A Trial of Finerenone in a Patient with Primary Aldosteronism.

Introduction: Primary aldosteronism (PA), a common secondary cause of arterial hypertension, is treated either surgically or pharmacologically with mineralocorticoid receptor antagonists (MRAs). These drugs, while effective, can cause allergic reactions and have side effects, including menstrual cycle disorders in women. Finerenone is a new, highly selective, nonsteroidal MRA with excellent side-effect profile, primarily intended to slow the progression of diabetic kidney disease and improve cardiovascular outcomes in these patients.

Aldosterone Robustly Promotes Atrial Fibrillation in the Presence of Chronic Volume Overload in Rats.

We investigated the modulatory effects of aldosterone on atrial remodeling induced by an abdominal aorto-venocaval shunt (AVS) in rats, as patients with primary hyperaldosteronism are suggested to have a higher risk of developing atrial fibrillation (AF). The rats were divided into four groups based on the basis of whether they underwent AVS surgery, received aldosterone using an intraperitoneally implanted osmotic minipump, or both. Aldosterone was started at 0.

A New Disease Severity Score for Measuring Treatment Response to Adrenalectomy in Patients With Primary Aldosteronism.

Objective: Cure after adrenalectomy for primary aldosteronism has been reported in only 15% to 40% of patients, with no disease severity score available to measure response objectively. Furthermore, the criteria used to define cure are outdated. This study aims to determine the rate of cure based on the current definition of normal blood pressure and develop a disease severity score to measure clinical improvement after adrenalectomy for primary aldosteronism.

Suppressed Renin Status Is a Risk Factor for Cardiocerebrovascular Events in Bilateral Primary Aldosteronism Treated With Mineralocorticoid Receptor Antagonists.

Objective: Mineralocorticoid receptor antagonists are the recommended medical therapy for bilateral primary aldosteronism (BPA). Patients with BPA have higher risk of cardiocerebrovascular disease (CCVD) than those with essential hypertension. There is no consensus on the criteria to assess the effectiveness of medical therapy for BPA.

Exploring the pathogenesis linking primary aldosteronism and obstructive sleep apnea via bioinformatic analysis.

Primary aldosteronism (PA) and obstructive sleep apnea (OSA) are both considered independent risk factors for hypertension, which can lead to an increase in cardiovascular disease incidence and mortality. Clinical studies have found a bidirectional relationship between OSA and PA. However, the underlying mechanism between them is not yet clear.

Cardiovascular and all-cause mortality outcomes of adrenalectomy versus medical treatment in primary aldosteronism: an umbrella review.

Background: Primary aldosteronism (PA) is now recognized as the most prevalent form of secondary hypertension globally, contributing significantly to cardiovascular morbidity and mortality. This umbrella review aims to systematically compare cardiovascular outcomes and all-cause mortality in PA patients undergoing adrenalectomy versus mineralocorticoid receptor antagonist (MRA) treatment, aiming to inform optimal management strategies.

Method: Following PRISMA guidelines (Supplemental Digital Content 1, http://links.

Ruptured triple hormone-secreting adrenal cortical carcinoma with hyperaldosteronism, hypercortisolism, and elevated normetanephrine: a case report.

We report a case of a ruptured triple hormone-secreting adrenal mass with hyperaldosteronism, hypercortisolism, and elevated normetanephrine levels, diagnosed as adrenal cortical carcinoma (ACC) by histology. A 53-year-old male patient who initially presented with abdominal pain was referred to our hospital for angiocoagulation of an adrenal mass rupture. Abdominal computed tomography revealed a heterogeneous 19×11×15 cm right adrenal mass with invasion into the right lobe of the liver, inferior vena cava, retrocaval lymph nodes, and aortocaval lymph nodes.

C-X-C Motif Chemokine Receptor 4-Directed Scintigraphy Using [Tc]Tc-Pentixatec in Primary Aldosteronism: A Proof-of-Concept Study.

C-X-C motif chemokine receptor 4 (CXCR4)-directed imaging has gained clinical interest in aiding clinical diagnostics in primary aldosteronism (PA). We retrospectively evaluated the feasibility of CXCR4-directed scintigraphy using the novel CXCR-4 ligand [Tc]Tc-pentixatec in patients with PA. Six patients (mean age ± SD, 49 ± 15 y) underwent CXCR4-directed scintigraphy (including planar imaging and SPECT/CT) 30, 120, and 240 min after injection of 435 ± 50 MBq of [Tc]Tc-pentixatec.

Utility of Adrenal Vein Sampling With and Without Ultra-Low Dose ACTH Infusion in the Diagnostic Evaluation of Primary Aldosteronism.

Background: Adrenal vein sampling (AVS), integral to identifying surgically remediable unilateral primary aldosteronism (PA), is technically challenging and subject to fluctuations in cortisol and aldosterone secretion. Intra-procedural adrenocorticotropic hormone (ACTH), conventionally administered as a 250-μg bolus and/or 50 μg per hour infusion, increases cortisol and aldosterone secretion and can improve AVS success, but may cause discordant lateralisation compared to unstimulated AVS.

Aims: To assess if AVS performed with ultra-low dose ACTH infusion causes discordant lateralisation.

Primary aldosteronism prevalence enhanced by strict adherence to 2016 Endocrine Society guidelines: insights from an endocrine hypertension unit.

Introduction: Primary aldosteronism is the most frequent cause of hypertension although is undetected. The 2016 Endocrine Society guidelines (2016-ESG) recommendations for primary aldosteronism detection are unfulfilled. We aimed to ascertain the prevalence of primary aldosteronism, following the screening criteria endorsed by the 2016-ESG.

[Research progress of KCNJ5 gene in aldosterone-producing adenoma].

Aldosterone-producing adenoma is a subtype of primary aldosteronism. Recent advancements in multi-omics research have led to significant progress in understanding primary aldosteronism at the genetic level. Among the various genes associated with the development of aldosterone-producing adenomas, the KCNJ5 (potassium inwardly rectifying channel, subfamily J, member 5) gene has received considerable attention due to its prevalence as the most common somatic mutation gene in primary aldosteronism.

Cracking the Code: A Case Report on Low-Renin Hypertension.

Low-renin hypertension (LRH) is characterized by hypertension accompanied by low serum renin levels. LRH is a spectrum, including low-renin essential hypertension (LREH), primary hyperaldosteronism, and several acquired or familial secondary forms. Here, we present a case of LRH.

Safety and efficacy of bilateral superselective adrenal arterial embolization for treatment of idiopathic hyperaldosteronism: a prospective single-center study.

Objective: This study aimed to assess the efficacy and safety of bilateral superselective adrenal arterial embolization (SAAE) in patients with bilateral idiopathic hyperaldosteronism (IHA), a subtype of PA.

Methods: Ninety-eight patients with bilateral IHA underwent bilateral SAAE between August 2022 and August 2023. Sixty-eight patients were followed up for up to 12 months.