| Title | Adrenal venous sampling in primary aldosteronism: a low dilution of adrenal venous blood is crucial for a correct interpretation of the results. | | Author(s) | Ceral J, Solar M, Krajina A, Ballon M, Suba P, Cap J | | Institution | J Ceral, Internal Medicine, Charles University Prague, Medical Faculty Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. | | Source | Eur J Endocrinol 2009 Jul 15. | | Abstract | Objective: In primary aldosteronism, adrenal venous sampling (AVS) is essential for subtype differentiation as it evaluates aldosterone secretion from both adrenals. Selectivity of adrenal sampling is assessed by the ratio of cortisol concentrations in adrenal venous blood and inferior vena cava blood (adrenalC/ivcC). Since the criteria for selective adrenal sampling differs among the reported literature, we performed a study to evaluate influence of different selectivity criteria on AVS results. Design and methods: Reports of AVS were screened retrospectively. All AVS were performed with cosyntropin infusion. Reports containing samples with adrenalC/ivcC >/= 10 taken from both adrenals and at least one other adrenal sample characterised by adrenalC/ivcC >/= 1.1 were enrolled. For each individual, we chose reference samples that were defined by the highest adrenalC/ivcC achieved from each adrenal. The significance of the remaining samples with adrenalC/ivcC >/= 1.1 was analysed in regards to their respective reference samples. We assessed the impact of analysed samples on identification of lateralisation of aldosterone secretion that is crucial for decisions concerning adrenalectomy.
Results: AVS reports of 87 patients were enrolled. A total of 225 adrenal samples were analysed and divided into five groups according to adrenalC/ivcC: 1.1-1.99, 2-2.99, 3-4.99, 5-9.99 and >/= 10. By comparing reference to analysed samples, a concordant assessment with respect to lateralisation of aldosterone secretion was observed in 39%, 52%, 72%, 85%, and 94% of the respective groups of analysed samples.
Conclusion: AVS provides consistent information when adrenal samples with high cortisol concentrations are used. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19605541 |
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