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Title

Effects of acetazolamide on cerebrovascular function and breathing stability at 5050 m

Authors
Burgess, Keith R
Thomas, Kate N
Lucas, Samuel J E
Cotter, James D
Peebles, Karen C
Ainslie, Philip N
Published in The Journal of Physiology. 2012, vol. 590, no. Pt 5, p. 1213-25
Abstract One of the many actions of the carbonic anhydrase inhibitor, acetazolamide (ACZ), is to accelerate acclimatisation and reduce periodic breathing during sleep. The mechanism(s) by which ACZ may improve breathing stability, especially at high altitude, remain unclear. We tested the hypothesis that acute I.V. ACZ would enhance cerebrovascular reactivity to CO₂ at altitude, and thereby lower ventilatory drive and improve breathing stability during wakefulness. We measured arterial blood gases, minute ventilation (˙VE) and middle cerebral artery blood flow velocity (MCAv) before and 30 min following ACZ administration (I.V. 10 mg kg⁻¹) in 12 healthy participants at sea level and following partial acclimatisation to altitude (5050 m).Measures were made at rest and during changes in end-tidal PCO₂ and PO₂ (isocapnic hypoxia). At sea level, ACZ increased resting MCAv and its reactivity to both hypocapnia and hypercapnia (P < 0.05), and lowered resting VE, arterial O₂ saturation (Sa,O₂ ) and arterial PO₂ (Pa,O₂) (P < 0.05); arterial PCO₂ (Pa,CO₂ ) was unaltered (P > 0.05). At altitude, ACZ also increased resting MCAv and its reactivity to both hypocapnia and hypercapnia (resting MCAv and hypocapnia reactivity to a greater extent than at sea level). Moreover, ACZ at altitude elevated Pa,CO₂ and again lowered resting Pa,O₂ and Sa,O₂ (P <0.05). Although the ˙VE sensitivity to hypercapnia or isocapnic hypoxia was unaltered following ACZ at both sea level and altitude (P > 0.05), breathing stability at altitude was improved (e.g. lower incidence of ventilatory oscillations and variability of tidal volume; P < 0.05). Our data indicate that I.V. ACZ elevates cerebrovascular reactivity and improves breathing stability at altitude, independent of changes in peripheral or central chemoreflex sensitivities. We speculate that Pa,CO₂-mediated elevations in cerebral perfusion and an enhanced cerebrovascular reactivity may partly account for the improved breathing stability following ACZ at high altitude.
Keywords Acetazolamide/pharmacologyAdultAltitudeBlood Gas AnalysisBrain/blood supply/drug effects/physiologyCarbon Dioxide/physiologyCarbonic Anhydrase Inhibitors/pharmacologyCerebral Arteries/drug effects/physiologyCerebrovascular Circulation/drug effectsFemaleHumansMalePulmonary Ventilation/drug effectsRegional Blood Flow/drug effectsRespiration/drug effectsYoung Adult
Identifiers
PMID: 22219343
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Research group Groupe Kayser Bengt (médecine du sport) (306)
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FAN, Jui-Lin et al. Effects of acetazolamide on cerebrovascular function and breathing stability at 5050 m. In: The Journal of Physiology, 2012, vol. 590, n° Pt 5, p. 1213-25. https://archive-ouverte.unige.ch/unige:25170

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Deposited on : 2013-01-09

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