Bilateral aldosterone suppression and its resolution in adrenal vein sampling of patients with primary aldosteronism: analysis of data from the WAVES-J study

Yui Shibayama, Norio Wada, Hironobu Umakoshi, Takamasa Ichijo, Yuichi Fujii, Kohei Kamemura, Tatsuya Kai, Ryuichi Sakamoto, Atsushi Ogo, Yuichi Matsuda, Tomikazu Fukuoka, Mika Tsuiki, Tomoko Suzuki, Mitsuhide Naruse

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Context: In adrenal vein sampling (AVS) for patients with primary aldosteronism, the contralateral ratio of aldosterone/cortisol (A/C) between the nondominant adrenal vein and the inferior vena cava is one of the best criteria for determining lateralized aldosterone secretion. Despite successful cannulation in some patients, the A/C ratios in the adrenal veins are bilaterally lower than that in the inferior vena cava (bilateral aldosterone suppression; BAS). Objectives: To investigate the prevalence of BAS in AVS and how to resolve this condition. Design and setting: Retrospective study involving nine referral centres. Patients: Four hundred and ninety-one patients who were confirmed as having primary aldosteronism and had an AVS between January 2006 and December 2013. Measurements: The prevalence of BAS before and after ACTH stimulation was compared. In addition, we investigated other methods for overcoming BAS. Results: In 304 patients with successful AVS before ACTH stimulation, BAS was observed in 29 (9·5%). BAS was resolved after ACTH stimulation in 22 patients. In 276 patients with successful AVS both before and after ACTH stimulation, the frequency of BAS was significantly reduced after ACTH (8·7% vs 2·5%, P < 0·01). In a few patients, BAS was also resolved by adding a sampling point at the common trunk of the left adrenal vein and by an alternative drainage vein from the adrenal tumour. Conclusions: BAS sometimes occurs in AVS without ACTH stimulation. ACTH stimulation significantly reduces BAS with a single AVS procedure.

Original languageEnglish
Pages (from-to)696-702
Number of pages7
JournalClinical Endocrinology
Volume85
Issue number5
DOIs
Publication statusPublished - Nov 1 2016
Externally publishedYes

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Hyperaldosteronism
Aldosterone
Veins
Adrenocorticotropic Hormone
Inferior Vena Cava
Hydrocortisone
Glandular and Epithelial Neoplasms
Catheterization
Drainage
Referral and Consultation
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Bilateral aldosterone suppression and its resolution in adrenal vein sampling of patients with primary aldosteronism : analysis of data from the WAVES-J study. / Shibayama, Yui; Wada, Norio; Umakoshi, Hironobu; Ichijo, Takamasa; Fujii, Yuichi; Kamemura, Kohei; Kai, Tatsuya; Sakamoto, Ryuichi; Ogo, Atsushi; Matsuda, Yuichi; Fukuoka, Tomikazu; Tsuiki, Mika; Suzuki, Tomoko; Naruse, Mitsuhide.

In: Clinical Endocrinology, Vol. 85, No. 5, 01.11.2016, p. 696-702.

Research output: Contribution to journalArticle

Shibayama, Y, Wada, N, Umakoshi, H, Ichijo, T, Fujii, Y, Kamemura, K, Kai, T, Sakamoto, R, Ogo, A, Matsuda, Y, Fukuoka, T, Tsuiki, M, Suzuki, T & Naruse, M 2016, 'Bilateral aldosterone suppression and its resolution in adrenal vein sampling of patients with primary aldosteronism: analysis of data from the WAVES-J study', Clinical Endocrinology, vol. 85, no. 5, pp. 696-702. https://doi.org/10.1111/cen.13090
Shibayama, Yui ; Wada, Norio ; Umakoshi, Hironobu ; Ichijo, Takamasa ; Fujii, Yuichi ; Kamemura, Kohei ; Kai, Tatsuya ; Sakamoto, Ryuichi ; Ogo, Atsushi ; Matsuda, Yuichi ; Fukuoka, Tomikazu ; Tsuiki, Mika ; Suzuki, Tomoko ; Naruse, Mitsuhide. / Bilateral aldosterone suppression and its resolution in adrenal vein sampling of patients with primary aldosteronism : analysis of data from the WAVES-J study. In: Clinical Endocrinology. 2016 ; Vol. 85, No. 5. pp. 696-702.
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T1 - Bilateral aldosterone suppression and its resolution in adrenal vein sampling of patients with primary aldosteronism

T2 - analysis of data from the WAVES-J study

AU - Shibayama, Yui

AU - Wada, Norio

AU - Umakoshi, Hironobu

AU - Ichijo, Takamasa

AU - Fujii, Yuichi

AU - Kamemura, Kohei

AU - Kai, Tatsuya

AU - Sakamoto, Ryuichi

AU - Ogo, Atsushi

AU - Matsuda, Yuichi

AU - Fukuoka, Tomikazu

AU - Tsuiki, Mika

AU - Suzuki, Tomoko

AU - Naruse, Mitsuhide

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Context: In adrenal vein sampling (AVS) for patients with primary aldosteronism, the contralateral ratio of aldosterone/cortisol (A/C) between the nondominant adrenal vein and the inferior vena cava is one of the best criteria for determining lateralized aldosterone secretion. Despite successful cannulation in some patients, the A/C ratios in the adrenal veins are bilaterally lower than that in the inferior vena cava (bilateral aldosterone suppression; BAS). Objectives: To investigate the prevalence of BAS in AVS and how to resolve this condition. Design and setting: Retrospective study involving nine referral centres. Patients: Four hundred and ninety-one patients who were confirmed as having primary aldosteronism and had an AVS between January 2006 and December 2013. Measurements: The prevalence of BAS before and after ACTH stimulation was compared. In addition, we investigated other methods for overcoming BAS. Results: In 304 patients with successful AVS before ACTH stimulation, BAS was observed in 29 (9·5%). BAS was resolved after ACTH stimulation in 22 patients. In 276 patients with successful AVS both before and after ACTH stimulation, the frequency of BAS was significantly reduced after ACTH (8·7% vs 2·5%, P < 0·01). In a few patients, BAS was also resolved by adding a sampling point at the common trunk of the left adrenal vein and by an alternative drainage vein from the adrenal tumour. Conclusions: BAS sometimes occurs in AVS without ACTH stimulation. ACTH stimulation significantly reduces BAS with a single AVS procedure.

AB - Context: In adrenal vein sampling (AVS) for patients with primary aldosteronism, the contralateral ratio of aldosterone/cortisol (A/C) between the nondominant adrenal vein and the inferior vena cava is one of the best criteria for determining lateralized aldosterone secretion. Despite successful cannulation in some patients, the A/C ratios in the adrenal veins are bilaterally lower than that in the inferior vena cava (bilateral aldosterone suppression; BAS). Objectives: To investigate the prevalence of BAS in AVS and how to resolve this condition. Design and setting: Retrospective study involving nine referral centres. Patients: Four hundred and ninety-one patients who were confirmed as having primary aldosteronism and had an AVS between January 2006 and December 2013. Measurements: The prevalence of BAS before and after ACTH stimulation was compared. In addition, we investigated other methods for overcoming BAS. Results: In 304 patients with successful AVS before ACTH stimulation, BAS was observed in 29 (9·5%). BAS was resolved after ACTH stimulation in 22 patients. In 276 patients with successful AVS both before and after ACTH stimulation, the frequency of BAS was significantly reduced after ACTH (8·7% vs 2·5%, P < 0·01). In a few patients, BAS was also resolved by adding a sampling point at the common trunk of the left adrenal vein and by an alternative drainage vein from the adrenal tumour. Conclusions: BAS sometimes occurs in AVS without ACTH stimulation. ACTH stimulation significantly reduces BAS with a single AVS procedure.

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