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
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
Safety and Efficacy of an Automated Nurse-Driven Diuretic Titration Protocol: the Yale Diuretic Pathway
Meegan G, Sangkachand P, O'Brien M, Riello R, Soucier R, Jacoby D, Gleason O, Fleming J, Griffin M, Ivey-Miranda J, Cox Z, Rao V, Testani J. Safety and Efficacy of an Automated Nurse-Driven Diuretic Titration Protocol: the Yale Diuretic Pathway. Journal Of Cardiac Failure 2020, 26: s22. DOI: 10.1016/j.cardfail.2020.09.070.Peer-Reviewed Original ResearchAcute decompensated heart failureDiuretic doseLoop diureticsSodium outputBlood pressureEMR orderTitration protocolDecompensated heart failureSystolic blood pressureDaily urine outputSpot urine samplesNet fluid outputDiuretic resistanceFurosemide equivalentsFirst doseMedian doseSodium excretionHeart failureSerum potassiumSubsequent dosesUrine outputClinical outcomesMedian timeSerum magnesiumSame doseValidation of Natriuretic Response Prediction Equation in Patients with Acute Decompensated Heart Failure
Gleason O, Meegan G, Fleming J, Griffin M, Ivey-Miranda J, Cox Z, Rao V, Testani J. Validation of Natriuretic Response Prediction Equation in Patients with Acute Decompensated Heart Failure. Journal Of Cardiac Failure 2020, 26: s2. DOI: 10.1016/j.cardfail.2020.09.015.Peer-Reviewed Original ResearchNatriuretic responseSodium outputUrine collectionDiuretic administrationAcute decompensated heart failureIntravenous loop diuretic therapyLoop diuretic administrationLoop diuretic therapySpot urine sodiumDecompensated heart failureHeart failure admissionsRoutine clinical practiceSpot urine samplesNet fluid outputTotal sodium excretionUrine spot samplesADHF patientsDiuretic therapySodium excretionUrine sodiumHeart failureLoop diureticsUrine outputClinical practiceFluid output
2018
Real World Use of Hypertonic Saline in Refractory Acute Decompensated Heart Failure: A U.S. Center's Experience
Goljo E, Soufer A, Colna M, Rao V, D'Ambrosi J, Riello R, Mahoney D, Tang W, Testani J. Real World Use of Hypertonic Saline in Refractory Acute Decompensated Heart Failure: A U.S. Center's Experience. Journal Of Cardiac Failure 2018, 24: s32. DOI: 10.1016/j.cardfail.2018.07.093.Peer-Reviewed Original ResearchAcute decompensated heart failureHypertonic saline solutionDecompensated heart failureHSS administrationHeart failureSerum sodiumHypertonic salineTreatment responseSetting of ADHFHigh-dose loop diureticsMethods Electronic medical recordsLarge urban academic hospitalInotropes/vasopressorsReal-world safetySerum sodium concentrationUrban academic hospitalPotential therapeutic effectsNet fluid outputPositive treatment responseAdditional rigorous studiesElectronic medical recordsImprovement of creatinineADHF patientsFurosemide equivalentsCenter experience