Correlation between lateralization index of adrenalvenoussamplingandstandardized outcome in primary aldosteronism

Hironobu Umakoshi, Mika Tsuiki, Maki Yokomoto-Umakoshi, Yoshiyu Takeda, Yoneda Takashi, Isao Kurihara, Hiroshi Itoh, Takuyuki Katabami, Takamasa Ichijo, Norio Wada, Yui Shibayama, Takanobu Yoshimoto, Kenji Ashida, Yoshihiro Ogawa, Junji Kawashima, Masakatsu Sone, Nobuya Inagaki, Katsutoshi Takahashi, Minemori Watanabe, Yuichi MatsudaHiroki Kobayashi, Hirotaka Shibata, Kohei Kamemura, Michio Otsuki, Yuichi Fujii, Koichi Yamamto, Atsushi Ogo, Shintaro Okamura, Shozo Miyauchi, Tomikazu Fukuoka, Shoichiro Izawa, Toshihiko Yanase, Shigeatsu Hashimoto, Masanobu Yamada, Yuichiro Yoshikawa, Tatsuya Kai, Tomoko Suzuki, Takashi Kawamura, Mitsuhide Naruse

研究成果: ジャーナルへの寄稿記事

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Objectives: The aim of this study was to investigate the impact of adrenal venous sampling (AVS) lateralization cutoffs on surgical outcomes. Patients and Methods: Cosyntropin-stimulated AVS was used to guide surgical management of 377 patients with primary aldosteronism (PA) who were evaluated 6 months after surgery. Main Outcome Measures: The proportion of patients that achieved clinical benefit and complete biochemical success based on the AVS aldosterone lateralization index (LI) was determined. Results: Clinical benefit was achieved in 29 of 47 patients with an LI between 2 and 4, in 66 of 101 with an LI between 4 and 10, and in 158 of 203 with an LI > 10 (P, 0.01 for trend). Complete biochemical success was achieved in 27 of 42 with an LI between 2 and 4, in 60 of 76 with an LI between 4 and 10, and in 127 of 155 with an LI > 10 (P = 0.024 for trend). After adjustment for confounders and using those patients with an LI between 2 and 4 as a reference, a clinical benefit was associated only with those with an LI > 10 (OR, 2.30; 95% CI, 1.03 to 5.16), whereas complete biochemical success was associated with those with an LI between 4 and 10 (OR, 2.83; 95% CI, 1.14 to 7.01) or LI > 10 (OR, 3.55; 95% CI, 1.47 to 8.55). Conclusions: Difference of clinical outcome was relatively small when strict LI diagnostic threshold was used; biochemical cure was sufficiently achieved when an LI > 4 was used. Our study by standardized outcome measures validated that an LI > 4 may be appropriate for determining unilateral disease in PA.

元の言語英語
ページ(範囲)893-902
ページ数10
ジャーナルJournal of the Endocrine Society
2
発行部数8
DOI
出版物ステータス出版済み - 8 2018

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

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    Umakoshi, H., Tsuiki, M., Yokomoto-Umakoshi, M., Takeda, Y., Takashi, Y., Kurihara, I., Itoh, H., Katabami, T., Ichijo, T., Wada, N., Shibayama, Y., Yoshimoto, T., Ashida, K., Ogawa, Y., Kawashima, J., Sone, M., Inagaki, N., Takahashi, K., Watanabe, M., ... Naruse, M. (2018). Correlation between lateralization index of adrenalvenoussamplingandstandardized outcome in primary aldosteronism. Journal of the Endocrine Society, 2(8), 893-902. https://doi.org/10.1210/JS.2018-00055