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N/A N=29 Randomized Double-blind Basic Science

Predicting Successful Sleep Apnea Treatment With Acetazolamide in Heart Failure Patients

Heart Failures

Enrolled (actual)
29
Serious AEs
0.0%
Results posted
Jun 2018
Primary outcome: Primary: The Severity of Sleep Disordered Breathing (Apnea-hypopnea Index, AHI) — 26.3; 36.1; 32.3; 44.6 events per hour

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Acetazolamide (Drug); Placebo (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
David Andrew Wellman
Primary completion
Dec 2016

Outcome Measures

OutcomeResultp-value
PRIMARY
The Severity of Sleep Disordered Breathing (Apnea-hypopnea Index, AHI)
26.3; 36.1; 32.3; 44.6
SECONDARY
Ventilatory Chemoreflex Sensitivity, "Loop Gain" Using Carbon Dioxide Pulses
0.40; 0.49
SECONDARY
Sympathetic Activity (Urinary Norepinephrine)
40.8; 35.0
SECONDARY
Left-atrial Volume
34.3; 40.0
SECONDARY
Brain Natriuretic Peptide (NT-proBNP)
919; 932
SECONDARY
Pittsburgh Sleep Quality Index
6.7; 7.5

Summary

The ultimate goal is to improve our understanding of the pathophysiology and resistance to effective treatment of sleep disordered breathing in patients with heart failure, with a focus on selecting patients that will benefit specifically from acetazolamide treatment. The study addresses three primary hypotheses: 1) Acetazolamide treatment will reduce the apnea-hypopnea index and improve markers of heart-failure severity in heart-failure patients with sleep apnea. 2) Acetazolamide will provide the greatest improvement in patients with the most severe ventilatory control instability (strongest chemoreflex response to carbon dioxide; highest loop gain). 3) Acetazolamide will act primarily via stabilizing ventilatory control (reducing loop gain), rather than via improvement to upper airway anatomy, pulmonary congestion, and cardiac function.

Eligibility Criteria

Inclusion Criteria (Heart failure patients)

  • Left ventricular ejection fraction (EF) <50%, or heart failure with preserved EF
  • Age 18-89

Exclusion Criteria

  • severe obstructive respiratory disease
  • unstable heart failure status
  • recent use of positive airway pressure therapy
  • current use of opioids, benzodiazepines
  • severe kidney disease
  • severe anemia
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01377987). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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