2023
The 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 fraction
2020
Venous Congestion, Not Cardiac Index is Associated with Diuretic Resistance
Eder M, Griffin M, Fleming J, Gleason O, Meegan G, Ivey-Miranda J, Cox Z, Rao V, Testani J. Venous Congestion, Not Cardiac Index is Associated with Diuretic Resistance. Journal Of Cardiac Failure 2020, 26: s30-s31. DOI: 10.1016/j.cardfail.2020.09.095.Peer-Reviewed Original ResearchRight atrial pressureBaseline right atrial pressureAcute decompensated heart failureCardiac indexLow cardiac indexDiuretic efficiencyMin/m2Daily urine outputDiuretic resistanceUrine outputDiuretic responseVenous congestionDiuretic doseHeart failureDE groupHigher baseline right atrial pressureHigher right atrial pressureElevated right atrial pressureBaseline cardiac indexLoop diuretic doseDecompensated heart failureCongestive heart failureSubset of patientsGreater diuretic responseCardiorenal interactionsSodium glucose cotransporter 2 inhibitors as diuretic adjuvants in acute decompensated heart failure: a case series
Griffin M, Riello R, Rao VS, Ivey-Miranda J, Fleming J, Maulion C, McCallum W, Sarnak M, Collins S, Inzucchi SE, Testani JM. Sodium glucose cotransporter 2 inhibitors as diuretic adjuvants in acute decompensated heart failure: a case series. ESC Heart Failure 2020, 7: 1966-1971. PMID: 32476296, PMCID: PMC7373933, DOI: 10.1002/ehf2.12759.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureSodium-glucose cotransporter 2 inhibitorsGlucose cotransporter 2 inhibitorsDecompensated heart failureCotransporter 2 inhibitorsType 2 diabetesSGLT-2iBlood pressureHeart failureUrine outputYale-New Haven HospitalWeight lossIncidence of hypokalaemiaSGLT-2i initiationSGLT-2i therapyGlucose-lowering medicationsHeart failure outcomesCohort of patientsAverage weight lossDiuretic dosingDiuretic resistanceAdjunctive therapyWorsened survivalDiuretic efficiencyDiuretic monotherapyReal 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 variables
2019
Biomarkers of Intravascular and Extravascular Volume Overload: Associations with Parameters of Cardio-Renal Dysfunction
Gomez N, Stewart B, Barnett J, Thomas A, Wycallis E, Pattoli M, Struyk G, Fleming J, Shamlian P, Raghavendra P, Mahoney D, Ivey-Miranda J, Griffin M, Rao V, Testani J. Biomarkers of Intravascular and Extravascular Volume Overload: Associations with Parameters of Cardio-Renal Dysfunction. Journal Of Cardiac Failure 2019, 25: s21. DOI: 10.1016/j.cardfail.2019.07.060.Peer-Reviewed Original ResearchIntravascular volume overloadCardio-renal dysfunctionExtravascular volume overloadNT-proBNPCA 125Volume overloadDiuretic efficiencyFluid overloadHeart failureUrinary kidney injury molecule-1Kidney injury molecule-1Higher NT-proBNPLoop diuretic dosePlasma NT-proBNPInjury molecule-1Median NT-proBNPCarbohydrate antigen 125Cardio-renal functionIntravascular fluid overloadExtravascular fluid overloadDiuretic doseIntravascular overloadLower eGFRSodium excretionUrine albuminUrine Growth Differentiation Factor-15 is Not an Independent Biomarker of Cardio-Renal Interactions in Patients with Heart Failure
Barnett J, Stewart B, Gomez N, Thomas A, Wycallis E, Pattoli M, Struyk G, Fleming J, Shamlian P, Raghavendra P, Mahoney D, Ivey-Miranda J, Griffin M, Rao V, Testani J. Urine Growth Differentiation Factor-15 is Not an Independent Biomarker of Cardio-Renal Interactions in Patients with Heart Failure. Journal Of Cardiac Failure 2019, 25: s21-s22. DOI: 10.1016/j.cardfail.2019.07.063.Peer-Reviewed Original ResearchGrowth differentiation factor 15Plasma GDF-15GDF-15Heart failureDiuretic efficiencyDifferentiation factor 15Independent predictorsFactor 15Urinary cystatin C levelsCardio-renal interactionsLoop diuretic doseWorse kidney functionGlomerular filtration rateCystatin C levelsDiuretic doseNT-proBNPSodium excretionDiabetic patientsFractional excretionKidney functionPrognostic valueIndependent biomarkerOutpatient settingStress-responsive biomarkersFiltration rate
2016
029 Differential Effect of Diuretic Efficiency on Survival in Acute Heart Failure Patients with Preserved Versus Reduced Ejection Fraction
Assefa M, Hanberg J, Maaten J, Broughton J, Rao V, Testani J. 029 Differential Effect of Diuretic Efficiency on Survival in Acute Heart Failure Patients with Preserved Versus Reduced Ejection Fraction. Journal Of Cardiac Failure 2016, 22: s13. DOI: 10.1016/j.cardfail.2016.06.046.Peer-Reviewed Original Research