2024
Effects 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 ManagerMellitusPatientsThe 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 gapsTrialsTherapyFailureDietary 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 challenge
2023
Association of Pulmonary Arterial Pulsatility Index (PAPi) with Kidney Outcomes Among Patients Admitted for Acute Decompensated Heart Failure
Tuttle M, Tighiouart H, Testani J, Banlengchit R, Moises A, Sarnak H, Oka T, Kiernan M, Sarnak M, McCallum W. Association of Pulmonary Arterial Pulsatility Index (PAPi) with Kidney Outcomes Among Patients Admitted for Acute Decompensated Heart Failure. Journal Of The American Society Of Nephrology 2023, 34: 144-145. DOI: 10.1681/asn.20233411s1144d.Peer-Reviewed Original ResearchCardiorenal interactions in heart failure: insights from recent therapeutic advances
Damman K, Testani J. Cardiorenal interactions in heart failure: insights from recent therapeutic advances. Cardiovascular Research 2023, 120: 1372-1384. PMID: 37364186, PMCID: PMC11472538, DOI: 10.1093/cvr/cvad096.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsHeart failureRisk patientsCardiovascular diseaseNew therapiesHigh cardiovascular risk patientsOutcomes of patientsCardiovascular risk patientsChronic kidney diseaseHigh-risk patientsRecent therapeutic advancesSpecific drug classesHigh mortality rateHealth care expendituresCardiorenal continuumCardiorenal interactionsMRA therapyRenal endpointsCardiovascular eventsCardiorenal diseaseKidney diseaseTherapeutic advancesDrug classesTherapeutic approachesMortality ratePatientsSGLT2 inhibitors and diuretics in heart failure: clicking reset on the renal volume setpoint?
Borlaug B, Testani J. SGLT2 inhibitors and diuretics in heart failure: clicking reset on the renal volume setpoint? European Heart Journal 2023, 44: 2944-2946. PMID: 37220086, DOI: 10.1093/eurheartj/ehad345.Commentaries, Editorials and LettersIn-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 changeReadmissionDiureticsPatientsImprovement 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 admissionPatientsEffect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure
Mentz R, Anstrom K, Eisenstein E, Sapp S, Greene S, Morgan S, Testani J, Harrington A, Sachdev V, Ketema F, Kim D, Desvigne-Nickens P, Pitt B, Velazquez E, Adams K, Bhatt K, DeWald T, Axsom K, Murthy S, Rich J, Testani J, Smith B, Vader J, McCulloch M, Skopicki H, Psotka M, Heroux A, Lala-Trindade A, Stevens G, Tang W, Lev Y, William P, Eberly A, Gottleib S, Haught W, Grafton G, Larned J, Tejwani L, Mody F, Krim S, Robinson M, Fang J, Adler A, Bell A, Banerjee D, Ruiz Duque E, Mizyed A, Rommel J, Arhinful J, Goyal P, Hall M, Hummel S, Shetty S, Haas D, Vilaro J, Alexy T, Herre J, Clark J, Ambrosy A, Gaglianello N, Ramasubbu K, Meadows J, Tabtabai S, Sherwood M, Hasni S, D'Urso M, Muneer B, Dunlap S, Davis W, Friedman D, Guglin M, Ferguson A, Abbate A, Smart F. Effect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure. JAMA 2023, 329: 214-223. PMID: 36648467, PMCID: PMC9857435, DOI: 10.1001/jama.2022.23924.Peer-Reviewed Original ResearchConceptsCause mortalityHeart failureTorsemide groupFurosemide groupTotal hospitalizationsCause hospitalizationEffects of torsemideDiuretic strategyPrespecified subgroupsSecondary outcomesEjection fractionMedian agePrimary outcomeHospitalizationMAIN OUTCOMEPatientsFurosemideMortalityMonthsTorsemidePrimary hypothesisSignificant differencesFinal dateOutcomesTrials
2022
Changes in the Inferior Vena Cava Are More Sensitive Than Venous Pressure During Fluid Removal: A Proof-of-Concept Study
Posada-Martinez EL, Cox ZL, Cano-Nieto MM, Ibarra-Marquez ND, Moreno-Villagomez J, Gudiño-Bravo P, Arias-Godinez JA, Lopez-Gil S, Madero M, Rao VS, Mebazaa A, Burkhoff D, Cowie MR, Fudim M, Damman K, Borlaug BA, Testani JM, Ivey-Miranda JB. Changes in the Inferior Vena Cava Are More Sensitive Than Venous Pressure During Fluid Removal: A Proof-of-Concept Study. Journal Of Cardiac Failure 2022, 29: 463-472. PMID: 36243338, DOI: 10.1016/j.cardfail.2022.09.012.Peer-Reviewed Original ResearchConceptsInferior vena cava diameterPeripheral venous pressureCentral venous pressureVenous pressureUltrafiltration volumeHeart failureVolume statusMean ultrafiltration volumeManagement of patientsVena cava diameterInferior vena cavaDiastolic dysfunctionCardiac dysfunctionStable hemodialysisVena cavaHemodialysis sessionFluid removalPatientsDialysisHemodialysisDysfunctionConcept studyGreater magnitudeStatusCavaInferior 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
Multinephron Segment Diuretic Therapy to Overcome Diuretic Resistance in Acute Heart Failure: A Single-Center Experience
Cox ZL, Sarrell BA, Cella MK, Tucker B, Arroyo JP, Umanath K, Tidwell W, Guide A, Testani JM, Lewis JB, Dwyer JP. Multinephron Segment Diuretic Therapy to Overcome Diuretic Resistance in Acute Heart Failure: A Single-Center Experience. Journal Of Cardiac Failure 2021, 28: 21-31. PMID: 34403831, DOI: 10.1016/j.cardfail.2021.07.016.Peer-Reviewed Original ResearchConceptsAcute heart failureDiuretic resistanceDiuretic therapyHeart failureUrine outputSerum chemistryRenal replacement therapySingle medical centerSingle-center experienceAHF cohortDiuretic classesHospital mortalityTotal cohortKidney functionSerum sodiumCarbonic anhydrase inhibitorsProspective studyReplacement therapyCase-level evidenceRetrospective analysisMedical CenterDay 7Own controlTherapyPatientsUse of diuretics and outcomes in patients with type 2 diabetes: findings from the EMPA‐REG OUTCOME trial
Pellicori P, Fitchett D, Kosiborod MN, Ofstad AP, Seman L, Zinman B, Zwiener I, Wanner C, George J, Inzucchi SE, Testani JM, Cleland JGF. Use of diuretics and outcomes in patients with type 2 diabetes: findings from the EMPA‐REG OUTCOME trial. European Journal Of Heart Failure 2021, 23: 1085-1093. PMID: 34031968, PMCID: PMC11497224, DOI: 10.1002/ejhf.2220.Peer-Reviewed Original ResearchConceptsUse of LDDiagnosis of HFHeart failureLoop diureticsHF diagnosisEMPA-REG OUTCOME trialType 2 diabetes mellitusSigns of congestionCardiovascular eventsCardiovascular mortalityOutcome trialsDiabetes mellitusPatient subgroupsPatientsDiagnosisHigh rateOutcomesMellitusT2DMDiureticsSymptomsMortalityBaselineTrialsEffect of Sotagliflozin on Total Hospitalizations in Patients With Type 2 Diabetes and Worsening Heart Failure : A Randomized Trial.
Szarek M, Bhatt DL, Steg PG, Cannon CP, Leiter LA, McGuire DK, Lewis JB, Riddle MC, Voors AA, Metra M, Lund LH, Komajda M, Testani JM, Wilcox CS, Ponikowski P, Lopes RD, Banks P, Tesfaye E, Ezekowitz JA, Verma S, Pitt B. Effect of Sotagliflozin on Total Hospitalizations in Patients With Type 2 Diabetes and Worsening Heart Failure : A Randomized Trial. Annals Of Internal Medicine 2021, 174: 1065-1072. PMID: 34152828, DOI: 10.7326/m21-0651.Peer-Reviewed Original ResearchConceptsHeart failurePlacebo groupType 2 diabetesSotagliflozin groupRate of daysSodium-glucose cotransporter 2 inhibitorsEffect of sotagliflozinPrespecified efficacy outcomeWorsening Heart FailureDuration of admissionPlacebo-controlled trialCotransporter 2 inhibitorsPatient-centered outcomesSodium-glucose cotransporter 1Poisson regression modelsCardiovascular deathEfficacy outcomesTotal hospitalizationsUrgent visitsEjection fractionPatients' qualityDisease burdenSotagliflozinHospitalizationPatients
2020
Renal profiling based on estimated glomerular filtration rate and spot urine sodium identifies high‐risk acute heart failure patients
Biegus J, Zymliński R, Testani J, Marciniak D, Zdanowicz A, Jankowska EA, Banasiak W, Ponikowski P. Renal profiling based on estimated glomerular filtration rate and spot urine sodium identifies high‐risk acute heart failure patients. European Journal Of Heart Failure 2020, 23: 729-739. PMID: 33190378, DOI: 10.1002/ejhf.2053.Peer-Reviewed Original ResearchConceptsAcute heart failureGlomerular filtration rateHeart failureFiltration rateDay 1Acute heart failure patientsHospital heart failureSpot urine sodiumHeart failure patientsUrinary sodium concentrationAHF patientsInotrope useTherapeutic profilingUrine sodiumFailure patientsIndependent prognosticatorRenal functionDay 2PatientsEGFRConcomitant assessmentWater handlingSodium concentrationPrognosticatorExcretersPrediction 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 curveResponsivenessAdministrationMinutesPatientsDifferential Impact of Class I and Class II Panel Reactive Antibodies on Post-Heart Transplant Outcomes
Ivey-Miranda JB, Kunnirickal S, Bow L, Maulion C, Testani JM, Jacoby D, Kransdorf EP, Bellumkonda L. Differential Impact of Class I and Class II Panel Reactive Antibodies on Post-Heart Transplant Outcomes. Journal Of Cardiac Failure 2020, 27: 40-47. PMID: 32750489, DOI: 10.1016/j.cardfail.2020.07.012.Peer-Reviewed Original ResearchConceptsPanel reactive antibodyCause mortalityReactive antibodiesClass IClass II panel reactive antibodiesAdult heart transplant patientsPost-heart transplant outcomesClass IIRejection-related mortalityHeart transplant patientsOrgan Sharing dataHeart transplantationTransplant outcomesTransplant patientsSensitized patientsUnited NetworkIsolated elevationHigh riskGroup 2Group 1High mortalityCombined elevationGroup 4MortalityPatientsCystatin C and Muscle Mass in Patients With Heart Failure
Ivey-Miranda JB, Inker LA, Griffin M, Rao V, Maulion C, Turner JM, Wilson FP, Tang WHW, Levey AS, Testani JM. Cystatin C and Muscle Mass in Patients With Heart Failure. Journal Of Cardiac Failure 2020, 27: 48-56. PMID: 32750487, PMCID: PMC8672303, DOI: 10.1016/j.cardfail.2020.07.013.Peer-Reviewed Original ResearchConceptsHeart failureCreatinine clearanceMuscle massCystatin CHigher muscle massAssociation of eGFRcysGlomerular filtration rateLow muscle massCystatin C levelsAccurate GFR estimationMultivariable analysisFiltration rateEGFRcysEGFRcrBody compositionGFR estimationPatientsCreatinineC levelsClearanceMortalityAssociationEffect 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
Diuretic Strategies for Loop Diuretic Resistance in Acute Heart Failure The 3T Trial
Cox ZL, Hung R, Lenihan DJ, Testani JM. Diuretic Strategies for Loop Diuretic Resistance in Acute Heart Failure The 3T Trial. JACC Heart Failure 2019, 8: 157-168. PMID: 31838029, PMCID: PMC7058489, DOI: 10.1016/j.jchf.2019.09.012.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAgedChlorothiazideDiureticsDose-Response Relationship, DrugDouble-Blind MethodDrug Therapy, CombinationFemaleFollow-Up StudiesFurosemideHeart FailureHumansInfusions, IntravenousMaleMetolazoneMiddle AgedProspective StudiesRetrospective StudiesTolvaptanTreatment OutcomeConceptsAcute heart failureLoop diuretic resistanceDiuretic resistanceHigh-dose loop diuretic therapyLoop diuretic therapyDouble-blinded trialInfusion of furosemideCombination diureticsDiuretic strategyDiuretic therapyOral metolazoneTolvaptan therapyDiuretic efficacyHeart failurePrimary outcomePatientsLimited evidenceWeight lossTherapyChlorothiazideMetolazoneTolvaptanDiureticsInfusionCohort