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

被引：13

作者：

Lee, Seung-Eun ^{[1
]}

Park, Sung Woon ^{[2
]}

Choi, Min Sun ^{[1
]}

Kim, Gyuri ^{[1
]}

Yoo, Jee Hee ^{[3
]}

Ahn, Jiyeon ^{[4
]}

Jun, Ji Eun ^{[5
]}

Park, Hong Suk ^{[6
]}

Hyun, Dongho ^{[6
]}

Cho, Sung Ki ^{[6
]}

Ko, Seong Eun ^{[6
]}

Kim, Beom-Jun ^{[7
]}

Kim, Jong Woo ^{[8
,9
]}

Yoon, Hyun-Ki ^{[8
,9
]}

Koh, Jung-Min ^{[7
]}

Lee, Seung Hun ^{[1
]}

Kim, Jae Hyeon ^{[1
]}

机构：

[1] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Div Endocrinol & Metab,Dept Med, 81 Irwon Ro, Seoul 06351, South Korea

[2] CHA Univ, CHA Gangnam Med Ctr, Dept Internal Med, Div Endocrinol & Metab, Seoul, South Korea

[3] Yonsei Univ, Wonju Coll Med, Dept Internal Med, Wonju, Gangwon Do, South Korea

[4] Myongji Hosp, Dept Med, Div Endocrinol & Metab, Goyang Si, Gyeonggi Do, South Korea

[5] Kyung Hee Univ, Kyung Hee Univ Hosp Gangdong, Dept Endocrinol & Metab, Seoul, South Korea

[6] Sungkyunkwan Univ, Samsung Med Ctr, Dept Radiol, Seoul, South Korea

[7] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Med,Div Endocrinol & Metab, Seoul, South Korea

[8] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul, South Korea

[9] Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul, South Korea

来源：

THERAPEUTIC ADVANCES IN ENDOCRINOLOGY AND METABOLISM | 2021年 / 12卷

关键词：

adrenal vein sampling; lateralization index; primary aldosteronism; subclinical hypercortisolism; PRIMARY HYPERALDOSTERONISM; COMPUTED-TOMOGRAPHY; FAILED CANNULATION; DIAGNOSTIC UTILITY; SUPPRESSION; IDENTIFICATION; WORK;

D O I：

10.1177/2042018821989239

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页数：12

共 32 条

[1] Hyperaldosteronism: Sampling the adrenal veins [J].