Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion

Mitsuhiro Kishino, Takanobu Yoshimoto, Masashi Nakadate, Yoshiaki Katada, Eiichiro Kanda, Shuichiro Nakaminato, Yukihisa Saida, Yoshihiro Ogawa, Ukihide Tateishi

研究成果: ジャーナルへの寄稿記事

3 引用 (Scopus)

抜粋

We evaluated the influence of catheter sampling position and size on left adrenal venous sampling (AVS) in patients with primary aldosteronism (PA) and analyzed their relationship to cortisol secretion. This retrospective study included 111 patients with a diagnosis of primary aldosteronism who underwent tetracosactide-stimulated AVS. Left AVS was obtained from two catheter positions — the central adrenal vein (CAV) and the common trunk. For common trunk sampling, 5-French catheters were used in 51 patients, and microcatheters were used in 60 patients. Autonomous cortisol secretion was evaluated with a low-dose dexamethasone suppression test in 87 patients. The adrenal/inferior vena cava cortisol concentration ratio [selectivity index (SI)] was significantly lower in samples from the left common trunk than those of the left CAV and right adrenal veins, but this difference was reduced when a microcatheter was used for common trunk sampling. Sample dilution in the common trunk of the left adrenal vein can be decreased by limiting sampling speed with the use of a microcatheter. Meanwhile, there was no significant difference in SI between the left CAV and right adrenal veins. Laterality, determined according to aldosterone/cortisol ratio (A/C ratio) based criteria, showed good reproducibility regardless of sampling position, unlike the absolute aldosterone value based criteria. However, in 11 cases with autonomous cortisol co-secretion, the cortisol hypersecreting side tended to be underestimated when using A/C ratio based criteria. Left CAV sampling enables symmetrical sampling, and may be essential when using absolute aldosterone value based criteria in cases where symmetrical cortisol secretion is uncertain.

元の言語英語
ページ(範囲)347-355
ページ数9
ジャーナルEndocrine Journal
64
発行部数3
DOI
出版物ステータス出版済み - 1 1 2017
外部発表Yes

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

フィンガープリント Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion' の研究トピックを掘り下げます。これらはともに一意のフィンガープリントを構成します。

  • これを引用

    Kishino, M., Yoshimoto, T., Nakadate, M., Katada, Y., Kanda, E., Nakaminato, S., Saida, Y., Ogawa, Y., & Tateishi, U. (2017). Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion. Endocrine Journal, 64(3), 347-355. https://doi.org/10.1507/endocrj.EJ16-0433