Context: Adrenal vein sampling (AVS) is the only reliable means to distinguish between aldosterone-producing adenoma and bilateral adrenal hyperplasia, the two most common subtypes of primary aldosteronism (PA). AVS protocols are not standardized and vary widely between centers.
Objective: The objective of the study was to retrospectively investigate whether the presence of contralateral adrenal (CL) suppression of aldosterone secretion was associated with improved postoperative outcomes in patients who underwent unilateral adrenalectomy for PA.
Setting: The study was carried out in eight different referral centers in Italy, Germany, and Japan.
Patients: From 585 consecutive AVS in patients with confirmed PA, 234 procedures met the inclusion criteria and were used for the subsequent analyses.
Results: Overall, 82% of patients displayed contralateral suppression. This percentage was significantly higher in ACTH stimulated compared with basal procedures (90% vs 77%). The CL ratio was inversely correlated with the aldosterone level at diagnosis and, among AVS parameters, with the lateralization index (P = .02 and P = .01, respectively). The absence of contralateral suppression was not associated with a lower rate of response to adrenalectomy in terms of both clinical and biochemical parameters, and patients with CL suppression underwent a significantly larger reduction in the aldosterone levels after adrenalectomy.
Conclusions: For patients with lateralizing indices of greater than 4 (which comprised the great majority of subjects in this study), CL suppression should not be required to refer patients to adrenalectomy because it is not associated with a larger blood pressure reduction after surgery and might exclude patients from curative surgery.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1210/jc.2014-2345 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Optimal vein access selection in adrenal vein sampling via upper extremity approach: a retrospective analysis of 325 cases.
Sci Rep
January 2025
Department of Cardiovascular, The Second Affiliated Hospital of Chongqing Medical University, No. 74, Linjiang Road, Yuzhong District, Chongqing, 400010, China.
In order to provide some references for vein approach selection in adrenal vein sampling (AVS), this retrospective study analyzed 325 cases of primary aldosteronism (PA) patients who underwent AVS via the upper extremity vein approach, comparing the differences in complications and visual analogue scale (VAS) scores through median cubital vein (MCV), basilic vein (BV), and cephalic vein (CV). The results indicated no significant difference in the incidence of venous spasm (right MCV vs. right BV vs.
View Article and Find Full Text PDFEGFR, TP53, and CUL3 Triple Mutation in Non-Small Cell Lung Cancer and its Potentially Poor Prognosis: A Case Report and Database Analysis.
Thorac Cancer
December 2024
Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
Concurrent mutations in tumor protein p53 (TP53) or Kelch-like ECH-associated protein 1-nuclear factor erythroid 2-related factor 2-pathway components are linked to poor outcomes in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC), but the impact of triple mutations remains unclear. We report a case of EGFR-, TP53-, and Cullin 3 (CUL3)-mutant NSCLC in a 43-year-old woman with widespread metastases at diagnosis, including those in the contralateral lung, distant lymph nodes, pericardium, liver, bones, left adrenal gland, and brain. She received osimertinib as first-line therapy, but pericardial effusion and liver metastases progressed rapidly over 3 months, and she was switched to carboplatin and pemetrexed.
View Article and Find Full Text PDFGa-pentixafor PET/CT Is a Supplementary Method for Primary Aldosteronism Subtyping Compared with Adrenal Vein Sampling.
Mol Imaging Biol
December 2024
Department of Nuclearuclear Medicine, Peking University First Hospital, Beijing, China.
Purpose: To investigate the diagnostic efficacy of Ga-pentixafor positron emission tomography/computed tomography (PET/CT) in primary aldosteronism (PA) subtyping and lateralization of aldosterone secretion in PA patients.
Procedures: 37 patients who were diagnosed with PA, were prospectively enrolled in the study, and underwent adrenal vein sampling (AVS) after Ga-pentixafor PET/CT was conducted. Lateralization index (LI), defined as aldosterone/cortisol ratio in the dominant side to the contralateral adrenal vein when bilateral adrenal vein catheterization succeeded, and the aldosterone/cortisol ratio in the left adrenal vein to IVC (LAV/IVC) when the catheterization of right adrenal vein failed, were applied to determine lateralization side.
Diagnostic Performance of Imaging Methods in Predicting Lung Cancer Metastases.
J Comput Assist Tomogr
December 2024
From the Department of Radiology, Faculty of Medicine, Prof Dr Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey.
Objective: This study aimed to investigate the possibility of distant organ metastasis using an algorithm developed to evaluate the morphology and localization of lung masses.
Methods: Patients diagnosed with lung cancer between 2016 and 2023 were included. The lesion's morphological characteristics, proximity to important structures, and maximum standardized uptake value were recorded.
[F]AlF-NOTA-pentixather PET/CT of CXCR4 in patients with suspected primary hyperaldosteronism.
Theranostics
December 2024
Department of Nuclear Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China.
Distinguishing unilateral aldosterone-producing adenomas (APA) from idiopathic hyperaldosteronism (IHA), nonfunctional adrenal adenoma (NFA), and pheochromocytoma (PHEO) within primary aldosteronism (PA) presents a significant challenge. Studies have demonstrated high levels of chemokine receptor (CXCR) 4 expression in APA, thereby validating the use of Ga-labeled CXCR4 PET/CT for detecting APA. This study evaluates the efficacy of [F]AlF-NOTA-pentixather PET/CT in distinguishing APA from other PA types.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!