Comparison of Cortisol, Androstenedione and Metanephrines to Assess Selectivity and Lateralization of Adrenal Vein Sampling in Primary Aldosteronism

被引:19
|
作者
Ceolotto, Giulio [1 ]
Antonelli, Giorgia [2 ]
Caroccia, Brasilina [1 ]
Battistel, Michele [3 ]
Barbiero, Giulio [3 ]
Plebani, Mario [2 ]
Rossi, Gian Paolo [1 ]
机构
[1] Univ Padua, Specialized Ctr Blood Pressure Disorders Reg Vene, Dept Med DIMED, I-35126 Padua, Italy
[2] Univ Padua, Dept Med DIMED, Lab Med, I-35126 Padua, Italy
[3] Univ Padua, Inst Radiol, Dept Med DIMED, I-35126 Padua, Italy
关键词
adrenal vein sampling; cortisol; androstenedione; metanephrines; primary aldosteronism; DIAGNOSIS; ASSAY;
D O I
10.3390/jcm10204755
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Success of adrenal vein sampling (AVS) is verified by the selectivity index (SI), i.e., by a step-up of cortisol levels between the adrenal vein and the infrarenal inferior vena cava samples, beyond a given cut-off. We tested the hypothesis that androstenedione, metanephrine, and normetanephrine, which have higher gradients than cortisol, could increase the rate of AVS studies judged to be bilaterally successful and usable for the clinical decision making. We prospectively compared within-patient, head-to-head, the selectivity index of androstenedione (SIA), metanephrine (SIM), and normetanephrine (SINM), and cortisol (SIC) in consecutive hypertensive patients with primary aldosteronism submitted to AVS. Main outcome measures were rate of bilateral success, SI values, and identification of unilateral PA. We recruited 136 patients (55 + 10 years, 35% women). Compared to the SIC, the SIA values were 3.5-fold higher bilaterally, and the SIM values were 7-fold and 4.4-fold higher on the right and the left side, respectively. With the SIA and the SIM the rate of bilaterally successful AVS increased by 14% and 15%, respectively without impairing the identification of unilateral PA. We concluded that androstenedione and metanephrine outperformed cortisol for ascertaining AVS success, thus increasing the AVS studies useable for the clinical decision making.
引用
收藏
页数:13
相关论文
共 50 条
  • [41] Adrenal androgens versus cortisol for primary aldosteronism subtype determination in adrenal venous sampling
    Viukari, Marianna
    Kokko, Eeva
    Porsti, Ilkka
    Leijon, Helena
    Vesterinen, Tiina
    Hinkka, Tero
    Soinio, Minna
    Schalin-Jantti, Camilla
    Matikainen, Niina
    Nevalainen, Pasi, I
    CLINICAL ENDOCRINOLOGY, 2022, 97 (03) : 241 - 249
  • [42] Adrenal vein sampling using rapid cortisol assays in primary aldosteronism is useful in centers with low success rates
    Betz, Matthias J.
    Degenhart, Christoph
    Fischer, Evelyn
    Pallauf, Anna
    Brand, Volker
    Linsenmaier, Ulrich
    Beuschlein, Felix
    Bidlingmaier, Martin
    Reincke, Martin
    EUROPEAN JOURNAL OF ENDOCRINOLOGY, 2011, 165 (02) : 301 - 306
  • [43] Chromogranin A Measurement for Assessing the Selectivity of Adrenal Venous Sampling in Primary Aldosteronism
    Seccia, Teresa M.
    Miotto, Diego
    De Toni, Renzo
    Maniero, Carmela
    Vincenzi, Matteo
    Motta, Raffaella
    Pessina, Achille C.
    Rossi, Gian Paolo
    JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2011, 96 (05): : E825 - E829
  • [44] Subtyping of primary aldosteronism by adrenal vein sampling: effect of acute D2 receptor dopaminergic blockade on adrenal vein cortisol and chromogranin A levels
    Seccia, Teresa M.
    Miotto, Diego
    De Toni, Renzo
    Gallina, Valentina
    Vincenzi, Matteo
    Pessina, Achille C.
    Rossi, Gian Paolo
    EUROPEAN JOURNAL OF ENDOCRINOLOGY, 2011, 165 (01) : 85 - 90
  • [45] Adrenal vein sampling for identification of surgically curable primary aldosteronism: impact of accessory hepatic veins on the selectivity index
    Rossi, G. P.
    Pitter, G.
    Seccia, T. M.
    Cavasin, N.
    De, Toni R.
    Vincenzi, M.
    Pessina, A. C.
    Feltrin, G. P.
    Miotto, D.
    HYPERTENSION, 2008, 52 (04) : 759 - 759
  • [46] Left-right differences in adrenal vein sampling for primary aldosteronism
    Miyoshi, Arina
    Wada, Norio
    Bada, Shuhei
    Obara, Shinji
    Takahashi, Bunya
    Usubuchi, Hiroaki
    Terae, Satoshi
    ENDOCRINE JOURNAL, 2020, 67 (03) : 327 - 334
  • [47] Segmental Adrenal Vein Sampling in Patients With Primary Aldosteronism Superlative or Superfluous?
    Turcu, Adina F.
    Gomez-Sanchez, Celso E.
    HYPERTENSION, 2020, 76 (03) : 662 - 664
  • [48] Role of adrenal vein sampling in primary aldosteronism: the Monash Health experience
    Teng, J.
    Hutchinson, M. E.
    Doery, J. C. G.
    Choy, K. W.
    Chong, W.
    Fuller, P. J.
    Yang, J.
    INTERNAL MEDICINE JOURNAL, 2015, 45 (11) : 1141 - 1146
  • [49] PO2-guided Adrenal Vein Sampling In Primary Aldosteronism
    Omata, Kei
    Tezuka, Yuta
    Ono, Yoshikiyo
    Satoh, Fumitoshi
    HYPERTENSION, 2023, 80
  • [50] Evaluation of Adrenal Vein Sampling Use and Outcomes in Patients With Primary Aldosteronism
    Yeung, Alyssa
    Friedmann, Patricia
    In, Haejin
    Bloomgarden, Noah
    McAuliffe, John C.
    Libutti, Steven K.
    Laird, Amanda M.
    JOURNAL OF SURGICAL RESEARCH, 2020, 256 : 673 - 679