Roman F Kind, Michael Furian, Aline Buergin, Philipp M Scheiwiller, Laura Mayer, Simon R Schneider, Mona Lichtblau, Lara Muralt, Maamed Mademilov, Talant M Sooronbaev, Silvia Ulrich, Konrad E Bloch
{"title":"乙酰唑胺对高原COPD患者运动表现的影响:随机对照试验。","authors":"Roman F Kind, Michael Furian, Aline Buergin, Philipp M Scheiwiller, Laura Mayer, Simon R Schneider, Mona Lichtblau, Lara Muralt, Maamed Mademilov, Talant M Sooronbaev, Silvia Ulrich, Konrad E Bloch","doi":"10.1183/23120541.00767-2024","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In patients with COPD, preventive treatment with acetazolamide reduces adverse health effects during altitude travel. We investigated whether preventive acetazolamide treatment modifies exercise performance in COPD patients going to high altitude.</p><p><strong>Methods: </strong>In this randomised, double-blind trial, lowlanders with COPD, forced expiratory volume in 1 s (FEV<sub>1</sub>) 40-80% predicted, were assigned to acetazolamide (375 mg per 24 h) or placebo treatment starting 24 h before ascent and while staying at 3100 m. Patients performed progressive cycling exercise to exhaustion at 760 m, before taking the study drug, and within 4 h after arrival at 3100 m. The primary outcome was the maximal power output (W<sub>max</sub>).</p><p><strong>Results: </strong>103 patients (32 women), mean±sd age 57.2±8.1 years, FEV<sub>1</sub> 66±11% predicted, were included in per-protocol analyses. In 53 patients receiving acetazolamide, W<sub>max</sub> and oxygen uptake (<i>V</i>'<sub>O<sub>2</sub></sub> <sub>max</sub>) at 760 m and 3100 m were 105±27 and 91±25 W, and 18.0±4.8 and 15.5±3.7 mL·min<sup>-1</sup>·kg<sup>-1</sup> (p<0.001, both changes). Corresponding W<sub>max</sub> and <i>V</i>'<sub>O<sub>2</sub></sub> <sub>max</sub> in 50 patients receiving placebo were 107±34 and 97±28 W, and 18.9±6.0 and 17.2±5.0 mL·min<sup>-1</sup>·kg<sup>-1</sup> (p<0.001, both changes). Between-group differences (95% CI) in altitude-induced W<sub>max</sub> changes were -3.0 W (-8.7 to +2.7, p=0.305) and in <i>V</i>'<sub>O<sub>2</sub></sub> <sub>max</sub> changes were -0.8 mL·min<sup>-1</sup>·kg<sup>-1</sup> (-2.1 to +0.5, p=0.213). Acetazolamide mitigated the altitude-induced reduction of <i>P</i> <sub>aO<sub>2</sub></sub> by 0.7 kPa (0.1 to 1.3, p=0.016). At 3100 m, maximal work rate with respiratory exchange ratio ≤1 was greater with acetazolamide than with placebo by 10.1 W (4.0 to 16.2, p=0.022).</p><p><strong>Conclusions: </strong>In lowlanders with COPD, preventive treatment with acetazolamide did not modify the altitude-induced reduction in maximal work rate. However, acetazolamide enhanced arterial oxygenation and submaximal, moderate-intensity work capacity compared with placebo.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 1","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744325/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effects of acetazolamide on exercise performance in patients with COPD going to high altitude: randomised controlled trial.\",\"authors\":\"Roman F Kind, Michael Furian, Aline Buergin, Philipp M Scheiwiller, Laura Mayer, Simon R Schneider, Mona Lichtblau, Lara Muralt, Maamed Mademilov, Talant M Sooronbaev, Silvia Ulrich, Konrad E Bloch\",\"doi\":\"10.1183/23120541.00767-2024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In patients with COPD, preventive treatment with acetazolamide reduces adverse health effects during altitude travel. We investigated whether preventive acetazolamide treatment modifies exercise performance in COPD patients going to high altitude.</p><p><strong>Methods: </strong>In this randomised, double-blind trial, lowlanders with COPD, forced expiratory volume in 1 s (FEV<sub>1</sub>) 40-80% predicted, were assigned to acetazolamide (375 mg per 24 h) or placebo treatment starting 24 h before ascent and while staying at 3100 m. Patients performed progressive cycling exercise to exhaustion at 760 m, before taking the study drug, and within 4 h after arrival at 3100 m. The primary outcome was the maximal power output (W<sub>max</sub>).</p><p><strong>Results: </strong>103 patients (32 women), mean±sd age 57.2±8.1 years, FEV<sub>1</sub> 66±11% predicted, were included in per-protocol analyses. In 53 patients receiving acetazolamide, W<sub>max</sub> and oxygen uptake (<i>V</i>'<sub>O<sub>2</sub></sub> <sub>max</sub>) at 760 m and 3100 m were 105±27 and 91±25 W, and 18.0±4.8 and 15.5±3.7 mL·min<sup>-1</sup>·kg<sup>-1</sup> (p<0.001, both changes). Corresponding W<sub>max</sub> and <i>V</i>'<sub>O<sub>2</sub></sub> <sub>max</sub> in 50 patients receiving placebo were 107±34 and 97±28 W, and 18.9±6.0 and 17.2±5.0 mL·min<sup>-1</sup>·kg<sup>-1</sup> (p<0.001, both changes). Between-group differences (95% CI) in altitude-induced W<sub>max</sub> changes were -3.0 W (-8.7 to +2.7, p=0.305) and in <i>V</i>'<sub>O<sub>2</sub></sub> <sub>max</sub> changes were -0.8 mL·min<sup>-1</sup>·kg<sup>-1</sup> (-2.1 to +0.5, p=0.213). Acetazolamide mitigated the altitude-induced reduction of <i>P</i> <sub>aO<sub>2</sub></sub> by 0.7 kPa (0.1 to 1.3, p=0.016). At 3100 m, maximal work rate with respiratory exchange ratio ≤1 was greater with acetazolamide than with placebo by 10.1 W (4.0 to 16.2, p=0.022).</p><p><strong>Conclusions: </strong>In lowlanders with COPD, preventive treatment with acetazolamide did not modify the altitude-induced reduction in maximal work rate. However, acetazolamide enhanced arterial oxygenation and submaximal, moderate-intensity work capacity compared with placebo.</p>\",\"PeriodicalId\":11739,\"journal\":{\"name\":\"ERJ Open Research\",\"volume\":\"11 1\",\"pages\":\"\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-01-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744325/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ERJ Open Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1183/23120541.00767-2024\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ERJ Open Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1183/23120541.00767-2024","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Effects of acetazolamide on exercise performance in patients with COPD going to high altitude: randomised controlled trial.
Background: In patients with COPD, preventive treatment with acetazolamide reduces adverse health effects during altitude travel. We investigated whether preventive acetazolamide treatment modifies exercise performance in COPD patients going to high altitude.
Methods: In this randomised, double-blind trial, lowlanders with COPD, forced expiratory volume in 1 s (FEV1) 40-80% predicted, were assigned to acetazolamide (375 mg per 24 h) or placebo treatment starting 24 h before ascent and while staying at 3100 m. Patients performed progressive cycling exercise to exhaustion at 760 m, before taking the study drug, and within 4 h after arrival at 3100 m. The primary outcome was the maximal power output (Wmax).
Results: 103 patients (32 women), mean±sd age 57.2±8.1 years, FEV1 66±11% predicted, were included in per-protocol analyses. In 53 patients receiving acetazolamide, Wmax and oxygen uptake (V'O2max) at 760 m and 3100 m were 105±27 and 91±25 W, and 18.0±4.8 and 15.5±3.7 mL·min-1·kg-1 (p<0.001, both changes). Corresponding Wmax and V'O2max in 50 patients receiving placebo were 107±34 and 97±28 W, and 18.9±6.0 and 17.2±5.0 mL·min-1·kg-1 (p<0.001, both changes). Between-group differences (95% CI) in altitude-induced Wmax changes were -3.0 W (-8.7 to +2.7, p=0.305) and in V'O2max changes were -0.8 mL·min-1·kg-1 (-2.1 to +0.5, p=0.213). Acetazolamide mitigated the altitude-induced reduction of PaO2 by 0.7 kPa (0.1 to 1.3, p=0.016). At 3100 m, maximal work rate with respiratory exchange ratio ≤1 was greater with acetazolamide than with placebo by 10.1 W (4.0 to 16.2, p=0.022).
Conclusions: In lowlanders with COPD, preventive treatment with acetazolamide did not modify the altitude-induced reduction in maximal work rate. However, acetazolamide enhanced arterial oxygenation and submaximal, moderate-intensity work capacity compared with placebo.
期刊介绍:
ERJ Open Research is a fully open access original research journal, published online by the European Respiratory Society. The journal aims to publish high-quality work in all fields of respiratory science and medicine, covering basic science, clinical translational science and clinical medicine. The journal was created to help fulfil the ERS objective to disseminate scientific and educational material to its members and to the medical community, but also to provide researchers with an affordable open access specialty journal in which to publish their work.