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Primary aldosteronism subtyping in the setting of partially successful adrenal vein sampling

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Abstract
Background and aims:

Frequent failure of adrenal vein (AV) cannulation is a major obstacle to the universal use of adrenal vein sampling (AVS) for subtyping primary aldosteronism (PA). This study aimed to confirm and modify the value of a previously reported AVS parameter for PA subtyping in the case of cannulation failure on one side.

Methods:

Successfully catheterized AVS studies in 157 patients (121 patients as a derivation cohort and 36 patients as a validation cohort) from two tertiary hospitals were retrospectively reviewed. The AV/inferior vena cava (IVC) index was defined by dividing the aldosterone/cortisol ratio (ACR) of AV by the ACR of the IVC. Cutoff values for lateralized PA were obtained from two methods: scatterplots and the values corresponding to Youden's index in receiver operating characteristic (ROC) curves, on the assumption of catheterization failure on one side.

Results:

Due to multiple samplings in a single AVS procedure, 252 left AV/IVC ratios (LIRs) and 272 right AV/IVC ratios (RIRs) were calculated. Scatterplot cutoffs of LIR >5.4 or Scatterplot cutoffs of RIR 7.0 showed a sensitivity of 55.1% and a specificity of 98.6%. ROC curve cutoffs of LIR <= 0.8 or >3.1 predicted unilateral PA with a sensitivity of 82.5% and a specificity of 69.6%. ROC curve cutoffs of RIR <= 0.8 or >3.9 resulted in 87.4% sensitivity and 80.7% specificity.

Conclusion:

In the case of unilateral AVS failure, the AV/IVC index may help in diagnosing PA subtype.
Author(s)
고성은고정민김규리김범준김재현김종우박성운박홍석안지연유지희윤현기이승은이승훈전지은조성기최민선현동호
Issued Date
2021
Type
Article
Keyword
adrenal vein samplinglateralization indexOriginal Researchprimary aldosteronismsubclinical hypercortisolism
DOI
10.1177/2042018821989239
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7882
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_771dacdfbe0e47cb8829a68bb387f902&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Primary%20aldosteronism%20subtyping%20in%20the%20setting%20of%20partially%20successful%20adrenal%20vein%20sampling&amp;offset=0&amp;pcAvailability=true
Publisher
THERAPEUTIC ADVANCES IN ENDOCRINOLOGY AND METABOLISM
Location
미국
Language
영어
ISSN
2042-0188
Citation Volume
12
Citation Number
0
Citation Start Page
1
Citation End Page
12
Appears in Collections:
Medicine > Medicine
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