2023
Sodium restriction in patients with chronic heart failure and reduced ejection fraction: A randomized controlled trial
Ivey-Miranda J, Almeida-Gutierrez E, Herrera-Saucedo R, Posada-Martinez E, Chavez-Mendoza A, Mendoza-Zavala G, Cigarroa-Lopez J, Magaña-Serrano J, Rivera-Leaños R, Treviño-Mejia A, Revilla-Monsalve C, Flores-Umanzor E, Espinola-Zavaleta N, Orea-Tejeda A, Garduño-Espinosa J, Saturno-Chiu G, Rao VS, Testani J, Borrayo-Sanchez G. Sodium restriction in patients with chronic heart failure and reduced ejection fraction: A randomized controlled trial. Cardiology Journal 2023, 30: 411-421. PMID: 34490604, PMCID: PMC10287066, DOI: 10.5603/cj.a2021.0098.Peer-Reviewed Original ResearchConceptsQuality of lifeSodium restrictionAdverse safety eventsNT-proBNPHeart failureSodium intakeEjection fractionSafety eventsN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideStable HF patientsChronic heart failureNT-proBNP levelsReduced ejection fractionLow sodium intakeBeneficial cardiac effectsAdverse safety signalsSolid clinical evidenceGOV IDENTIFIERUrinary sodiumHF patientsSymptomatic hypotensionCardiac effectsSecondary outcomesBlood pressureImprovement 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
2022
Hemoconcentration of Creatinine Minimally Contributes to Changes in Creatinine during the Treatment of Decompensated Heart Failure
Maulion C, Chen S, Rao VS, Ivey-Miranda JB, Cox ZL, Mahoney D, Coca SG, Negoianu D, Asher JL, Turner JM, Inker LA, Wilson FP, Testani JM. Hemoconcentration of Creatinine Minimally Contributes to Changes in Creatinine during the Treatment of Decompensated Heart Failure. Kidney360 2022, 3: 1003-1010. PMID: 35845336, PMCID: PMC9255871, DOI: 10.34067/kid.0007582021.Peer-Reviewed Original ResearchRates of In-Hospital Decongestion and Association with Mortality and Cardiovascular Outcomes Among Patients Admitted for Acute Heart Failure
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Rates of In-Hospital Decongestion and Association with Mortality and Cardiovascular Outcomes Among Patients Admitted for Acute Heart Failure. The American Journal Of Medicine 2022, 135: e337-e352. PMID: 35472391, PMCID: PMC10767835, DOI: 10.1016/j.amjmed.2022.04.003.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptideAcute heart failureHeart failure hospitalizationComposite outcomeHeart failureFailure hospitalizationCardiovascular outcomesCardiovascular mortalityNatriuretic peptideN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideHeart Failure Outcome StudyMultivariable Cox regression modelsResistant heart failureLower hazardCox regression modelRisk of mortalityPropensity-score matchingTolvaptan (EVEREST) trialCause mortalityCardiovascular benefitsVasopressin AntagonismVolume overloadReduced riskOutcome studies
2021
Rates of Reversal of Volume Overload in Hospitalized Acute Heart Failure: Association With Long-term Kidney Function
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Rates of Reversal of Volume Overload in Hospitalized Acute Heart Failure: Association With Long-term Kidney Function. American Journal Of Kidney Diseases 2021, 80: 65-78. PMID: 34843844, PMCID: PMC9135960, DOI: 10.1053/j.ajkd.2021.09.026.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptideAcute heart failureEGFR declineHeart failureVolume overloadKidney functionNatriuretic peptideLower riskN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideHeart Failure Outcome StudyLong-term kidney functionG4-G5Adverse kidney outcomesClinical congestion scoreKidney function declineGlomerular filtration rateCause-specific hazards modelKidney outcomesTolvaptan (EVEREST) trialCardiovascular outcomesVasopressin AntagonismImproved survivalFunction declineDecreased riskRenal Hemodynamics and Renin-Angiotensin-Aldosterone System Profiles in Patients With Heart Failure
Lytvyn Y, Burns KD, Testani JM, Lytvyn A, Ambinathan JPN, Osuntokun O, Godoy LC, Cherney DZI, Parker JD. Renal Hemodynamics and Renin-Angiotensin-Aldosterone System Profiles in Patients With Heart Failure. Journal Of Cardiac Failure 2021, 28: 385-393. PMID: 34487814, DOI: 10.1016/j.cardfail.2021.08.015.Peer-Reviewed Original ResearchConceptsPlasma renin activityRenal blood flowAngiotensin converting enzymeHeart failureArteriolar resistanceGreater renal vascular resistanceEffective renal plasma flowRenal hemodynamic functionRenal vascular resistanceGlomerular filtration rateRenal plasma flowCardiorenal pathophysiologyGomez's equationsLower ERPFAldosterone systemIntravenous dobutamineNeurohormonal activationRenal hemodynamicsRenin activityVascular resistanceRenal profileRenin-AngiotensinHemodynamic functionLower GFRRenal veinNatriuretic 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
Acute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Acute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure. JACC Heart Failure 2020, 8: 537-547. PMID: 32535124, PMCID: PMC9027677, DOI: 10.1016/j.jchf.2020.03.009.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptideAcute decompensated heart failureDecompensated heart failureHeart failureKidney functionAdverse outcomesAcute declineNT-proBNPComposite outcomeNatriuretic peptideHigh riskMultivariable Cox regression modelsTotal proteinAcute kidney functionMarkers of decongestionN-terminal prohormoneGlomerular filtration rateCox regression modelEGFR declineCardiovascular deathVolume overloadFiltration rateEGFRHospital changesDecongestionReal-Time Prediction of Acute Kidney Injury in Hospitalized Adults: Implementation and Proof of Concept
Ugwuowo U, Yamamoto Y, Arora T, Saran I, Partridge C, Biswas A, Martin M, Moledina DG, Greenberg JH, Simonov M, Mansour SG, Vela R, Testani JM, Rao V, Rentfro K, Obeid W, Parikh CR, Wilson FP. Real-Time Prediction of Acute Kidney Injury in Hospitalized Adults: Implementation and Proof of Concept. American Journal Of Kidney Diseases 2020, 76: 806-814.e1. PMID: 32505812, PMCID: PMC8667815, DOI: 10.1053/j.ajkd.2020.05.003.Peer-Reviewed Original ResearchConceptsAKI alertsHospitalized adultsKidney injuryUrban tertiary care hospitalAcute kidney injurySerum creatinine levelsObservational cohort studyTertiary care hospitalSerum creatinine concentrationBeats/minElectronic health recordsAKI diagnosisCohort studyCreatinine levelsInpatient mortalitySystolic bloodFractional excretionCenter studyBlood biomarkersUnivariable associationsUrine microscopyCreatinine concentrationClinical careElevated riskUrea nitrogenImproved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study
Akiyama E, Cinotti R, Čerlinskaitė K, Van Aelst LNL, Arrigo M, Placido R, Chouihed T, Girerd N, Zannad F, Rossignol P, Badoz M, Launay J, Gayat E, Cohen‐Solal A, Lam CSP, Testani J, Mullens W, Cotter G, Seronde M, Mebazaa A. Improved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study. ESC Heart Failure 2020, 7: 996-1006. PMID: 32277607, PMCID: PMC7261539, DOI: 10.1002/ehf2.12645.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionTricuspid annular plane systolic excursionNeutrophil Gelatinase-Associated LipocalinVenous pressureAHF patientsHFrEF patientsCardiac chamber dimensionsEchocardiographic parametersDyspnea patientsHeart failureNatriuretic peptidePlasma volumeMid-regional pro-atrial natriuretic peptideAcute heart failure patientsDiastolic Heart Failure StudyAnnular plane systolic excursionPro-atrial natriuretic peptideB-type natriuretic peptideE-wave deceleration timeInferior vena cava diameterAcute heart failureDiastolic heart failureGelatinase-Associated LipocalinGlomerular filtration rateHeart failure patients
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 incidenceAge associated non-linear regulation of redox homeostasis in the anucleate platelet: Implications for CVD risk patients
Jain K, Tyagi T, Patell K, Xie Y, Kadado AJ, Lee SH, Yarovinsky T, Du J, Hwang J, Martin KA, Testani J, Ionescu CN, Hwa J. Age associated non-linear regulation of redox homeostasis in the anucleate platelet: Implications for CVD risk patients. EBioMedicine 2019, 44: 28-40. PMID: 31130473, PMCID: PMC6604369, DOI: 10.1016/j.ebiom.2019.05.022.Peer-Reviewed Original ResearchMeSH KeywordsAdaptation, PhysiologicalAge FactorsAgedAged, 80 and overAgingAnimalsAntioxidantsApoptosisBiomarkersBlood PlateletsCardiovascular DiseasesComorbidityDisease Models, AnimalFemaleHomeostasisHumansMaleMiceMiddle AgedOxidation-ReductionOxidative StressPlatelet ActivationPlatelet AdhesivenessReactive Oxygen SpeciesRisk AssessmentRisk FactorsConceptsRisk patientsMouse studiesPlatelet phenotypeMajor adverse cardiovascular eventsHigh cardiovascular risk patientsAdaptive increaseAdverse cardiovascular eventsCentral pathophysiological roleCVD risk patientsCardiovascular risk patientsAggressive antiplatelet therapyEffect of comorbidityAge group 40Young healthy subjectsAntiplatelet therapyCardiovascular eventsYear age cohortAdvanced ageCVD patientsGroup 40Healthy subjectsPathophysiological roleElderly populationCardiovascular pathologyPatientsTreating Heart Failure With Antihyperglycemic Medications: Is Now the Right Time?
Testani JM, Inzucchi SE, Voors AA. Treating Heart Failure With Antihyperglycemic Medications: Is Now the Right Time? Circulation 2019, 139: 2383-2385. PMID: 31107618, DOI: 10.1161/circulationaha.119.038854.Commentaries, Editorials and LettersBiomarkersBlood GlucoseDiabetes Mellitus, Type 2Disease ProgressionEvidence-Based MedicineGlucagon-Like Peptide-1 ReceptorHeart FailureHospitalizationHumansIncretinsProtective FactorsRandomized Controlled Trials as TopicRisk AssessmentRisk FactorsSodium-Glucose Transporter 2 InhibitorsTreatment OutcomeElevated renalase levels in patients with acute coronary microvascular dysfunction – A possible biomarker for ischemia
Safdar B, Guo X, Johnson C, D'Onofrio G, Dziura J, Sinusas AJ, Testani J, Rao V, Desir G. Elevated renalase levels in patients with acute coronary microvascular dysfunction – A possible biomarker for ischemia. International Journal Of Cardiology 2019, 279: 155-161. PMID: 30630613, PMCID: PMC6482834, DOI: 10.1016/j.ijcard.2018.12.061.Peer-Reviewed Original ResearchConceptsCoronary microvascular dysfunctionFramingham risk scorePET/CTChest painInflammatory markersMicrovascular dysfunctionEmergency departmentRisk scoreRb-82 PET/CTElevated renalase levelsAcute chest painCoronary artery diseaseC-reactive proteinVascular endothelial growth factorAnti-inflammatory proteinTumor necrosis factorEndothelial growth factorAngina historyCMD diagnosisRenalase levelsHypertensive crisisED presentationsHemodynamic instabilityArtery diseaseHeart failure
2018
Early urine electrolyte patterns in patients with acute heart failure
Collins SP, Jenkins CA, Baughman A, Miller KF, Storrow AB, Han JH, Brown NJ, Liu D, Luther JM, McNaughton CD, Self WH, Peng D, Testani JM, Lindenfeld J. Early urine electrolyte patterns in patients with acute heart failure. ESC Heart Failure 2018, 6: 80-88. PMID: 30295437, PMCID: PMC6351901, DOI: 10.1002/ehf2.12368.Peer-Reviewed Original ResearchConceptsAcute heart failureDiuretic administrationDiuretic resistanceHeart failureLoop diureticsLow urinary sodiumEscalation of therapyUrine sodium excretionSubset of patientsSystolic blood pressureEmergency department patientsUrine sodium concentrationAHF diagnosisAHF patientsIntravenous diureticsUrinary sodiumED staySodium excretionUrinary electrolytesUrine sodiumNatriuretic responseStandard therapyBlood pressureDepartment patientsUrine outputPerturbations in serum chloride homeostasis in heart failure with preserved ejection fraction: insights from TOPCAT
Grodin JL, Testani JM, Pandey A, Sambandam K, Drazner MH, Fang JC, Tang WHW. Perturbations in serum chloride homeostasis in heart failure with preserved ejection fraction: insights from TOPCAT. European Journal Of Heart Failure 2018, 20: 1436-1443. PMID: 29893446, DOI: 10.1002/ejhf.1229.Peer-Reviewed Original ResearchConceptsSerum chloride levelsLoop diuretic useHeart failureSerum chlorideCause deathDiuretic useEjection fractionMultivariable Cox proportional hazards modelsCardiac Function Heart FailureCox proportional hazards modelAldosterone Antagonist TrialHeart failure hospitalizationPrimary composite endpointLower serum chlorideProportional hazards modelSerum chloride concentrationChloride levelsSpironolactone useCardiovascular deathFailure hospitalizationMultivariable adjustmentComposite endpointLoop diureticsClinical outcomesHazards modelHemodynamic factors associated with serum chloride in ambulatory patients with advanced heart failure
Grodin JL, Mullens W, Dupont M, Taylor DO, McKie PM, Starling RC, Testani JM, Tang WHW. Hemodynamic factors associated with serum chloride in ambulatory patients with advanced heart failure. International Journal Of Cardiology 2018, 252: 112-116. PMID: 29249420, DOI: 10.1016/j.ijcard.2017.11.024.Peer-Reviewed Original ResearchConceptsPulmonary capillary wedge pressureAdvanced chronic heart failureFick cardiac indexPulmonary artery systolic pressureRight atrial pressureVentricular assist device placementHeart transplantHeart rateHeart failureSerum chlorideHigher cardiac filling pressuresPoor long-term outcomesSerum Cl levelsCapillary wedge pressureCardiac filling pressuresChronic heart failureAdvanced heart failureInvasive hemodynamic assessmentHeart failure patientsRisk of deathLong-term outcomesLower serum chlorideConventional clinical parametersBackward regression modelAssociation of hemodynamicsWorsening Renal Function in Patients With Acute Heart Failure Undergoing Aggressive Diuresis Is Not Associated With Tubular Injury
Ahmad T, Jackson K, Rao VS, Tang WHW, Brisco-Bacik MA, Chen HH, Felker GM, Hernandez AF, O'Connor CM, Sabbisetti VS, Bonventre JV, Wilson FP, Coca SG, Testani JM. Worsening Renal Function in Patients With Acute Heart Failure Undergoing Aggressive Diuresis Is Not Associated With Tubular Injury. Circulation 2018, 137: 2016-2028. PMID: 29352071, PMCID: PMC6066176, DOI: 10.1161/circulationaha.117.030112.Peer-Reviewed Original ResearchMeSH KeywordsAcetylglucosaminidaseAcute DiseaseAcute Kidney InjuryAgedAged, 80 and overBiomarkersCreatinineCystatin CDiuresisFemaleGlomerular Filtration RateHeart FailureHepatitis A Virus Cellular Receptor 1HumansKidneyLipocalin-2MaleMiddle AgedSodium Potassium Chloride Symporter InhibitorsTime FactorsTreatment OutcomeUnited StatesConceptsKidney injury molecule-1Neutrophil gelatinase-associated lipocalinInjury molecule-1Acute heart failureGelatinase-associated lipocalinRenal tubular injuryTubular injury biomarkersAggressive diuresisROSE-AHF trialsTubular injuryInjury biomarkersRenal functionHeart failureMolecule-1D-glucosaminidaseHigh-dose loop diuretic therapyAcute heart failure treatmentKidney tubular injuryLoop diuretic therapyAcute kidney injuryGlomerular filtration rateHeart failure treatmentDiuretic therapyFurosemide equivalentsKidney injury
2017
Novel Biomarkers for the Risk Stratification of Heart Failure with Preserved Ejection Fraction
Cypen J, Ahmad T, Testani JM, DeVore AD. Novel Biomarkers for the Risk Stratification of Heart Failure with Preserved Ejection Fraction. Current Heart Failure Reports 2017, 14: 434-443. PMID: 28803400, DOI: 10.1007/s11897-017-0358-4.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsHeart failureEjection fractionHF biomarkersRisk stratificationReduced ejection fractionTreatment of HFpEFBrain natriuretic peptideValuable prognostic markerKey pathophysiologic componentUse of biomarkersSignificant therapeutic targetSystemic inflammationPathophysiologic componentsNatriuretic peptidePrognostic valueMyocardial fibrosisPrognostic markerNovel biomarkersCurrent evidenceTherapeutic targetHFpEFReviewThe useSummaryFurther investigationBiomarkersInflammation