{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:10:09Z","timestamp":1791245409207,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Acetazolamide has been used to attenuate Hunter-Cheyne-Stokes breathing with central sleep apnea (CSA) associated with heart failure. However, the mechanisms underlying this improvement remain to be fully elucidated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We hypothesized that acetazolamide stabilizes CSA by attenuating the ventilatory sensitivity to CO2, which is increased in patients with heart failure and is thought to be the major mechanism mediating CSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six consecutive male patients with stable systolic heart failure and CSA (apnea-hypopnea index [AHI] \u2265 15 episodes\/h) were randomized to a double-blind crossover protocol with acetazolamide or placebo received 1 hour before bedtime for six nights with 2 weeks of wash-out. Under both conditions, we measured the hypercapnic ventilatory response (HCVR), arterial blood Pco \u00a02, steady-state metabolic CO2 production, overnight attended polysomnography, and also assessed cardiac and pulmonary function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Compared with placebo, acetazolamide significantly decreased the AHI (65 \u00b1 32 vs. 31 \u00b1 19 events\/h, mean \u00b1 SD). Acetazolamide increased the HCVR slope by 55% (3.3 \u00b1 1.7 vs. 5.1 \u00b1 2.4 L\/min\/mm Hg; P = 0.03), an increase that far exceeded the 12% fall in arterial Pco \u00a02 (P = 0.02). The acetazolamide-induced change in the balance of these effects (\u0394HCVR \u00d7 Pco \u00a02) was inversely associated with the reduction in AHI (r = 0.8; P = 0.045).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This placebo-controlled study indicates that acetazolamide improves CSA in patients with heart failure despite an increase in the slope of the HCVR. However, because the degree of HCVR elevation inhibits the improvement in unstable breathing, an increased CO2 chemosensitivity may be a key mechanism underlying an incomplete resolution of CSA with acetazolamide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.201306-201oc","type":"journal-article","created":{"date-parts":[[2014,2,14]],"date-time":"2014-02-14T10:04:54Z","timestamp":1392372294000},"page":"80-86","source":"Crossref","is-referenced-by-count":59,"title":["Acetazolamide Attenuates Hunter-Cheyne-Stokes Breathing but Augments the Hypercapnic Ventilatory Response in Patients with Heart Failure"],"prefix":"10.1093","volume":"11","author":[{"given":"Shahrokh","family":"Javaheri","sequence":"first","affiliation":[{"name":"Pulmonary Service, Department of Veterans Affairs Medical Center, and Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott 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