2024
Peak Tricuspid Regurgitation Jet Velocity and Kidney Outcomes in Patients With Heart Failure With Preserved Ejection Fraction
Oka T, Tighiouart H, McCallum W, Tuttle M, Testani J, Sarnak M. Peak Tricuspid Regurgitation Jet Velocity and Kidney Outcomes in Patients With Heart Failure With Preserved Ejection Fraction. Kidney International Reports 2024 DOI: 10.1016/j.ekir.2024.07.009.Peer-Reviewed Original ResearchLeft ventricular ejection fractionPulmonary artery pressureCreatinine doublingEGFR declineEjection fractionKidney outcomesHeart failurePeak tricuspid regurgitant jet velocityDoubling of serum creatinineTricuspid regurgitant jet velocityElevated pulmonary artery pressureAssociated with lower eGFRWorsening kidney functionVentricular ejection fractionRegurgitant jet velocityCox proportional hazards modelsProportional hazards modelPost hoc analysisBaseline eGFRSerum creatinineLow eGFRTOPCAT trialFollow-upKidney functionArterial pressureEffects of Dapagliflozin on Body Composition and Its Relation to Hemodynamics in Heart Failure With Preserved Ejection Fraction
Naser J, Tada A, Harada T, Reddy Y, Carter R, Testani J, Jensen M, Borlaug B. Effects of Dapagliflozin on Body Composition and Its Relation to Hemodynamics in Heart Failure With Preserved Ejection Fraction. Circulation 2024, 149: 2026-2028. PMID: 38885297, PMCID: PMC11185269, DOI: 10.1161/circulationaha.124.069479.Peer-Reviewed Original ResearchSodium zirconium cyclosilicate in patients with HFrEF and hyperkalemia: REALIZE-K rationale, design, and baseline characteristics
Kosiborod M, Cherney D, Connelly K, Desai A, Guimarães P, Kuthi L, Lala A, Madrini V, Merkely B, Villota J, Squire I, Testani J, Vaclavik J, Verma S, Wranicz J, Dahl M, Eudicone J, Friberg L, Petrie M. Sodium zirconium cyclosilicate in patients with HFrEF and hyperkalemia: REALIZE-K rationale, design, and baseline characteristics. JACC Heart Failure 2024 PMID: 38878009, DOI: 10.1016/j.jchf.2024.05.003.Peer-Reviewed Original ResearchMineralocorticoid receptor antagonistsSodium zirconium cyclosilicateZirconium cyclosilicateBaseline characteristicsOpen-label run-inN-terminal pro B-type natriuretic peptideMineralocorticoid receptor antagonist useRun-inPro B-type natriuretic peptideB-type natriuretic peptidePlacebo-controlled trialRisk of hyperkalemiaReduced ejection fractionPrimary composite endpointDouble-blindEjection fractionReceptor antagonistLowered potassiumOptimal therapyNatriuretic peptideIncident hyperkalemiaProportion of participantsTherapy useHFrEFComposite endpoint
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 pressureThe 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 fractionEffect 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
Renal effects of guideline‐directed medical therapies in heart failure: a consensus document from the Heart Failure Association of the European Society of Cardiology
Mullens W, Martens P, Testani JM, Tang WHW, Skouri H, Verbrugge FH, Fudim M, Iacoviello M, Franke J, Flammer AJ, Palazzuoli A, Barragan PM, Thum T, Marcos MC, Miró Ò, Rossignol P, Metra M, Lassus J, Orso F, Jankowska EA, Chioncel O, Milicic D, Hill L, Seferovic P, Rosano G, Coats A, Damman K. Renal effects of guideline‐directed medical therapies in heart failure: a consensus document from the Heart Failure Association of the European Society of Cardiology. European Journal Of Heart Failure 2022, 24: 603-619. PMID: 35239201, DOI: 10.1002/ejhf.2471.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsChronic heart failureHeart failureRenal functionEjection fractionClinical practiceConsensus documentSodium-glucose cotransporter 2 inhibitorsGuideline-directed medical therapyReduced ejection fraction patientsEjection fraction patientsHeart Failure AssociationCotransporter 2 inhibitorsEuropean SocietyPharmacologic treatment optionsPoor renal functionDisease-modifying therapiesGood clinical practiceTreatment-induced changesDrug implementationHF drugsCardiology guidelinesESC guidelinesRenal effectsMedical therapyLifesaving therapyEvidence-Based Medical Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Chronic Kidney Disease
Beldhuis IE, Lam CSP, Testani JM, Voors AA, Van Spall HGC, Maaten J, Damman K. Evidence-Based Medical Therapy in Patients With Heart Failure With Reduced Ejection Fraction and Chronic Kidney Disease. Circulation 2022, 145: 693-712. PMID: 35226558, PMCID: PMC9074837, DOI: 10.1161/circulationaha.121.052792.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsChronic kidney diseasePresence of CKDSevere chronic kidney diseaseHeart failure hospitalizationReduced ejection fractionHFrEF therapyHeart failureFailure hospitalizationEjection fractionMedical therapyKidney diseaseDrug classesSodium-glucose cotransporter 2 inhibitorsEvidence-based medical therapyGlucose cotransporter 2 inhibitorsStrong independent risk factorEnd pointCKD stage 3bPoor cardiovascular outcomesCKD stage 5Combined end pointCotransporter 2 inhibitorsIndependent risk factorSevere heart failureGlomerular filtration rate
2021
Association Between Rates of In-Hospital Decongestion Among Patients with Heart Failure with Reduced Ejection Fraction with Longer-Term Kidney Outcomes
McCallum W, Tighiouart H, Testani J, Griffin M, Konstam M, Udelson J, Sarnak M. Association Between Rates of In-Hospital Decongestion Among Patients with Heart Failure with Reduced Ejection Fraction with Longer-Term Kidney Outcomes. Journal Of The American Society Of Nephrology 2021, 32: 687-687. DOI: 10.1681/asn.20213210s1687c.Peer-Reviewed Original ResearchEffect 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
Altered Hemodynamics and End-Organ Damage in Heart Failure
Verbrugge FH, Guazzi M, Testani JM, Borlaug BA. Altered Hemodynamics and End-Organ Damage in Heart Failure. Circulation 2020, 142: 998-1012. PMID: 32897746, PMCID: PMC7482031, DOI: 10.1161/circulationaha.119.045409.Peer-Reviewed Original ResearchConceptsHeart failureHemodynamic derangementsHemodynamic perturbationsElevated cardiac filling pressuresReduced cardiac outputCardiac filling pressuresEnd-organ damagePulmonary vascular diseaseHeart failure phenotypeMultiple organ systemsCapillary stress failureDevelopment of abnormalitiesCardiogenic shockHemodynamic abnormalitiesRenal functionEjection fractionClinical outcomesPulmonary congestionVenous capacityCardiac outputPericardial constraintVascular diseaseChronic diseasesFilling pressureVentilatory controlAssociation of Volume Overload With Kidney Function Outcomes Among Patients With Heart Failure With Reduced Ejection Fraction
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Association of Volume Overload With Kidney Function Outcomes Among Patients With Heart Failure With Reduced Ejection Fraction. Kidney International Reports 2020, 5: 1661-1669. PMID: 33102958, PMCID: PMC7569703, DOI: 10.1016/j.ekir.2020.07.015.Peer-Reviewed Original ResearchB-type natriuretic peptideKidney function outcomesReduced ejection fractionVolume overloadCKD stageEGFR declineFunction outcomesNatriuretic peptideEjection fractionHeart failureCongestion scoreMultivariable modelN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideGlomerular filtration rate declineHeart Failure Outcome StudyMultivariable Cox regression modelsChronic kidney disease stageClinical congestion scoreElevated natriuretic peptidesJugular venous distensionLow NT-proBNPKidney disease stageCox regression modelTolvaptan (EVEREST) trial
2019
Adverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction
Reddy YNV, Obokata M, Testani JM, Felker GM, Tang WHW, Abou-Ezzeddine OF, Sun JL, Chakrabothy H, McNulty S, Shah SJ, Lewis GD, Stevenson LW, Redfield MM, Borlaug BA. Adverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction. Journal Of Cardiac Failure 2019, 26: 101-107. PMID: 31618698, PMCID: PMC7036022, DOI: 10.1016/j.cardfail.2019.09.015.Peer-Reviewed Original ResearchConceptsRenal functionNonobese patientsHeart failureObese HFpEFObese patientsEjection fractionRenal responseAdverse renal responsesRight ventricular remodelingGlomerular filtration rateBody mass indexPlasma volume expansionSimilar weight lossCardiorenal hemodynamicsRenal dysfunctionPathophysiologic featuresMass indexAtrial fibrillationDecongestive therapyVentricular remodelingPericardial restraintFiltration rateHFpEFObese phenotypeSevere worseningUrinary Sodium Profiling in Chronic Heart Failure to Detect Development of Acute Decompensated Heart Failure
Martens P, Dupont M, Verbrugge FH, Damman K, Degryse N, Nijst P, Reynders C, Penders J, Tang WHW, Testani J, Mullens W. Urinary Sodium Profiling in Chronic Heart Failure to Detect Development of Acute Decompensated Heart Failure. JACC Heart Failure 2019, 7: 404-414. PMID: 31047021, DOI: 10.1016/j.jchf.2019.02.011.Peer-Reviewed Original ResearchConceptsChronic HF patientsHF patientsHeart failureSodium excretionAcute decompensated heart failureAcute heart failure hospitalizationLongitudinal changesChronic heart failureDecompensated heart failureHeart failure hospitalizationHigher sodium excretionUrinary sodium concentrationGlomerular filtration rate measurementInterindividual differencesLarge interindividual differencesFiltration rate measurementAHF hospitalizationDyspnea scoreFailure hospitalizationNT-proBNPChronic heartEjection fractionIndependent predictorsClinical endpointsPathophysiologic interactions
2018
Perturbations 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 model
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 investigationBiomarkersInflammationSerum Chloride and Sodium Interplay in Patients With Acute Myocardial Infarction and Heart Failure With Reduced Ejection Fraction
Ferreira JP, Girerd N, Duarte K, Coiro S, McMurray JJ, Dargie HJ, Pitt B, Dickstein K, Testani JM, Zannad F, Rossignol P. Serum Chloride and Sodium Interplay in Patients With Acute Myocardial Infarction and Heart Failure With Reduced Ejection Fraction. Circulation Heart Failure 2017, 10: e003500. PMID: 28159825, DOI: 10.1161/circheartfailure.116.003500.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedBiomarkersChloridesComorbidityDatabases, FactualFemaleHeart FailureHumansKaplan-Meier EstimateLinear ModelsMaleMiddle AgedMyocardial InfarctionNonlinear DynamicsPrognosisProportional Hazards ModelsRandomized Controlled Trials as TopicRetrospective StudiesRisk AssessmentRisk FactorsSodiumStroke VolumeVentricular Dysfunction, LeftVentricular Function, LeftConceptsHeart failureAcute myocardial infarctionSerum chlorideMyocardial infarctionPrognostic informationPrognostic variablesSodium levelsReduced left ventricular functionLow sodiumReduced ejection fractionLeft ventricular functionLower serum chlorideSignificant prognostic informationRelevant prognostic informationSerum chloride levelsPost-myocardial infarctionLow sodium levelsMore comorbiditiesCause mortalitySystolic dysfunctionCardiovascular mortalityEjection fractionVentricular functionClinical outcomesMortality rate
2014
The Incidence, Risk, and Consequences of Atrial Arrhythmias in Patients with Continuous‐Flow Left Ventricular Assist Devices
Brisco MA, Sundareswaran KS, Milano CA, Feldman D, Testani JM, Ewald GA, Slaughter MS, Farrar DJ, Goldberg LR, Investigators F. The Incidence, Risk, and Consequences of Atrial Arrhythmias in Patients with Continuous‐Flow Left Ventricular Assist Devices. Journal Of Cardiac Surgery 2014, 29: 572-580. PMID: 24750460, DOI: 10.1111/jocs.12336.Peer-Reviewed Original ResearchConceptsLeft ventricular assist deviceLate atrial arrhythmiaAtrial arrhythmiasVentricular assist deviceFunctional statusRisk factorsAssist deviceHeartMate II Left Ventricular Assist DeviceIncidence of AASix-minute walk distanceDestination therapy trialsDays of supportStrong risk factorQuality of lifePreoperative creatinineLVAD patientsSerum creatinineWalk distanceEjection fractionHeart failureLVAD supportQOL improvementMultivariable modelSimilar survivalBlanking period