Hypertension (Dallas, Tex. : 1979) · 2023
Unilaterally Selective Adrenal Vein Sampling for Identification of Surgically Curable Primary Aldosteronism.
СтатьяПоддержка исследования: вне правительства СШАНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Rossi Gian Paolo, Bagordo Domenico, Amar Laurence, Azizi Michel, Riester Anna, Reincke Martin, Degenhart Christoph, Widimský Jiří, Naruse Mitsuhide, Deinum Jaap, Kocjan Tomaz, Negro Aurelio, Rossi Ermanno, Kline Gregory, Tanabe Akiyo, Satoh Fumitoshi, Rump Lars Christian, Vonend Oliver, Willenberg Holger S, Fuller Peter J, Yang Jun, Chee Nicholas Yong Nian, Magill Steven B, Shafigullina Zulfiya, Quinkler Marcus, Oliveras Anna, Lee Bo-Ching, Chang Chin-Chen, Wu Vin-Cent, Krátká Zuzana, Battistel Michele, Rossitto Giacomo, Seccia Teresa Maria
Аннотация
BACKGROUND: Adrenal venous sampling is recommended for the identification of unilateral surgically curable primary aldosteronism but is often clinically useless, owing to failed bilateral adrenal vein cannulation.
OBJECTIVES: To investigate if only unilaterally selective adrenal vein sampling studies can allow the identification of the responsible adrenal.
METHODS: Among 1625 patients consecutively submitted to adrenal vein sampling in tertiary referral centers, we selected those with selective adrenal vein sampling results in at least one side; we used surgically cured unilateral primary aldosteronism as gold reference. The accuracy of different values of the relative aldosterone secretion index (RASI), which estimates the amount of aldosterone produced in each adrenal gland corrected for catheterization selectivity, was examined.
RESULTS: We found prominent differences in RASI values distribution between patients with and without unilateral primary aldosteronism. The diagnostic accuracy of RASI values estimated by the area under receiver operating characteristic curves was 0.714 and 0.855, respectively, in the responsible and the contralateral side; RASI values >2.55 and ≤0.96 on the former and the latter side furnished the highest accuracy for detection of surgically cured unilateral primary aldosteronism. Moreover, in the patients without unilateral primary aldosteronism, only 20% and 16% had RASI values ≤0.96 and >2.55.
CONCLUSIONS: With the strength of a large real-life data set and use of the gold reference entailing an unambiguous diagnosis of unilateral primary aldosteronism, these results indicate the feasibility of identifying unilateral primary aldosteronism using unilaterally selective adrenal vein sampling results.
REGISTRATION: URL: https://www.
CLINICALTRIALS: gov; Unique identifier: NCT01234220.
OBJECTIVES: To investigate if only unilaterally selective adrenal vein sampling studies can allow the identification of the responsible adrenal.
METHODS: Among 1625 patients consecutively submitted to adrenal vein sampling in tertiary referral centers, we selected those with selective adrenal vein sampling results in at least one side; we used surgically cured unilateral primary aldosteronism as gold reference. The accuracy of different values of the relative aldosterone secretion index (RASI), which estimates the amount of aldosterone produced in each adrenal gland corrected for catheterization selectivity, was examined.
RESULTS: We found prominent differences in RASI values distribution between patients with and without unilateral primary aldosteronism. The diagnostic accuracy of RASI values estimated by the area under receiver operating characteristic curves was 0.714 and 0.855, respectively, in the responsible and the contralateral side; RASI values >2.55 and ≤0.96 on the former and the latter side furnished the highest accuracy for detection of surgically cured unilateral primary aldosteronism. Moreover, in the patients without unilateral primary aldosteronism, only 20% and 16% had RASI values ≤0.96 and >2.55.
CONCLUSIONS: With the strength of a large real-life data set and use of the gold reference entailing an unambiguous diagnosis of unilateral primary aldosteronism, these results indicate the feasibility of identifying unilateral primary aldosteronism using unilaterally selective adrenal vein sampling results.
REGISTRATION: URL: https://www.
CLINICALTRIALS: gov; Unique identifier: NCT01234220.