Adrenal Venous Sampling in Patients With Positive Screening but Negative Confirmatory Testing for Primary Aldosteronism

Adrenal venous sampling is considered to be the most reliable diagnostic procedure to lateralize aldosterone excess in primary aldosteronism (PA). However, normative criteria have not been established partially because of a lack of data in non-PA hypertensive patients. The aim of the study was to in...

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Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2016-05, Vol.67 (5), p.1014-1019
Main Authors: Umakoshi, Hironobu, Naruse, Mitsuhide, Wada, Norio, Ichijo, Takamasa, Kamemura, Kohei, Matsuda, Yuichi, Fujii, Yuichi, Kai, Tatsuya, Fukuoka, Tomikazu, Sakamoto, Ryuichi, Ogo, Atsushi, Suzuki, Tomoko, Nanba, Kazutaka, Tsuiki, Mika
Format: Article
Language:English
Subjects:
Adrenal Glands - blood supply
Age Factors
Aged
Aldosterone - blood
Cohort Studies
Cosyntropin - pharmacology
Female
Humans
Hyperaldosteronism - blood
Hyperaldosteronism - diagnosis
Hypertension - blood
Hypertension - diagnosis
Japan
Male
Mass Screening - methods
Middle Aged
Reference Values
Retrospective Studies
Severity of Illness Index
Sex Factors
Statistics, Nonparametric
Tertiary Care Centers
Veins
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Summary:Adrenal venous sampling is considered to be the most reliable diagnostic procedure to lateralize aldosterone excess in primary aldosteronism (PA). However, normative criteria have not been established partially because of a lack of data in non-PA hypertensive patients. The aim of the study was to investigate aldosterone concentration and its gradient in the adrenal vein of non-PA hypertensive patients. We retrospectively studied the results of cosyntropin-stimulated adrenal venous sampling in 40 hypertensive patients who showed positive screening testing but negative results in 2 confirmatory tests/captopril challenge test and saline infusion test. Plasma aldosterone concentration, aldosterone/cortisol ratio, its higher/lower ratio (lateralization index) in the adrenal vein with cosyntropin stimulation were measured. Median plasma aldosterone concentration in the adrenal vein was 25 819 pg/mL (range, 5154–69 920) in the higher side and 12 953 (range, 1866–36 190) pg/mL in the lower side (P
ISSN:0194-911X
1524-4563
DOI:10.1161/HYPERTENSIONAHA.115.06607