Erazo-Castillo Johana Elizabeth, Ramos-Picón Juan Camilo, Galván-Barrios Johana Patricia, Picón-Jaimes Yelson Alejandro
Emssanar, Pasto, Colombia.
National University of Colombia, Bogotá, Colombia.
Curr Cardiol Rep. 2025 Jun 23;27(1):99. doi: 10.1007/s11886-025-02257-0.
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.
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.
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).
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.
乙酰唑胺用于治疗心力衰竭，以增强利尿作用并减轻容量超负荷。它在近端小管中作为利尿剂发挥作用，抑制碳酸氢盐、水和钠的重吸收。
进行了一项系统评价并对2014年至2024年期间的研究进行荟萃分析，以评估与其他药物相比，乙酰唑胺在失代偿性心力衰竭中的疗效。纳入观察性研究和临床试验。检索了Medline、Scopus、科学网、Cochrane系统评价数据库和世界卫生组织临床试验注册库。对每个结局进行了敏感性分析。
在心力衰竭患者的标准利尿治疗中加用乙酰唑胺可提高利尿效率，减少液体平衡，并促进钠流失。还观察到N末端脑钠肽前体（Pro-BNP-NT）水平降低和容量超负荷症状改善。最显著的结果是利钠作用，观察到有利于乙酰唑胺的平均差异：平均差为56.98，95%置信区间为（27.7-86.2）。
乙酰唑胺可能是治疗心力衰竭患者充血、改善容量超负荷体征和症状的有效选择。其对平均利尿作用的效果与其他利尿剂相当或略高。此外，它可引起钠排泄的有利变化，优化电解质平衡的管理。
