Use of Acetazolamide in People with Decompensated Heart Failure: A Systematic Review and Meta-Analysis.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Cardiology Reports Pub Date : 2025-06-23 DOI:10.1007/s11886-025-02257-0

Johana Elizabeth Erazo-Castillo, Juan Camilo Ramos-Picón, Johana Patricia Galván-Barrios, Yelson Alejandro Picón-Jaimes

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Abstract

Introduction: Acetazolamide is used in heart failure to improve diuresis and reduce volume overload. It acts as a diuretic in the proximal tubule, inhibiting the reabsorption of bicarbonate, water, and sodium.

Methods: A systematic review with meta-analysis of studies between 2014 and 2024 was conducted to evaluate the efficacy of Acetazolamide in decompensated heart failure compared to other drugs. Observational studies and clinical trials were considered. Searches were conducted in Medline, Scopus, Web of Science, CENTRAL and the World Health Organization clinical trials registry. A sensitivity analysis was performed for each outcome.

Results: The addition of Acetazolamide to standard diuretic treatment in patients with heart failure produces greater diuretic efficiency, a reduction in fluid balance, and a promotion of sodium loss. A decrease in Pro-BNP-NT levels and an improvement in volume overload symptoms have also been observed. The most notable result was natriuresis, where a mean difference in favour of Acetazolamide was observed: MD of 56.98 with a 95% CI (27.7-86.2).

Conclusions: Acetazolamide may be an effective option for managing congestion in patients with heart failure, improving the signs and symptoms of volume overload. Its effect on mean diuresis is comparable to or slightly higher than that observed with other diuretics. In addition, it induces favourable changes in sodium excretion, optimizing the management of electrolyte balance.

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乙酰唑胺在失代偿性心力衰竭患者中的应用：一项系统综述和荟萃分析。

简介：乙酰唑胺用于心力衰竭，以改善利尿和减少容量过载。它在近端小管中起利尿剂的作用，抑制碳酸氢盐、水和钠的重吸收。方法：对2014年至2024年的研究进行系统回顾和荟萃分析，评价乙酰唑胺与其他药物相比对失代偿性心力衰竭的疗效。考虑了观察性研究和临床试验。在Medline、Scopus、Web of Science、CENTRAL和世界卫生组织临床试验登记处进行了检索。对每个结果进行敏感性分析。结果：在心力衰竭患者的标准利尿治疗中加入乙酰唑胺可提高利尿效率，降低体液平衡，促进钠流失。还观察到Pro-BNP-NT水平的降低和容量过载症状的改善。最显著的结果是尿钠，其中乙酰唑胺的平均差异为：MD为56.98,95% CI（27.7-86.2）。结论：乙酰唑胺可能是治疗心力衰竭患者充血的有效选择，可改善容量过载的体征和症状。它对平均利尿的作用与其他利尿剂相当或略高。此外，它诱导钠排泄的有利变化，优化电解质平衡的管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Cardiology Reports CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.20

自引率

2.70%

发文量

209

期刊介绍： The aim of this journal is to provide timely perspectives from experts on current advances in cardiovascular medicine. We also seek to provide reviews that highlight the most important recently published papers selected from the wealth of available cardiovascular literature. We accomplish this aim by appointing key authorities in major subject areas across the discipline. Section editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.