Verbrugge FH, et al. - In this prospective, two-center study, researchers investigated how natriuresis, decongestion, kidney function, and neurohumoral activation in acute heart failure (AHF) are potentially influenced by acetazolamide. They examined 34 patients with AHF on loop diuretics with volume overload. In a random manner, participants received either acetazolamide 250–500 mg daily plus bumetanide 1–2 mg bid or high-dose loop diuretics. In patients with AHF at high risk for diuretic resistance, increased natriuretic response to loop diuretics was achieved with the addition of acetazolamide vs an increase in loop diuretic dose. Patients who received acetazolamide with low-dose loop diuretics demonstrated a non-significant trend towards lower all-cause mortality or heart failure readmissions vs high-dose loop diuretic monotherapy.