Acetazolamide effects on natriuresis and diuresis in acute heart failure treated with furosemide and SGLT2i (SANDI)
Por:
González, JG, Magaña, JG, Llàcer, P, Pal, AF, Trullàs, JC, Zegrí-Reiriz, I, Díez-Villanueva, P, Fernandez, AE, Manzano, LP, Fernández, ABM, Pérez, PC, López-Azor, JC, Martínez, R, D'Amato, M, Pascual, CF, Ruiz-Ruiz, E, Pisón, EP, Anter, MB, Marcos, MC
Publicada:
1 abr 2026
Resumen:
Aims Early adjunctive therapy with intravenous acetazolamide in combination with loop diuretics has been shown to enhance decongestion in acute heart failure (AHF). However, patients receiving sodium-glucose cotransporter-2 inhibitors (SGLT2i) were excluded from previous acetazolamide trials, and the efficacy of this combination remains unknown. This study aims to evaluate the natriuretic and diuretic effects of acetazolamide in patients with AHF treated with intravenous furosemide and concomitant SGLT2i therapy.Methods The SANDI study is a prospective, multicentre, observational study enrolling 64 patients hospitalized with AHF and clinical signs of congestion. All participants will receive intravenous loop diuretics and an SGLT2i within the first 24 h of admission. If congestion persists 24 h after SGLT2i initiation, intravenous acetazolamide will be administered up to 2 consecutive days. The primary endpoint is the change in natriuresis within the first 24 h following acetazolamide administration. Secondary endpoints include changes in diuresis, body weight, ADVOR clinical congestion score, and ultrasound-based congestion parameters.Conclusion The SANDI study will determine whether adding acetazolamide to intravenous furosemide and SGLT2i enhances early natriuresis and diuresis in patients with AHF and persistent congestion.
Filiaciones:
González, JG:
Hosp Univ Puerta Hierro, Dept Cardiol, C Joaquin Rodrigo 2, Madrid 28222, Spain
Magaña, JG:
Hosp Univ Cent Def Gomez Ulla, Dept Cardiol, Madrid, Spain
Llàcer, P:
Hosp Univ Ramon y Cajal, Dept Internal Med, IRYCIS, Madrid, Spain
Univ Alcala, Fac Med & Ciencias Salud, Dept Med & Med Specialties, Madrid, Spain
Pal, AF:
Hosp Univ Girona Doctor Josep Trueta, Dept Cardiol, Girona, Spain
Trullàs, JC:
Hosp Olot I Comarcal Garrotxa, Dept Internal Med, Girona, Spain
Cent Univ Catalonia UV UCC, Inst Res & Innovat Life & Hlth Sci Cent Catalonia, Tissue Repair & Regenerat Lab TR2Lab, Univ Vic,Fac Med, Barcelona, Spain
Zegrí-Reiriz, I:
Hosp Santa Creu & Sant Pau, Dept Pediat, Barcelona, Spain
Díez-Villanueva, P:
Hosp Univ Princesa, Dept Cardiol, Madrid, Spain
Fernandez, AE:
Hosp Univ Severo Ochoa, Dept Cardiol, Madrid, Spain
Manzano, LP:
Hosp Univ Virgen Nieves, Dept Cardiol, Granada, Spain
Fernández, ABM:
Hosp Univ Vall dHebron, Dept Cardiol, Barcelona, Spain
Pérez, PC:
Hosp Clin Barcelona, Dept Cardiol, Barcelona, Spain
López-Azor, JC:
Hosp Univ Puerta Hierro, Dept Cardiol, C Joaquin Rodrigo 2, Madrid 28222, Spain
Martínez, R:
Hosp Univ Puerta Hierro, Dept Cardiol, C Joaquin Rodrigo 2, Madrid 28222, Spain
D'Amato, M:
Hosp Univ Cent Def Gomez Ulla, Dept Cardiol, Madrid, Spain
Pascual, CF:
Hosp Univ Cent Def Gomez Ulla, Dept Cardiol, Madrid, Spain
Ruiz-Ruiz, E:
Hosp Olot I Comarcal Garrotxa, Dept Internal Med, Girona, Spain
Pisón, EP:
Hosp Univ Ramon y Cajal, Dept Internal Med, IRYCIS, Madrid, Spain
Univ Alcala, Fac Med & Ciencias Salud, Dept Med & Med Specialties, Madrid, Spain
Anter, MB:
Hosp Univ Girona Doctor Josep Trueta, Dept Cardiol, Girona, Spain
Marcos, MC:
Hosp Univ Puerta Hierro, Dept Cardiol, C Joaquin Rodrigo 2, Madrid 28222, Spain
Ctr Invest Biomed Red CIBER Cardiovasc, Madrid, Spain
Green Submitted, gold
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