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309 results on '"Rao, Veena S."'

3. Development of a Novel Intraperitoneal Icodextrin/Dextrose Solution for Enhanced Sodium Removal

Author

Asher, Jennifer L., Ivey-Miranda, Juan B., Maulion, Christopher, Cox, Zachary L., Borges-Vela, Julian A., Mendoza-Zavala, Genaro H., Cigarroa-Lopez, Jose A., Silva-Rueda, Rogelio I., Revilla-Monsalve, Cristina, Moreno-Villagomez, Julieta, Ramos-Mastache, Daniela, Goedje, Oliver, Crosbie, Ian, McIntyre, Christopher, Finkelstein, Fredrick, Turner, Jeffrey M., Testani, Jeffrey M., and Rao, Veena S.

Published
2025
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4. Renin-Angiotensin-Aldosterone System Activation and Diuretic Response in Ambulatory Patients With Heart Failure

Author

Amatruda, Jonathan G, Scherzer, Rebecca, Rao, Veena S, Ivey-Miranda, Juan B, Shlipak, Michael G, Estrella, Michelle M, and Testani, Jeffrey M

Subjects
Cardiovascular, Hypertension, Heart Disease, Clinical Research, Cardiorenal syndrome, diuretic resistance, heart failure, loop diuretics, natriuresis, renin-angiotensin-aldosterone system, torsemide
Abstract

Rationale & objectiveHeart failure treatment relies on loop diuretics to induce natriuresis and decongestion, but the therapy is often limited by diuretic resistance. We explored the association of renin-angiotensin-aldosterone system (RAAS) activation with diuretic response.Study designObservational cohort.Setting & populationEuvolemic ambulatory adults with chronic heart failure were administered torsemide in a monitored environment.PredictorsPlasma total renin, active renin, angiotensinogen, and aldosterone levels. Urine total renin and angiotensinogen levels.OutcomesSodium output per doubling of diuretic dose and fractional excretion of sodium per doubling of diuretic dose.Analytical approachRobust linear regression models estimated the associations of each RAAS intermediate with outcomes.ResultsThe analysis included 56 participants, and the median age was 65 years; 50% were women, and 41% were Black. The median home diuretic dose was 80-mg furosemide equivalents. In unadjusted and multivariable-adjusted models, higher levels of RAAS measures were generally associated with lower diuretic efficiency. Higher plasma total renin remained significantly associated with lower sodium output per doubling of diuretic dose (β = -0.41 [-0.76, -0.059] per SD change) with adjustment; higher plasma total and active renin were significantly associated with lower fractional excretion of sodium per doubling of diuretic dose (β = -0.48 [-0.83, -0.14] and β = -0.51 [-0.95, -0.08], respectively) in adjusted models. Stratification by RAAS inhibitor use did not substantially alter these associations.LimitationsSmall sample size; highly selected participants; associations may not be causal.ConclusionsAmong multiple measures of RAAS activation, higher plasma total and active renin levels were consistently associated with lower diuretic response. These findings highlight the potential drivers of diuretic resistance and underscore the need for high-quality trials of decongestive therapy enhanced by RAAS blockade.

Published
2022

6. Empagliflozin in Heart Failure: Regional Nephron Sodium Handling Effects

Author

Rao, Veena S., Ivey-Miranda, Juan B., Cox, Zachary L., Moreno-Villagomez, Julieta, Maulion, Christopher, Bellumkonda, Lavanya, Chang, John, Field, M. Paul, Wiederin, Daniel R., Butler, Javed, Collins, Sean P., Turner, Jeffrey M., Wilson, F. Perry, Inzucchi, Silvio E., Wilcox, Christopher S., Ellison, David H., and Testani, Jeffrey M.

Published
2024
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7. Randomized controlled trial of urinE chemiStry guided aCute heArt faiLure treATmEnt (ESCALATE): Rationale and design

Author

Cox, Zachary L., Siddiqi, Hasan K., Stevenson, Lynne W., Bales, Brian, Han, Jin H., Hart, Kimberly, Imhoff, Brant, Ivey-Miranda, Juan B., Jenkins, Cathy A., Lindenfeld, JoAnn, Shotwell, Matthew S., Miller, Karen F., Ooi, Henry, Rao, Veena S., Schlendorf, Kelly, Self, Wesley H., Siew, Edward D., Storrow, Alan, Walsh, Ryan, Wrenn, Jesse O., Testani, Jeffrey M., and Collins, Sean P.

Published
2023
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9. Changes in the Inferior Vena Cava Are More Sensitive Than Venous Pressure During Fluid Removal: A Proof-of-Concept Study

Author

Posada-Martinez, EDITH L., COX, ZACHARY L., CANO-NIETO, MARIANA M., IBARRA-MARQUEZ, NIKEIN D., MORENO-VILLAGOMEZ, JULIETA, GUDIÑO-BRAVO, PEDRO, ARIAS-GODINEZ, JOSE A., LOPEZ-GIL, SALVADOR, MADERO, MAGDALENA, RAO, VEENA S., MEBAZAA, ALEXANDRE, BURKHOFF, DANIEL, COWIE, MARTIN R., FUDIM, MARAT, DAMMAN, KEVIN, BORLAUG, BARRY A., TESTANI, JEFFREY M., and IVEY-MIRANDA, JUAN B.

Published
2023
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10. Effect on Survival of Concurrent Hemoconcentration and Increase in Creatinine During Treatment of Acute Decompensated Heart Failure

Author

Griffin, Matthew, Rao, Veena S, Fleming, James, Raghavendra, Parinita, Turner, Jeffrey, Mahoney, Devin, Wettersten, Nicholas, Maisel, Alan, Ivey-Miranda, Juan B, Inker, Lesley, Tang, Wai Hong Wilson, Wilson, Francis Perry, and Testani, Jeffrey M

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Cardiovascular, Clinical Research, Acute Disease, Aged, Biomarkers, Creatinine, Diuretics, Female, Heart Failure, Hospital Mortality, Humans, Male, Prognosis, Retrospective Studies, Survival Rate, United States, Water-Electrolyte Imbalance, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

Hemoconcentration during the treatment of acute decompensated heart failure is a surrogate for plasma volume reduction and is associated with improved survival, but most definitions only allow for hemoconcentration to be determined retrospectively. An increase in serum creatinine can also be a marker of aggressive decongestion, but in isolation is not specific. Our objective was to determine if combined hemoconcentration and worsening creatinine could better identify patients that were aggressively treated and, as such, may have improved postdischarge outcomes. A total of 4,181 patients hospitalized with acute decompensated heart failure were evaluated. Those who experienced both hemoconcentration and worsening creatinine at any point had a profile consistent with aggressive in-hospital treatment and longer length of stay (p

Published
2019

11. First‐in‐Human Study to Assess the Safety, Pharmacokinetics, and Pharmacodynamics of BMS‐986308: A Renal Outer Medullary Potassium Channel Inhibitor.

Author

Soleman, Sharif I., Maya, Juan, Levesque, Paul, Mohammad, Atif, Christopher, Lisa, Schumacher, Justin, Nanduri, Aparna, Sivakumar, Pitchumani, Kozinn, Marc, Costet, Philippe, Wang, Chang, Richter, Jeremy, Hawthorne, Dara, Bui, Anh, Rao, Veena S., Dickerson, Daniel, Testani, Jeffrey, Ramírez‐Valle, Francisco, Baribaud, Frédéric, and Murthy, Bindu

Subjects
POTASSIUM antagonists, POTASSIUM channels, BODY mass index, HEART failure patients, DIURESIS
Abstract

In patients with heart failure (HF) who respond inadequately to loop diuretic therapy, BMS‐986308, an oral, selective, reversible renal outer medullary potassium channel (ROMK) inhibitor may represent an effective diuretic with a novel mechanism of action. We present data from the first‐in‐human study aimed to assess the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) following single ascending doses of BMS‐986308 in healthy adult participants. Forty healthy participants, aged from 20 to 55 years, and body mass index (BMI) from 19.8 to 31.6 kg/m2 were assigned to 1 of 5 dose cohorts (1, 3, 10, 30, and 100 mg) and randomized (6:2) to receive BMS‐986308 oral solution or matching placebo. Following administration, BMS‐986308 was rapidly absorbed with a median time to maximum concentration (Tmax) of 1.00 to 1.75 h and exhibiting a mean terminal half‐life (t1/2) of approximately 13 h. Dose proportionality was evident in BMS‐986308 area under the concentration‐time curve (AUC), while maximum concentration (Cmax) was slightly greater than dose‐proportional. We observed that urine output (or diuresis; mL) and urinary sodium excretion (or natriuresis; mmol) increased in a dose‐dependent manner, starting at a minimum pharmacologically active dose of 30 mg. The largest mean changes from baseline in diuresis and natriuresis occurred in both the 6‐ and −24 h post‐dose period following administration of 100 mg (1683.0 mL and 2055.3 mL, and 231.7 mmol and 213.7 mmol, respectively; ***P < 0.001). Overall, single‐dose BMS‐986308 was found to be safe, well‐tolerated, with an excellent PK profile, and substantial diuretic and natriuretic activity. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Increased Spironolactone Dosing in Acute Heart Failure Alters Potassium Homeostasis but Does not Enhance Decongestion.

Author

NATOV, PETER S., IVEY-MIRANDA, JUAN B., COX, ZACHARY L., RAO, VEENA S., BUTLER, JAVED, KONSTAM, MARVIN A., KIERNAN, MICHAEL S., KAPUR, NAVIN K., and TESTANI, JEFFREY M.

Abstract

• The ATHENA-HF clinical trial did not find additional decongestive benefit of spironolactone 100 mg/day for 96 hours in acute heart failure. • We performed a post hoc analysis of whether this spironolactone dosage had any pharmacodynamic effects. • We found that increased spironolactone dosing limited potassium losses in acute heart failure treatment and reduced the need for potassium replacement. • However, patients with acute heart failure and lower serum potassium levels did not experience greater decongestion with this intervention. The ATHENA-HF (Aldosterone Targeted Neurohormonal Combined with Natriuresis Therapy in Heart Failure) clinical trial found no improvements in natriuretic peptide levels or clinical congestion when spironolactone 100 mg/day for 96 hours was used in addition to usual treatment for acute heart failure. We performed a post hoc analysis of ATHENA-HF to determine whether spironolactone treatment induced any detectable pharmacodynamic effects and whether patients with potentially greater aldosterone activity experienced additional decongestion. Trial subjects previously treated with spironolactone were excluded. We first examined for changes in renal potassium handling. Using the baseline serum potassium level as a surrogate marker of spironolactone activity, we then divided each treatment arm into tertiles of baseline serum potassium and explored for differences in laboratory and clinical congestion outcomes. Among spironolactone-naïve patients, the change in serum potassium did not differ after 24 hours or 48 hours but was significantly greater with spironolactone treatment compared to placebo at 72 hours (0.23 ± 0.55 vs 0.03 ± 0.60 mEq/L; P = 0.042) and 96 hours (0.32 ± 0.51 vs 0.13 ± 0.72 mEq/L; P = 0.046). Potassium supplementation was similar at treatment start and at 24 hours, but spironolactone-treated patients required substantially less potassium replacement at 48 hours (24% vs 36%; P = 0.048), 72 hours (21% vs 37%; P = 0.013), and 96 hours (11% vs 38%; P < 0.001). When the treatment arms were divided into tertiles of baseline serum potassium, there were no differences in the 96-hour log N-terminal pro-B-type natriuretic peptide levels, net fluid loss, urine output, or dyspnea relief in any of the potassium groups, with no effect modification by treatment exposure. Spironolactone 100 mg/day for 96 hours in patients receiving intravenous loop diuresis for acute heart failure has no clear added decongestive ability but does meaningfully limit potassium wasting. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Mechanistic Differences between Torsemide and Furosemide

Author

Rao, Veena S., Cox, Zachary L., Ivey-Miranda, Juan B., Neville, Daniel, Balkcom, Natasha, Moreno-Villagomez, Julieta, Ramos-Mastache, Daniela, Maulion, Christopher, Bellumkonda, Lavanya, Tang, W.H. Wilson, Collins, Sean P., Velazquez, Eric J., Mentz, Robert J., Wilson, F. Perry, Turner, Jeffrey M., Wilcox, Christopher S., Ellison, David H., Fang, James C., and Testani, Jeffrey M.

Published
2025
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17. Serial direct sodium removal in patients with heart failure and diuretic resistance

Author

Rao, Veena S., primary, Ivey‐Miranda, Juan B., additional, Cox, Zachary L., additional, Moreno‐Villagomez, Julieta, additional, Ramos‐Mastache, Daniela, additional, Neville, Daniel, additional, Balkcom, Natasha, additional, Asher, Jennifer L., additional, Bellumkonda, Lavanya, additional, Bigvava, Tamar, additional, Shaburishvili, Tamaz, additional, Bartunek, Jozef, additional, Wilson, F. Perry, additional, Finkelstein, Fredrick, additional, Maulion, Christopher, additional, Turner, Jeffrey M., additional, and Testani, Jeffrey M., additional

Published
2024
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19. Empagliflozin in Heart Failure: Regional Nephron Sodium Handling Effects

Author

Rao, Veena S., primary, Ivey-Miranda, Juan B., additional, Cox, Zachary L., additional, Moreno-Villagomez, Julieta, additional, Maulion, Christopher, additional, Bellumkonda, Lavanya, additional, Chang, John, additional, Field, M. Paul, additional, Wiederin, Daniel R., additional, Butler, Javed, additional, Collins, Sean P., additional, Turner, Jeffrey M., additional, Wilson, F. Perry, additional, Inzucchi, Silvio E., additional, Wilcox, Christopher S., additional, Ellison, David H., additional, and Testani, Jeffrey M., additional

Published
2023
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21. Empagliflozin in Heart Failure: Diuretic and Cardiorenal Effects

Author

Griffin, Matthew, Rao, Veena S., Ivey-Miranda, Juan, Fleming, James, Mahoney, Devin, Maulion, Christopher, Suda, Nisha, Siwakoti, Krishmita, Ahmad, Tariq, Jacoby, Daniel, Riello, Ralph, Bellumkonda, Lavanya, Cox, Zachary, Collins, Sean, Jeon, Sangchoon, Turner, Jeffrey M., Wilson, F. Perry, Butler, Javed, Inzucchi, Silvio E., and Testani, Jeffrey M.

Published
2020
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28. In-Hospital Observation on Oral Diuretics After Treatment for Acute Decompensated Heart Failure: Evaluating the Utility

Author

Ivey-Miranda, Juan B., primary, Rao, Veena S., additional, Cox, Zachary L., additional, Moreno-Villagomez, Julieta, additional, Mahoney, Devin, additional, Maulion, Christopher, additional, Bellumkonda, Lavanya, additional, Turner, Jeffrey M., additional, Collins, Sean, additional, Wilson, F. Perry, additional, Krumholz, Harlan M., additional, and Testani, Jeffrey M., additional

Published
2023
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33. Sodium restriction in patients with chronic heart failure and reduced ejection fraction: A randomized controlled trial.

Author

Ivey-Miranda, Juan B., Almeida-Gutierrez, Eduardo, Herrera-Saucedo, Raul, Posada-Martinez, Edith L., Chavez-Mendoza, Adolfo, Mendoza-Zavala, Genaro H., Cigarroa-Lopez, Jose A., Magaña-Serrano, Jose A., Rivera-Leaños, Roxana, Treviño-Mejia, Alberto, Revilla-Monsalve, Cristina, Flores-Umanzor, Eduardo J., Espinola-Zavaleta, Nilda, Orea-Tejeda, Arturo, Garduño-Espinosa, Juan, Saturno-Chiu, Guillermo, Rao, Veena S., Testani, Jeffrey M., and Borrayo-Sanchez, Gabriela

Published
2023
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35. Hemoconcentration of Creatinine Minimally Contributes to Changes in Creatinine during the Treatment of Decompensated Heart Failure

Author

Maulion, Christopher, primary, Chen, Sheldon, additional, Rao, Veena S., additional, Ivey-Miranda, Juan B., additional, Cox, Zachary L., additional, Mahoney, Devin, additional, Coca, Steven G., additional, Negoianu, Dan, additional, Asher, Jennifer L., additional, Turner, Jeffrey M., additional, Inker, Lesley A., additional, Wilson, F. Perry, additional, and Testani, Jeffrey M., additional

Published
2022
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38. Changes in inferior vena cava area represent a more sensitive metric than changes in filling pressures during experimental manipulation of intravascular volume and tone

Author

Ivey‐Miranda, Juan B., primary, Wetterling, Friedrich, additional, Gaul, Robert, additional, Sheridan, Stephen, additional, Asher, Jennifer L., additional, Rao, Veena S., additional, Maulion, Christopher, additional, Mahoney, Devin, additional, Mebazaa, Alexandre, additional, Gray, Alastair P., additional, Burkhoff, Daniel, additional, Cowie, Martin R., additional, Cox, Zachary L., additional, Butler, Javed, additional, Fudim, Marat, additional, McDonald, Kenneth, additional, Damman, Kevin, additional, Borlaug, Barry A., additional, and Testani, Jeffrey M., additional

Published
2022
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39. FGF-23 (Fibroblast Growth Factor-23) and Cardiorenal Interactions

Author

Ivey-Miranda, Juan B., primary, Stewart, Brendan, additional, Cox, Zachary L., additional, McCallum, Wendy, additional, Maulion, Christopher, additional, Gleason, Olyvia, additional, Meegan, Grace, additional, Amatruda, Jonathan G., additional, Moreno-Villagomez, Julieta, additional, Mahoney, Devin, additional, Turner, Jeffrey M., additional, Wilson, F. Perry, additional, Estrella, Michelle M., additional, Shlipak, Michael G., additional, Rao, Veena S., additional, and Testani, Jeffrey M., additional

Published
2021
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41. Renal negative pressure treatment as a novel therapy for heart failure-induced renal dysfunction

Author

Rao, Veena S., primary, Maulion, Christopher, additional, Asher, Jennifer L., additional, Ivey-Miranda, Juan B., additional, Cox, Zachary L., additional, Moreno-Villagomez, Julieta, additional, Mahoney, Devin, additional, Turner, Jeffrey M., additional, Wilson, F. Perry, additional, Wilcox, Christopher S., additional, and Testani, Jeffrey M., additional

Published
2021
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42. Compensatory post-diuretic renal sodium reabsorption is not a dominant mechanism of diuretic resistance in acute heart failure

Author

Cox, Zachary L, primary, Rao, Veena S, additional, Ivey-Miranda, Juan B, additional, Moreno-Villagomez, Julieta, additional, Mahoney, Devin, additional, Ponikowski, Piotr, additional, Biegus, Jan, additional, Turner, Jeffrey M, additional, Maulion, Christopher, additional, Bellumkonda, Lavanya, additional, Asher, Jennifer L, additional, Parise, Helen, additional, Wilson, Perry F, additional, Ellison, David H, additional, Wilcox, Christopher S, additional, and Testani, Jeffrey M, additional

Published
2021
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43. Sodium restriction in patients with chronic heart failure and reduced ejection fraction: A randomized controlled trial

Author

Ivey-Miranda, Juan Betuel, primary, Almeida-Gutierrez, Eduardo, additional, Herrera-Saucedo, Raul, additional, Posada-Martinez, Edith Liliana, additional, Chavez-Mendoza, Adolfo, additional, Mendoza-Zavala, Genaro Hiram, additional, Cigarroa-Lopez, Jose Angel, additional, Magaña-Serrano, Jose Antonio, additional, Rivera-Leaños, Roxana, additional, Treviño-Mejia, Alberto, additional, Revilla-Matute, Cristina, additional, Flores-Umanzor, Eduardo Josue, additional, Espinola-Zavaleta, Nilda, additional, Orea-Tejeda, Arturo, additional, Garduño-Espinosa, Juan, additional, Saturno-Chiu, Guillermo, additional, Rao, Veena S, additional, Testani, Jeffrey Moore, additional, and Borrayo-Sanchez, Gabriela, additional

Published
2021
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47. Reply

Author

Rao, Veena S., primary, Ivey-Miranda, Juan B., additional, Cox, Zachary L., additional, and Testani, Jeffrey M., additional

Published
2021
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48. Natriuretic Equation to Predict Loop Diuretic Response in Patients With Heart Failure

Author

Rao, Veena S., primary, Ivey-Miranda, Juan B., additional, Cox, Zachary L., additional, Riello, Ralph, additional, Griffin, Matthew, additional, Fleming, James, additional, Soucier, Richard, additional, Sangkachand, Prasama, additional, O’Brien, Margaret, additional, LoRusso, Francine, additional, D’Ambrosi, Julie, additional, Churchwell, Keith, additional, Mahoney, Devin, additional, Bellumkonda, Lavanya, additional, Asher, Jennifer L., additional, Maulion, Christopher, additional, Turner, Jeffrey M., additional, Wilson, F. Perry, additional, Collins, Sean P., additional, and Testani, Jeffrey M., additional

Published
2021
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