2024
Mechanistic Differences between Torsemide and Furosemide.
Rao V, Cox Z, Ivey-Miranda J, Neville D, Balkcom N, Moreno-Villagomez J, Ramos-Mastache D, Maulion C, Bellumkonda L, Tang W, Collins S, Velazquez E, Mentz R, Wilson F, Turner J, Wilcox C, Ellison D, Fang J, Testani J. Mechanistic Differences between Torsemide and Furosemide. Journal Of The American Society Of Nephrology 2024 PMID: 39196651, DOI: 10.1681/asn.0000000000000481.Peer-Reviewed Original ResearchTorsemide groupDiuretic doseTubular site of actionHigher diuretic dosesDose of furosemideProportion of dosesOral furosemideSite of actionPrescribed doseNeurohormonal activationMechanistic substudyClinical outcomesPharmacodynamic advantagesKidney dysfunctionPharmacodynamic parametersKidney functionRandomized trialsNatriuresisTubular sitesFurosemideTorsemideDoseTRANSFORM-HFPlasma volumeBody weight
2023
Updates in Cardiorenal Syndrome
McCallum W, Testani J. Updates in Cardiorenal Syndrome. Medical Clinics Of North America 2023, 107: 763-780. PMID: 37258013, PMCID: PMC10756136, DOI: 10.1016/j.mcna.2023.03.011.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
2021
FGF-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 severityRenal 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 vein
2020
Empagliflozin in Heart Failure
Griffin M, Rao VS, Ivey-Miranda J, Fleming J, Mahoney D, Maulion C, Suda N, Siwakoti K, Ahmad T, Jacoby D, Riello R, Bellumkonda L, Cox Z, Collins S, Jeon S, Turner JM, Wilson FP, Butler J, Inzucchi SE, Testani JM. Empagliflozin in Heart Failure. Circulation 2020, 142: 1028-1039. PMID: 32410463, PMCID: PMC7521417, DOI: 10.1161/circulationaha.120.045691.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsCotransporter 2 inhibitorsNeurohormonal activationHeart failureRenal dysfunctionBlood volumeHeart failure-related outcomesPlacebo-controlled crossover studyType 2 diabetes mellitusProximal tubular siteHeart failure outcomesStable heart failureUrinary glucose excretionUric acid levelsElectrolyte wastingEmpagliflozin monotherapyOral empagliflozinPlacebo periodStudy drugGlucose excretionNatriuretic effectPotassium wastingTubular sitesDiabetes mellitusFractional excretion
2016
Hypochloremia and Diuretic Resistance in Heart Failure
Hanberg JS, Rao V, Maaten J, Laur O, Brisco MA, Wilson F, Grodin JL, Assefa M, Broughton J, Planavsky NJ, Ahmad T, Bellumkonda L, Tang WH, Parikh CR, Testani JM. Hypochloremia and Diuretic Resistance in Heart Failure. Circulation Heart Failure 2016, 9: e003180. PMID: 27507113, PMCID: PMC4988527, DOI: 10.1161/circheartfailure.116.003180.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBiomarkersChloridesConnecticutCross-Sectional StudiesDown-RegulationDrug ResistanceFemaleFurosemideHeart FailureHumansKidneyMaleMiddle AgedOdds RatioPilot ProjectsProspective StudiesReninRisk FactorsSodiumSodium Potassium Chloride Symporter InhibitorsTime FactorsTreatment OutcomeConceptsDiuretic resistanceHeart failureCare centerSerum chloridePro-B-type natriuretic peptideChloride supplementationRenal free water excretionB-type natriuretic peptidePoor diuretic responsePlasma renin activityPlasma renin concentrationHeart failure cohortFree water excretionRecent epidemiological studiesBasic science evidenceBlood urea nitrogenSerum chloride levelsFurosemide equivalentsNeurohormonal activationRenin activityRenin concentrationCreatinine ratioLoop diureticsDiuretic responseSerum sodiumHypochloremia, Diuretic Resistance, and Outcome in Patients With Acute Heart Failure
Ter Maaten JM, Damman K, Hanberg JS, Givertz MM, Metra M, O'Connor CM, Teerlink JR, Ponikowski P, Cotter G, Davison B, Cleland JG, Bloomfield DM, Hillege HL, van Veldhuisen DJ, Voors AA, Testani JM. Hypochloremia, Diuretic Resistance, and Outcome in Patients With Acute Heart Failure. Circulation Heart Failure 2016, 9: e003109. PMID: 27507112, DOI: 10.1161/circheartfailure.116.003109.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAged, 80 and overBiomarkersChloridesDisease ProgressionDiureticsDown-RegulationDrug ResistanceFemaleHeart FailureHospitalizationHumansKaplan-Meier EstimateLinear ModelsMaleMiddle AgedMultivariate AnalysisProportional Hazards ModelsRisk FactorsTime FactorsTreatment OutcomeXanthinesConceptsAcute heart failureMEq/L.Heart failureDay 14Serum chloridePoor diuretic responseHours of admissionLower serum chlorideBlood urea nitrogenSerum chloride levelsAHF therapiesDiuretic resistancePROTECT trialNeurohormonal activationMultivariable adjustmentRenal functionHospital admissionMultivariable analysisDiuretic responseDiuretic responsivenessDiuretic targetChloride levelsUrea nitrogenHypochloremiaChloride homeostasisRenal dysfunction and chronic mechanical circulatory support
Brisco MA, Testani JM, Cook JL. Renal dysfunction and chronic mechanical circulatory support. Current Opinion In Cardiology 2016, 31: 277-286. PMID: 27022890, PMCID: PMC6176489, DOI: 10.1097/hco.0000000000000278.Peer-Reviewed Original ResearchConceptsMechanical circulatory supportRenal dysfunctionRenal functionCirculatory supportChronic mechanical circulatory supportPostoperative acute kidney injuryIrreversible renal dysfunctionAcute kidney injuryRight ventricular dysfunctionAdvanced heart failureCardiogenic shockKidney injuryNeurohormonal activationVentricular dysfunctionMost patientsHeart failureKidney functionSubsequent recurrenceVolume overloadVenous congestionEarly improvementDysfunctionDevice-related effectsReversible formDiagnostic tests
2011
Influence of renal dysfunction phenotype on mortality in the setting of cardiac dysfunction: analysis of three randomized controlled trials
Testani JM, Coca SG, Shannon RP, Kimmel SE, Cappola TP. Influence of renal dysfunction phenotype on mortality in the setting of cardiac dysfunction: analysis of three randomized controlled trials. European Journal Of Heart Failure 2011, 13: 1224-1230. PMID: 21926073, PMCID: PMC3200208, DOI: 10.1093/eurjhf/hfr123.Peer-Reviewed Original ResearchConceptsGlomerular filtration rateBUN/creatinineRenal insufficiencyNeurohormonal activationRisk of mortalityHeart failurePulmonary Artery Catheterization Effectiveness trialLeft Ventricular Dysfunction (SOLVD) trialBaseline renal insufficiencyBeta-Blocker EvaluationVentricular Dysfunction trialsHeart failure populationCongestive heart failureBlood urea nitrogenCreatinine ratioPrimary outcomeCardiac dysfunctionFailure populationFiltration rateEffectiveness trialPoor survivalStudy populationUrea nitrogenPatientsMortalityInteraction Between Loop Diuretic-Associated Mortality and Blood Urea Nitrogen Concentration in Chronic Heart Failure
Testani JM, Cappola TP, Brensinger CM, Shannon RP, Kimmel SE. Interaction Between Loop Diuretic-Associated Mortality and Blood Urea Nitrogen Concentration in Chronic Heart Failure. Journal Of The American College Of Cardiology 2011, 58: 375-382. PMID: 21757114, PMCID: PMC3980479, DOI: 10.1016/j.jacc.2011.01.052.Peer-Reviewed Original ResearchConceptsHigh-dose loop diureticsBlood urea nitrogenLoop diureticsBUN levelsNeurohormonal activationBaseline characteristicsHeart failureNormal BUN levelChronic heart failureRisk of deathBlood urea nitrogen concentrationElevated BUN levelsCongestive symptomsOverall cohortWorsened survivalImproved survivalPrimary outcomeAdverse outcomesUrea nitrogen concentrationDiureticsUrea nitrogenBUN concentrationPatientsMortalitySurvival