Predicting Successful Sleep Apnea Treatment With Acetazolamide in Heart Failure Patients
| Status: | Completed |
|---|---|
| Conditions: | Insomnia Sleep Studies, Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 89 |
| Updated: | 6/15/2018 |
| Start Date: | August 2011 |
| End Date: | December 2016 |
Physiological Study to Predict Successful Sleep Apnea Treatment With Acetazolamide in Heart Failure Patients
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.
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.
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
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