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Acetazolamide in the Cheyne—Stokes Respiration Therapy in Patients with Chronic Heart Failure: A Pilot Randomized Study

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Abstract

The long-lasting efficacy of the diuretic acetazolamide in the therapy of Cheyne–Stokes respiration (CSR) was assessed in the pilot study in patients with chronic heart failure (СHF) and reduced left ventricular ejection fraction (LVEF). A cohort of 21 patients included in the study had stable CHF II to IV functional class (according to NYHA) and CSR. All patients passed standard clinical-laboratory examinations, the arterial blood gas test, and cardiorespiratory monitoring during sleep. The subjects were randomized into two groups. Patients in the intervention group (n = 10) received a standard medical therapy in combination with a 250-mg dose of acetazolamide once a day while those in the control group (n = 11) received only a standard therapy. The observational period comprised 12 months. The mean apnea-hypopnea index (AHI) in the intervention group decreased significantly after 3 months from 32 to 13 (р = 0.005). No significant changes were observed in AHI in the control group. A statistically significant decrease (from 7.43 to 7.39; p = 0.007) in pH was recorded in the acetazolamide group. During further observation, 1 patient (10%) in the acetazolamide group and 4 patients (36.4%) in the control group died (the difference is nonsignificant). Treatment with acetazolamide at a daily dose of 250 mg significantly reduces the severity of CSR in patients with CHF. Acetazolamide may be recommended for the CSR therapy in patients with CHF.

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Authors and Affiliations

  1. Sechenov First Moscow State Medical University (Sechenov University), 119435, Moscow, Russia

    K. V. Sorokina, M. G. Poltavskaya, A. D. Palman, M. D. Kuklina, K. Yu. Kharkevich, A. D. Andreev, V. M. Kulikov & V. P. Sedov

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  1. K. V. Sorokina
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  2. M. G. Poltavskaya
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  3. A. D. Palman
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  4. M. D. Kuklina
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  5. K. Yu. Kharkevich
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  6. A. D. Andreev
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  7. V. M. Kulikov
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  8. V. P. Sedov
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Correspondence to K. V. Sorokina.

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COMPLIANCE WITH ETHICAL STANDARDS

The protocol of the study corresponds to the Helsinki Declaration recommentations and the principles of biomedical ethics and was approved by the local committee on ethics of the Sechenov First Moscow State University of RF Ministry of Health (Sechenov University), Moscow, Russia.

CONFLICT OF INTEREST

The authors declare the absence of evident and potential conflicts of interests associated with the publication of this article.

INFORMED CONSENT

Each participant of the study gave his/her voluntary written informed consent signed after informing him/her about potential risks and advantages, as well as about the nature of the upcoming study .

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Translated by N. Tarasyuk

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Sorokina, K.V., Poltavskaya, M.G., Palman, A.D. et al. Acetazolamide in the Cheyne—Stokes Respiration Therapy in Patients with Chronic Heart Failure: A Pilot Randomized Study. Hum Physiol 48, 78–85 (2022). https://doi.org/10.1134/S0362119721060104

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  • DOI: https://doi.org/10.1134/S0362119721060104

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