Acetazolamide in Decompensated Heart Failure with Volume Overload trial (<scp>ADVOR</scp>): baseline characteristics

Mullens, Wilfried; Dauw, Jeroen; Martens, Pieter; Meekers, Evelyne; Nijst, Petra; Verbrugge, Frederik H.; Chenot, Fabien; Moubayed, Samer; Dierckx, Riet; Blouard, Philippe; Derthoo, David; Smolders, Walter; Ector, Bavo; Hulselmans, Michaël; Lochy, Stijn; Raes, David; Craenenbroeck, Emeline Van; Vandekerckhove, Hans; Hofkens, Pieter-Jan; Goossens, Kathleen; Pouleur, Anne‐Catherine; Ceuninck, Michel De; Gabriël, Laurence; Timmermans, Philippe; Prihadi, Edgard A.; Durme, Frederik Van; Depauw, Michel; Vervloet, Delphine; Viaene, Els; Vachiéry, Jean‐Luc; Tartaglia, Katrien; Maaten, Jozine M. ter; Bruckers, Liesbeth; Droogné, Walter; Troisfontaines, Pierre; Damman, Kevin; Lassus, Johan; Mebazaa, Alexandre; Filippatos, Gerasimos; Ruschitzka, Frank; Dupont, Matthias

doi:10.1002/ejhf.2587

Cited by 29 publications

(33 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We want to emphasize that the reported treatment effect was demonstrated in real world patients (mean age was 78 years old, ∼43% with heart failure with reduced ejection fraction). 7 The most plausible explanation for this large treatment effect is the mechanism of the drug, which inhibits the absorption of sodium and bicarbonate ions in the renal proximal tubule, resulting in both natriuresis and diuresis. Whereas this ‘old’ and well-known drug can be used almost immediately, some challenges arise in the immediate future.…”

Section: Discussionmentioning

confidence: 99%

Acetazolamide for patients with acute decompensated heart failure with volume overload

Rosselló

Menon

Vranckx

2022

European Heart Journal. Acute Cardiovascular Care

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Acetazolamide for patients with acute decompensated heart failure with volume overload

Rosselló

Menon

Vranckx

2022

European Heart Journal. Acute Cardiovascular Care

View full text Add to dashboard Cite

“…Research evidence for sequential nephron blockade 6–10,16,17 . [Correction added on 16 August 2022, after first online publication: Figure 1 has been updated in this version.…”

Section: Figurementioning

confidence: 99%

“…While ADVOR recruited Figure 1 Research evidence for sequential nephron blockade. [6][7][8][9][10]16,17 [Correction added on 16 August 2022, after first online publication: 225 patients with HFrEF, the number of eligible patients would be expected to reduce as guidelines are adopted into routine clinical practice. Furthermore, there is now evidence for their potential use in patients with heart failure with preserved ejection fraction, which might further restrict the direct relevance of ADVOR.…”

mentioning

confidence: 99%

Combination diuretic therapy for acute heart failure: ‘alone we can do so little; together we can do so much’

Bromage

Cannatà

McDonagh

2022

European J of Heart Fail

View full text Add to dashboard Cite

This article refers to 'Acetazolamide in Decompensated Heart Failure with Volume Overload trial (ADVOR): baseline characteristics' by W. Mullens et al., published in this issue on pages 1601-1610.Acute heart failure (AHF) is associated with high in-hospital and post-discharge 1-year mortality, with rates up to 9% and 31%, respectively. 1,2 Evidence-based treatments for AHF are limited. So far, intravenous loop diuretics have one of the strongest (class I) recommendations for its treatment. 3 They are effective at reducing the signs and/or symptoms of volume overload and are recommended therapies across the entire spectrum of left ventricular ejection fraction. 3 However, the level of evidence is C, given the lack of large randomized controlled trials (RCTs) investigating the prognostic benefit of diuretic therapy compared to placebo. Their effects on mortality can only be extrapolated from small RCTs or meta-analyses. However, many of these studies did not specifically investigate patients with AHF, and used evidence being derived from trials using surrogate endpoints. 4 In addition, large RCTs of prognostic therapy for heart failure with reduced ejection fraction (HFrEF) recruited patients with high background rates of loop diuretic prescription, which adds indirect evidence for their use alongside guideline-directed therapy.Sequential nephron blockade is used as a second-line regimen to treat diuretic resistance, defined as an impaired sensitivity to diuretics resulting in reduced natriuresis and diuresis, and persistent congestion. 3,5 However, few studies have specifically examined combination therapy (Figure 1). In this issue of the Journal, Mullens et al. 6 describe the baseline characteristics of patients enrolled to the Acetazolamide in Decompensated Heart Failure with Volume Overload (ADVOR) trial and compare these to other contemporary trials in AHF. ADVOR is a multicentre, randomized, double-blind, placebo-controlled trial of acetazolamide in combination with intravenous loop diuretic therapy in admitted patientsThe opinions expressed in this article are not necessarily those of the Editors of the European Journal of Heart Failure or of the European Society of Cardiology.

show abstract

“…Acetazolamide as a potent inhibitor of proximal tubular sodium reabsorption could represent another interesting option in decongestive treatment strategies, as targeting sodium reabsorption in the proximal tubules implies potential benefits in HF. The ADVOR trail is currently investigating whether acetazolamide in combination with loop diuretic therapy can improve outcome and decongestion in acute HF with fluid overload [112,113]. Acetazolamide may be considered if loop diuretic response remains insufficient [53].…”

Section: Diuretics Volume Optimization and Ultrafiltrationmentioning

confidence: 99%

“…Given the dependency on RBF, higher doses of loop diuretics might be necessary in CRS. The soon to be published ADVOR trial with acetazolamide as a combinatorial diuretic treatment will clarify whether this strategy is superior to conventional loop diuretic treatment in acute HF [112,113]. The forthcoming CLOROTIC trial evaluates whether the addition of hydrochlorothiazide to a loop diuretic represents an effective strategy for decongestion in HF [131], since this is recommended for nephrotic patients with diuretic resistance [115].…”

Section: Diuretic Resistancementioning

confidence: 99%

Right Heart Function in Cardiorenal Syndrome

Kramer

Brinkkoetter

Rosenkranz

2022

Curr Heart Fail Rep

View full text Add to dashboard Cite

Purpose of Review Since CRS is critically dependent on right heart function and involved in interorgan crosstalk, assessment and monitoring of both right heart and kidney function are of utmost importance for clinical outcomes. This systematic review aims to comprehensively report on novel diagnostic and therapeutic paradigms that are gaining importance for the clinical management of the growing heart failure population suffering from CRS. Recent Findings Cardiorenal syndrome (CRS) in patients with heart failure is associated with poor outcome. Although systemic venous congestion and elevated central venous pressure have been recognized as main contributors to CRS, they are often neglected in clinical practice. The delicate hemodynamic balance in CRS is particularly determined by the respective status of the right heart. Summary The consideration of hemodynamic and CRS profiles is advantageous in tailoring treatment for better preservation of renal function. Assessment and monitoring of right heart and renal function by known and emerging tools like renal Doppler ultrasonography or new biomarkers may have direct clinical implications.

show abstract

Acetazolamide in Decompensated Heart Failure with Volume Overload trial (ADVOR): baseline characteristics

Abstract: To describe the baseline characteristics of participants in the Acetazolamide in Decompensated Heart Failure with Volume Overload (ADVOR) trial and compare these with other contemporary diuretic trials in acute heart failure (AHF).

Cited by 29 publications

References 40 publications

Acetazolamide for patients with acute decompensated heart failure with volume overload

Acetazolamide for patients with acute decompensated heart failure with volume overload

Combination diuretic therapy for acute heart failure: ‘alone we can do so little; together we can do so much’

Right Heart Function in Cardiorenal Syndrome

Contact Info

Product

Resources

About