2023
Perirenal Adipose Tissue Is Associated With Renal Dysfunction and Abnormal Hemodynamics in Patients With HFpEF
Boorsma E, Sorimachi H, ter Maaten J, van Veldhuisen D, Omote K, Takahashi N, Testani J, Willems T, Voors A, Borlaug B. Perirenal Adipose Tissue Is Associated With Renal Dysfunction and Abnormal Hemodynamics in Patients With HFpEF. JACC Heart Failure 2023, 11: 1463-1465. PMID: 37656080, DOI: 10.1016/j.jchf.2023.06.027.Peer-Reviewed Original ResearchSGLT2 inhibitors and diuretics in heart failure: clicking reset on the renal volume setpoint?
Borlaug B, Testani J. SGLT2 inhibitors and diuretics in heart failure: clicking reset on the renal volume setpoint? European Heart Journal 2023, 44: 2944-2946. PMID: 37220086, DOI: 10.1093/eurheartj/ehad345.Commentaries, Editorials and Letters
2021
Renal negative pressure treatment as a novel therapy for heart failure-induced renal dysfunction
Rao VS, Maulion C, Asher JL, Ivey-Miranda J, Cox ZL, Moreno-Villagomez J, Mahoney D, Turner JM, Wilson FP, Wilcox CS, Testani J. Renal negative pressure treatment as a novel therapy for heart failure-induced renal dysfunction. AJP Regulatory Integrative And Comparative Physiology 2021, 321: r588-r594. PMID: 34405731, DOI: 10.1152/ajpregu.00115.2021.Peer-Reviewed Original ResearchConceptsRenal plasma flowGlomerular filtration rateCongestive HFTubular pressureHeart failure hospitalizationPara-aminohippurate clearanceCentral venous pressureHigh fractional excretionNegative pressure therapyUrinary collecting systemNegative pressure treatmentSimilar diuresisFailure hospitalizationRenal dysfunctionCardiac tamponadeIothalamate clearanceFractional excretionRenal parametersKidney functionRenal congestionRenal responseRight kidneyVenous pressurePressure therapyControl kidneys
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
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 worseningChronic Heart Failure Is Infrequently Associated With Renal Dysfunction in Hypertrophic Cardiomyopathy
Rowin EJ, Romashko M, Testani JM, Koethe BC, Saxena D, Udelson JE, Maron BJ, Maron MS. Chronic Heart Failure Is Infrequently Associated With Renal Dysfunction in Hypertrophic Cardiomyopathy. Journal Of Cardiac Failure 2019, 25: 690-692. PMID: 31158468, DOI: 10.1016/j.cardfail.2019.05.012.Peer-Reviewed Original Research
2016
Different diuretic dose and response in acute decompensated heart failure: Clinical characteristics and prognostic significance
Palazzuoli A, Testani JM, Ruocco G, Pellegrini M, Ronco C, Nuti R. Different diuretic dose and response in acute decompensated heart failure: Clinical characteristics and prognostic significance. International Journal Of Cardiology 2016, 224: 213-219. PMID: 27657476, DOI: 10.1016/j.ijcard.2016.09.005.Peer-Reviewed Original ResearchConceptsLower diuretic efficiencyChronic kidney diseaseDiuretic efficiencyAdverse eventsDose administrationAcute decompensated heart failureDecompensated heart failureAdverse event ratesDiuretic doseWRF occurrenceRenal dysfunctionClinical characteristicsRenal functionHeart failureHD patientsMultivariable analysisClinical statusPrognostic significanceAdverse outcomesContinuous administrationKidney diseaseDE patientsLD patientsBest modalityPatientsReduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure
Hanberg JS, Sury K, Wilson FP, Brisco MA, Ahmad T, Maaten J, Broughton JS, Assefa M, Tang WH, Parikh CR, Testani JM. Reduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure. Journal Of The American College Of Cardiology 2016, 67: 2199-2208. PMID: 27173030, PMCID: PMC4867078, DOI: 10.1016/j.jacc.2016.02.058.Peer-Reviewed Original ResearchConceptsPulmonary artery catheterizationBlood urea nitrogenCardiac indexRenal functionHeart failureRenal dysfunctionGood renal functionReduced cardiac indexHigher cardiac indexGlomerular filtration rateSignificant inverse correlationMultiple subgroupsMulticenter populationWorse eGFRHF patientsCreatinine ratioArtery catheterizationPatient subgroupsFiltration rateSerial assessmentLinear mixed modelingESCAPE trialPatientsUrea nitrogenDysfunctionRenal 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 testsThe risk of death associated with proteinuria in heart failure is restricted to patients with an elevated blood urea nitrogen to creatinine ratio
Brisco MA, Zile MR, Maaten J, Hanberg JS, Wilson FP, Parikh C, Testani JM. The risk of death associated with proteinuria in heart failure is restricted to patients with an elevated blood urea nitrogen to creatinine ratio. International Journal Of Cardiology 2016, 215: 521-526. PMID: 27153048, PMCID: PMC4986924, DOI: 10.1016/j.ijcard.2016.04.100.Peer-Reviewed Original ResearchConceptsElevated blood urea nitrogenBUN/CrRenal dysfunctionBlood urea nitrogenCreatinine ratioUrea nitrogenLeft Ventricular Dysfunction (SOLVD) trialVentricular Dysfunction trialsGlomerular filtration rateRisk of deathBaseline characteristicsWorsened survivalAdverse eventsHeart failureTop tertileFiltration rateBottom tertileProteinuriaSurvival disadvantagePatientsMortalityTertileDysfunctionSurvivalSurvival models
2015
Amino-Terminal Pro-B-Type Natriuretic Peptide for Diagnosis and Prognosis in Patients With Renal Dysfunction A Systematic Review and Meta-Analysis
Schaub JA, Coca SG, Moledina DG, Gentry M, Testani JM, Parikh CR. Amino-Terminal Pro-B-Type Natriuretic Peptide for Diagnosis and Prognosis in Patients With Renal Dysfunction A Systematic Review and Meta-Analysis. JACC Heart Failure 2015, 3: 977-989. PMID: 26671676, PMCID: PMC4683413, DOI: 10.1016/j.jchf.2015.07.014.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureNT-proBNPRenal dysfunctionRenal functionHeart failureNatriuretic peptideDiagnosis of ADHFAmino-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptidePg/B-type natriuretic peptideAmino-Terminal ProElevated NT-proBNPHigher NT-proBNPDecompensated heart failurePooled risk ratioGlomerular filtration rateCoronary artery diseaseA Systematic ReviewADHF eventsArtery diseasePrognostic utilityWorse prognosisFiltration rateRisk ratioThe Impact of Donor and Recipient Renal Dysfunction on Cardiac Allograft Survival: Insights Into Reno-Cardiac Interactions
Laur O, Brisco MA, Kula AJ, Cheng SJ, Mangi AA, Bellumkonda L, Jacoby DL, Coca S, Tang WH, Parikh CR, Testani JM. The Impact of Donor and Recipient Renal Dysfunction on Cardiac Allograft Survival: Insights Into Reno-Cardiac Interactions. Journal Of Cardiac Failure 2015, 22: 368-375. PMID: 26616578, PMCID: PMC4904299, DOI: 10.1016/j.cardfail.2015.11.009.Peer-Reviewed Original ResearchConceptsRenal dysfunctionCardiac transplantationAdverse recipient outcomesCardiac allograft survivalOrgan Sharing registryGlomerular filtration ratePotent risk factorImpact of donorAllograft survivalCardiac allograftsRecipient deathRecipient outcomesUnited NetworkAdverse outcomesFiltration rateMyocardial necrosisRisk factorsCardiovascular diseaseHigh riskDonor characteristicsOlder ageRetransplantationDeathTransplantationDysfunctionEvidence of Mild Liver Dysfunction Identifies Stable Heart Failure Outpatients with Reversible Renal Dysfunction
Brisco MA, Cheng SJ, Laur O, Kula AJ, Testani JM. Evidence of Mild Liver Dysfunction Identifies Stable Heart Failure Outpatients with Reversible Renal Dysfunction. Cardiorenal Medicine 2015, 5: 229-236. PMID: 26195975, PMCID: PMC4478303, DOI: 10.1159/000430505.Peer-Reviewed Original ResearchReversible renal dysfunctionStable HF outpatientsMild liver dysfunctionAlanine aminotransferaseAspartate aminotransferaseHF outpatientsRenal dysfunctionElevated bilirubinLiver dysfunctionHeart failurePoor perfusionBeta-Blocker EvaluationDecompensated heart failureHeart failure outpatientsGlomerular filtration rateSigns of congestionBaseline characteristicsRenal functionPathophysiologic factorsLiver parametersFiltration ratePatientsDysfunctionOutpatientsBilirubinBlood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunction
Parrinello G, Torres D, Testani JM, Almasio PL, Bellanca M, Pizzo G, Cuttitta F, Pinto A, Butler J, Paterna S. Blood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunction. Internal And Emergency Medicine 2015, 10: 965-972. PMID: 26037394, DOI: 10.1007/s11739-015-1261-1.Peer-Reviewed Original ResearchConceptsBUN/CrInferior vena cavaRenal dysfunctionHeart failureVenous congestionBUN/Cr ratioMultiple logistic regression modelNYHA class 3Independent risk factorLong-term mortalityHeart failure patientsGlomerular filtration rateBlood urea nitrogenReceiver-operating characteristic analysisLogistic regression modelsCause deathHF outpatientsHF severityLower eGFRRenal functionAmbulatory visitsFailure patientsCreatinine ratioSingle centerRenal biomarkersThe kidney in heart failure: an update
Damman K, Testani JM. The kidney in heart failure: an update. European Heart Journal 2015, 36: 1437-1444. PMID: 25838436, PMCID: PMC4465636, DOI: 10.1093/eurheartj/ehv010.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsHeart failureRenal functionPhenotypes of HFReduced renal perfusionCardiorenal interactionsCardiorenal syndromeHF patientsHF statusRenal dysfunctionRenal perfusionGrim prognosisVenous congestionClinical syndromeTreatment strategiesHigh mortalityPatientsRecent evidenceSyndromeKidneyMortalityUpdated classificationMorbidityFailurePrognosisDysfunction
2014
Novel Renal Biomarkers to Assess Cardiorenal Syndrome
Brisco MA, Testani JM. Novel Renal Biomarkers to Assess Cardiorenal Syndrome. Current Heart Failure Reports 2014, 11: 485-499. PMID: 25239434, PMCID: PMC4224613, DOI: 10.1007/s11897-014-0226-4.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsRenal dysfunctionCardiorenal syndromeHeart failureRenal biomarkersNormal glomerular filtration rateIrreversible nephron lossSignificant renal impairmentHypertensive kidney diseaseGlomerular filtration rateNovel renal biomarkersCardiorenal interactionsRenal impairmentNephron lossDecongestive therapyAdverse outcomesKidney diseaseFiltration rateHigh prevalenceRenal performanceSyndromeBiomarkersFailurePrognosisDysfunctionTherapyAcute Kidney Injury in the Era of Ventricular Assist Devices
Brisco M, Testani J. Acute Kidney Injury in the Era of Ventricular Assist Devices. 2014, 111-124. DOI: 10.1007/978-1-4939-1273-5_9.ChaptersAcute kidney injuryVentricular assist deviceRenal functionKidney injuryRenal dysfunctionAssist deviceDurable mechanical circulatory supportAdvanced heart failureMajority of patientsMechanical circulatory supportRenal outcomesCardiac transplantationVAD implantationVAD placementHeart failureCirculatory supportPoor prognosisDestination therapyClinical significanceSignificant burdenPatientsGreater riskDysfunctionTherapyInjuryA Combined-Biomarker Approach to Clinical Phenotyping Renal Dysfunction in Heart Failure
Testani JM, Damman K, Brisco MA, Chen S, Laur O, Kula AJ, Tang WH, Parikh C. A Combined-Biomarker Approach to Clinical Phenotyping Renal Dysfunction in Heart Failure. Journal Of Cardiac Failure 2014, 20: 912-919. PMID: 25152498, PMCID: PMC4292792, DOI: 10.1016/j.cardfail.2014.08.008.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBiomarkersBlood Urea NitrogenCardio-Renal SyndromeCohort StudiesConfidence IntervalsCreatinineFemaleGlomerular Filtration RateHeart FailureHospitals, UniversityHumansMaleMiddle AgedPhenotypePrognosisRenal InsufficiencyRetrospective StudiesSensitivity and SpecificityStatistics, NonparametricSurvival RateConceptsB-type natriuretic peptideElevated B-type natriuretic peptideRenal dysfunctionHeart failureLower B-type natriuretic peptideUse of BNPCombined biomarker approachDecompensated heart failureIntrinsic kidney diseaseBlood urea nitrogenDifferent clinical phenotypesBUN/Diuretic resistanceInotrope useWorse survivalCreatinine ratioRisk stratificationDischarge diagnosisNatriuretic peptideVenous congestionKidney diseaseStratify patientsClinical phenotypingPatientsUrea nitrogen
2013
Biochemical Evidence of Mild Hepatic Dysfunction Identifies Decompensated Heart Failure Patients With Reversible Renal Dysfunction
Brisco MA, McCauley BD, Chen J, Parikh CR, Testani JM. Biochemical Evidence of Mild Hepatic Dysfunction Identifies Decompensated Heart Failure Patients With Reversible Renal Dysfunction. Journal Of Cardiac Failure 2013, 19: 739-745. PMID: 24263117, PMCID: PMC3884639, DOI: 10.1016/j.cardfail.2013.10.005.Peer-Reviewed Original ResearchConceptsReversible renal dysfunctionRenal dysfunctionLiver dysfunctionElevated international normalized ratioDecompensated heart failure patientsBaseline renal dysfunctionCharacteristic laboratory abnormalitiesDecompensated HF patientsLiver dysfunction resultsSigns of HFGlomerular filtration rateHeart failure patientsMild liver dysfunctionInternational normalized ratioIntrinsic kidney diseaseBiochemical evidenceHF patientsFailure patientsLaboratory abnormalitiesRenal functionPathophysiologic factorsDischarge diagnosisKidney diseaseMultifactorial pathophysiologyNormalized ratioInfluence of Age-Related Versus Non–Age-Related Renal Dysfunction on Survival in Patients With Left Ventricular Dysfunction
Testani JM, Brisco MA, Han G, Laur O, Kula AJ, Cheng SJ, Tang WH, Parikh CR. Influence of Age-Related Versus Non–Age-Related Renal Dysfunction on Survival in Patients With Left Ventricular Dysfunction. The American Journal Of Cardiology 2013, 113: 127-131. PMID: 24216124, PMCID: PMC3915785, DOI: 10.1016/j.amjcard.2013.09.029.Peer-Reviewed Original ResearchConceptsLow glomerular filtration rateGlomerular filtration rateVentricular dysfunctionRenal dysfunctionNormal agingLeft ventricular dysfunctionRisk of deathNormal aging resultsAge-related decreaseInfluence of ageBaseline eGFRMean eGFRLower eGFRWorsened survivalPrognostic importanceFiltration rateSurvival disadvantagePrimary analysisDysfunctionEGFRSignificant riskPatientsUnderlying mechanismRiskMortality