal Interactions
Ivey-Miranda JB, Stewart B, Cox ZL, McCallum W, Maulion C, Gleason O, Meegan G, Amatruda JG, Moreno-Villagomez J, Mahoney D, Turner JM, Wilson FP, Estrella MM, Shlipak MG, Rao VS, Testani JM. FGF-23 (Fibroblast Growth Factor-23) and Cardiorenal Interactions. Circulation Heart Failure 2021, 14: e008385. PMID: 34689571, PMCID: PMC8782627, DOI: 10.1161/circheartfailure.121.008385.Peer-Reviewed Original ResearchConceptsFGF-23Cardiorenal interactionsHeart failureDiuretic resistanceSodium avidityNeurohormonal activationMultivariable analysisDistal tubular sodium reabsorptionLoop diuretic doseTubular sodium reabsorptionGlomerular filtration rateCardiorenal dysfunctionDiuretic doseDiuretic treatmentNT-proBNPFractional excretionDiuretic administrationSodium reabsorptionPeak diuresisFiltration rateCare centerUrine samplingAnimal modelsSerum chlorideDisease severityREVeAL-HF Design and Rationale of a Pragmatic Randomized Controlled Trial Embedded Within Routine Clinical Practice
Ahmad T, Yamamoto Y, Biswas A, Ghazi L, Martin M, Simonov M, Hsiao A, Kashyap N, Velazquez EJ, Desai NR, Wilson FP. REVeAL-HF Design and Rationale of a Pragmatic Randomized Controlled Trial Embedded Within Routine Clinical Practice. JACC Heart Failure 2021, 9: 409-419. PMID: 33992566, DOI: 10.1016/j.jchf.2021.03.006.Peer-Reviewed Original ResearchConceptsHeart failurePatient outcomesClinical decision makingN-terminal pro-B-type natriuretic peptide levelsPro-B-type natriuretic peptide levelsPragmatic Randomized Controlled TrialIntravenous diuretic agentsNatriuretic peptide levelsRandomized Controlled TrialsRoutine clinical practiceEvidence-based interventionsElectronic health recordsControlled TrialsPatient populationAccurate prognosticationCommon causeDiuretic agentsPeptide levelsClinical practicePg/TrialsHealth recordsSignificant riskMortalityOutcomesNatriuretic 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
COVID-19 infections and outcomes in a live registry of heart failure patients across an integrated health care system
Caraballo C, McCullough M, Fuery MA, Chouairi F, Keating C, Ravindra NG, Miller PE, Malinis M, Kashyap N, Hsiao A, Wilson FP, Curtis JP, Grant M, Velazquez EJ, Desai NR, Ahmad T. COVID-19 infections and outcomes in a live registry of heart failure patients across an integrated health care system. PLOS ONE 2020, 15: e0238829. PMID: 32997657, PMCID: PMC7526909, DOI: 10.1371/journal.pone.0238829.Peer-Reviewed Original ResearchConceptsHeart failure patientsIntegrated health care systemHeart Failure RegistryHealth care systemFailure patientsCOVID-19 infectionCare systemCOVID-19SARS-CoV-2 infectionReal-time registryRenin-angiotensin blockersRetrospective chart reviewCoronary artery diseaseRisk of deathCOVID-19 testingAngiotensin blockersMultiple comorbiditiesRespiratory failureChart reviewSymptomatic patientsArtery diseaseHeart failureComorbid conditionsPatient mortalityClinical management