2024
Effects 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 ResearchSerial direct sodium removal in patients with heart failure and diuretic resistance
Rao V, Ivey‐Miranda J, Cox Z, Moreno‐Villagomez J, Ramos‐Mastache D, Neville D, Balkcom N, Asher J, Bellumkonda L, Bigvava T, Shaburishvili T, Bartunek J, Wilson F, Finkelstein F, Maulion C, Turner J, Testani J. Serial direct sodium removal in patients with heart failure and diuretic resistance. European Journal Of Heart Failure 2024, 26: 1215-1230. PMID: 38556717, DOI: 10.1002/ejhf.3196.Peer-Reviewed Original ResearchConceptsDiuretic resistanceCardiorenal syndromeHeart failureLoop diureticsDiuretic withdrawalHigh-dose loop diureticsN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideGrowth differentiation factor 15Carbohydrate antigen 125Differentiation factor 15Sodium removalRandomized controlled studyCardiorenal parametersDiuretic doseSoluble ST2Natriuretic peptideMedian timeDiuretic responseKidney injuryPeritoneal membraneElectrolyte handlingKidney functionDiureticsInterleukin-6
2023
Effect 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
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 severityEffect 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 burdenSotagliflozinHospitalizationPatientsNatriuretic 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 discriminationElectronic health record alerts for acute kidney injury: multicenter, randomized clinical trial
Wilson FP, Martin M, Yamamoto Y, Partridge C, Moreira E, Arora T, Biswas A, Feldman H, Garg AX, Greenberg JH, Hinchcliff M, Latham S, Li F, Lin H, Mansour SG, Moledina DG, Palevsky PM, Parikh CR, Simonov M, Testani J, Ugwuowo U. Electronic health record alerts for acute kidney injury: multicenter, randomized clinical trial. The BMJ 2021, 372: m4786. PMID: 33461986, PMCID: PMC8034420, DOI: 10.1136/bmj.m4786.Peer-Reviewed Original ResearchConceptsAcute kidney injuryElectronic health record alertsKidney injuryPrimary outcomeMedical recordsYale New Haven Health SystemCare practicesGlobal Outcomes creatinine criteriaLarge tertiary care centerComposite of progressionDays of randomizationReceipt of dialysisPrespecified secondary outcomesTertiary care centerPatients' medical recordsSmall community hospitalNon-teaching hospitalsElectronic health recordsCreatinine criteriaUsual careSecondary outcomesAdult inpatientsKidney diseaseClinical centersWorse outcomesThe Association of COVID-19 With Acute Kidney Injury Independent of Severity of Illness: A Multicenter Cohort Study
Moledina DG, Simonov M, Yamamoto Y, Alausa J, Arora T, Biswas A, Cantley LG, Ghazi L, Greenberg JH, Hinchcliff M, Huang C, Mansour SG, Martin M, Peixoto A, Schulz W, Subair L, Testani JM, Ugwuowo U, Young P, Wilson FP. The Association of COVID-19 With Acute Kidney Injury Independent of Severity of Illness: A Multicenter Cohort Study. American Journal Of Kidney Diseases 2021, 77: 490-499.e1. PMID: 33422598, PMCID: PMC7791318, DOI: 10.1053/j.ajkd.2020.12.007.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedCohort StudiesCOVID-19C-Reactive ProteinCreatinineDiureticsFemaleHospital MortalityHumansIntensive Care UnitsLength of StayMaleMiddle AgedProportional Hazards ModelsRenal DialysisRenal Insufficiency, ChronicRespiration, ArtificialRisk FactorsSARS-CoV-2Severity of Illness IndexUnited StatesVasoconstrictor AgentsConceptsAcute kidney injurySARS-CoV-2Cohort studyRisk factorsCOVID-19Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testingTime-updated Cox proportional hazards modelsDialysis-requiring acute kidney injuryYale New Haven Health SystemHigher inflammatory marker levelsMore acute kidney injuryCox proportional hazards modelMulticenter cohort studyHigh rateInflammatory marker levelsTraditional risk factorsProportional hazards modelCoronavirus disease 2019KDIGO criteriaNephrotoxin exposureKidney injuryInjury independentUnivariable analysisNasopharyngeal samplesMarker levels
2020
Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure
Bhatt DL, Szarek M, 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, Verma S, Lapuerta P, Pitt B. Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure. New England Journal Of Medicine 2020, 384: 117-128. PMID: 33200892, DOI: 10.1056/nejmoa2030183.Peer-Reviewed Original ResearchConceptsPrimary end-point eventEnd-point eventsHeart failureSotagliflozin groupCardiovascular causesPlacebo groupRate of deathFirst doseUrgent visitsSodium-glucose cotransporter 2 inhibitorsType 2 diabetes mellitusWorsening Heart FailureAcute kidney injuryDecompensated heart failureDouble-blind trialPrimary end pointStable heart failureCotransporter 2 inhibitorsPercentage of patientsRisk of hospitalizationKidney injuryPrespecified subgroupsDiabetes mellitusSevere hypoglycemiaSGLT2 inhibitorsRacial Differences in Diuretic Efficiency, Plasma Renin, and Rehospitalization in Subjects With Acute Heart Failure
Morris AA, Nayak A, Ko YA, D’Souza M, Felker GM, Redfield MM, Tang WHW, Testani JM, Butler J. Racial Differences in Diuretic Efficiency, Plasma Renin, and Rehospitalization in Subjects With Acute Heart Failure. Circulation Heart Failure 2020, 13: e006827. PMID: 32635768, PMCID: PMC7474850, DOI: 10.1161/circheartfailure.119.006827.Peer-Reviewed Original ResearchConceptsPlasma renin activityAcute heart failureLevels of PRADiuretic efficiencyHeart failureBlack patientsNonblack patientsAcute heart failure clinical trialsRacial differencesBaseline plasma renin activityHeart failure clinical trialsHigher diuretic efficiencyMeasures of decongestionRisk of rehospitalizationNonischemic heart failureNet fluid balanceSubset of subjectsGreater fluid lossRace/ethnic groupsCARRESS-HFDOSE-AHFFurosemide equivalentsROSE-AHFAldosterone systemNT-proBNPAcute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Acute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure. JACC Heart Failure 2020, 8: 537-547. PMID: 32535124, PMCID: PMC9027677, DOI: 10.1016/j.jchf.2020.03.009.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptideAcute decompensated heart failureDecompensated heart failureHeart failureKidney functionAdverse outcomesAcute declineNT-proBNPComposite outcomeNatriuretic peptideHigh riskMultivariable Cox regression modelsTotal proteinAcute kidney functionMarkers of decongestionN-terminal prohormoneGlomerular filtration rateCox regression modelEGFR declineCardiovascular deathVolume overloadFiltration rateEGFRHospital changesDecongestionReal-Time Prediction of Acute Kidney Injury in Hospitalized Adults: Implementation and Proof of Concept
Ugwuowo U, Yamamoto Y, Arora T, Saran I, Partridge C, Biswas A, Martin M, Moledina DG, Greenberg JH, Simonov M, Mansour SG, Vela R, Testani JM, Rao V, Rentfro K, Obeid W, Parikh CR, Wilson FP. Real-Time Prediction of Acute Kidney Injury in Hospitalized Adults: Implementation and Proof of Concept. American Journal Of Kidney Diseases 2020, 76: 806-814.e1. PMID: 32505812, PMCID: PMC8667815, DOI: 10.1053/j.ajkd.2020.05.003.Peer-Reviewed Original ResearchConceptsAKI alertsHospitalized adultsKidney injuryUrban tertiary care hospitalAcute kidney injurySerum creatinine levelsObservational cohort studyTertiary care hospitalSerum creatinine concentrationBeats/minElectronic health recordsAKI diagnosisCohort studyCreatinine levelsInpatient mortalitySystolic bloodFractional excretionCenter studyBlood biomarkersUnivariable associationsUrine microscopyCreatinine concentrationClinical careElevated riskUrea nitrogenEmpagliflozin 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 excretionAccess and Outcomes Among Hypertrophic Cardiomyopathy Patients in a Large Integrated Health System
Thomas A, Papoutsidakis N, Spatz E, Testani J, Soucier R, Chou J, Ahmad T, Darr U, Hu X, Li F, Chen ME, Bellumkonda L, Sumathipala A, Jacoby D. Access and Outcomes Among Hypertrophic Cardiomyopathy Patients in a Large Integrated Health System. Journal Of The American Heart Association 2020, 9: e014095. PMID: 31973610, PMCID: PMC7033886, DOI: 10.1161/jaha.119.014095.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCardiomyopathy, HypertrophicCause of DeathConnecticutDelivery of Health Care, IntegratedFemaleHealthcare DisparitiesHeart Disease Risk FactorsHospitalizationHumansMaleMiddle AgedOutcome and Process Assessment, Health CareReferral and ConsultationRetrospective StudiesRisk AssessmentSocial ClassSocial Determinants of HealthTreatment OutcomeConceptsSpecialty careHCM patientsCare cohortHypertrophic cardiomyopathyYale New Haven Health SystemLarge integrated health systemHealth systemBackground Hypertrophic cardiomyopathyRetrospective cohort studySocioeconomic statusPatients' socioeconomic statusHigher socioeconomic status groupsHypertrophic cardiomyopathy patientsIntegrated health systemSpecialty care accessSocioeconomic status groupsMedical insurance providersCardiomyopathy clinicCause deathLSES patientsCause hospitalizationCause mortalityNoncardiac causesCohort studySecondary outcomes
2019
Diuretic Strategies for Loop Diuretic Resistance in Acute Heart Failure The 3T Trial
Cox ZL, Hung R, Lenihan DJ, Testani JM. Diuretic Strategies for Loop Diuretic Resistance in Acute Heart Failure The 3T Trial. JACC Heart Failure 2019, 8: 157-168. PMID: 31838029, PMCID: PMC7058489, DOI: 10.1016/j.jchf.2019.09.012.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAgedChlorothiazideDiureticsDose-Response Relationship, DrugDouble-Blind MethodDrug Therapy, CombinationFemaleFollow-Up StudiesFurosemideHeart FailureHumansInfusions, IntravenousMaleMetolazoneMiddle AgedProspective StudiesRetrospective StudiesTolvaptanTreatment OutcomeConceptsAcute heart failureLoop diuretic resistanceDiuretic resistanceHigh-dose loop diuretic therapyLoop diuretic therapyDouble-blinded trialInfusion of furosemideCombination diureticsDiuretic strategyDiuretic therapyOral metolazoneTolvaptan therapyDiuretic efficacyHeart failurePrimary outcomePatientsLimited evidenceWeight lossTherapyChlorothiazideMetolazoneTolvaptanDiureticsInfusionCohortDevelopment and Validation of a Model for Predicting the Risk of Acute Kidney Injury Associated With Contrast Volume Levels During Percutaneous Coronary Intervention
Huang C, Li SX, Mahajan S, Testani JM, Wilson FP, Mena CI, Masoudi FA, Rumsfeld JS, Spertus JA, Mortazavi BJ, Krumholz HM. Development and Validation of a Model for Predicting the Risk of Acute Kidney Injury Associated With Contrast Volume Levels During Percutaneous Coronary Intervention. JAMA Network Open 2019, 2: e1916021. PMID: 31755952, PMCID: PMC6902830, DOI: 10.1001/jamanetworkopen.2019.16021.Peer-Reviewed Original ResearchConceptsCreatinine level increaseAcute kidney injuryPercutaneous coronary interventionContrast volumeAKI riskKidney injuryCoronary interventionBaseline riskCardiology National Cardiovascular Data Registry's CathPCI RegistryNational Cardiovascular Data Registry CathPCI RegistryRisk of AKIAcute Kidney Injury AssociatedDifferent baseline risksPCI safetyCathPCI RegistryInjury AssociatedMean ageDerivation setPreprocedural riskMAIN OUTCOMEAmerican CollegePrognostic studiesUS hospitalsCalibration slopeValidation setAdverse 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 worseningEffect on Survival of Concurrent Hemoconcentration and Increase in Creatinine During Treatment of Acute Decompensated Heart Failure
Griffin M, Rao VS, Fleming J, Raghavendra P, Turner J, Mahoney D, Wettersten N, Maisel A, Ivey-Miranda JB, Inker L, Tang WHW, Wilson FP, Testani JM. Effect on Survival of Concurrent Hemoconcentration and Increase in Creatinine During Treatment of Acute Decompensated Heart Failure. The American Journal Of Cardiology 2019, 124: 1707-1711. PMID: 31601358, PMCID: PMC6959849, DOI: 10.1016/j.amjcard.2019.08.034.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureHeart failureImproved survivalHigher loop diuretic dosesLoop diuretic dosesNet fluid lossPlasma volume reductionAggressive decongestionAggressive diuresisPostdischarge survivalDiuretic dosesPostdischarge outcomesSerum creatinineHospital treatmentHospital parametersBetter survivalCreatinineHemoconcentrationPatient carePatientsSurvivalLonger lengthVolume reductionTreatmentControlled decongestion by Reprieve therapy in acute heart failure: results of the TARGET‐1 and TARGET‐2 studies
Biegus J, Zymlinski R, Siwolowski P, Testani J, Szachniewicz J, Tycińska A, Banasiak W, Halpert A, Levin H, Ponikowski P. Controlled decongestion by Reprieve therapy in acute heart failure: results of the TARGET‐1 and TARGET‐2 studies. European Journal Of Heart Failure 2019, 21: 1079-1087. PMID: 31127666, DOI: 10.1002/ejhf.1533.Peer-Reviewed Original ResearchConceptsAcute heart failureEnd of therapyHeart failureDiuretic-based regimenStandard diuretic therapyPatient global assessmentPrimary efficacy endpointCentral venous pressureSystolic blood pressureDiuretic therapyEffective decongestionMean diuresisEfficacy endpointRenal injuryBlood pressureVenous pressureMean creatinineOwn controlPatientsTherapyGlobal assessmentFluid lossSodium lossTherapy supportDecongestionA simple real-time model for predicting acute kidney injury in hospitalized patients in the US: A descriptive modeling study
Simonov M, Ugwuowo U, Moreira E, Yamamoto Y, Biswas A, Martin M, Testani J, Wilson FP. A simple real-time model for predicting acute kidney injury in hospitalized patients in the US: A descriptive modeling study. PLOS Medicine 2019, 16: e1002861. PMID: 31306408, PMCID: PMC6629054, DOI: 10.1371/journal.pmed.1002861.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedAged, 80 and overConnecticutDecision Support TechniquesElectronic Health RecordsFemaleHospital MortalityHumansInpatientsMaleMiddle AgedPatient AdmissionPredictive Value of TestsPrognosisRenal DialysisRetrospective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsConceptsAcute kidney injuryImminent acute kidney injuryElectronic health recordsKidney injuryHospital 1Prediction of AKIRenal replacement therapyOptimal treatment strategyLaboratory dataReceiver operator characteristic curveInternal validation setAKI occurrenceAKI severityHospitalized adultsMedical comorbiditiesOverall cohortAdverse eventsHospitalized patientsSurgical wardsSignificant morbidityReplacement therapyExternal validation data setsHospital 2Hospital 3Study hospital