Abstract

Context

In adrenal venous sampling (AVS) for patients with primary aldosteronism (PA), apparent bilateral aldosterone suppression (ABAS), defined as lower aldosterone/cortisol ratios in the bilateral adrenal veins than that in the inferior vena cava, is occasionally experienced. ABAS is uninterpretable with respect to lateralization of excess aldosterone production. We previously reported that ABAS was not a rare phenomenon and was significantly reduced after adrenocorticotropic hormone (ACTH) administration.

Objective

To validate the effects of ACTH administration and adding sampling positions in the left adrenal vein on the prevalence of ABAS in the larger Japan Primary Aldosteronism Study.

Patients

The data from 1689 patients with PA who underwent AVS between January 2006 and October 2016 were studied. All patients in the previous study, the West Japan Adrenal Vein Sampling study, were excluded.

Outcome Measurements

The prevalence of ABAS was investigated at two sampling positions in the left adrenal vein, the central vein and the common trunk, without and with ACTH administration.

Results

The prevalence of ABAS with ACTH administration was significantly lower than that without ACTH administration [without ACTH vs with ACTH: 79/440 (18.0%) vs 45/591 (7.6%); P < 0.001]. With ACTH administration, the prevalence of ABAS was not different between the sampling position, at the central vein and at the common trunk [33/591 (5.6%) vs 32/591 (5.4%); P = 1.00].

Conclusions

The effectiveness of ACTH administration for the reduction of ABAS in AVS regardless of the sampling position in the left adrenal vein was confirmed in the larger cohort.

Details

Title
The Occurrence of Apparent Bilateral Aldosterone Suppression in Adrenal Vein Sampling for Primary Aldosteronism
Author
Shibayama, Yui 1 ; Wada, Norio 1 ; Naruse, Mitsuhide 2 ; Kurihara, Isao 3 ; Ito, Hiroshi 3 ; Yoneda, Takashi 4 ; Takeda, Yoshiyu 4 ; Umakoshi, Hironobu 2 ; Tsuiki, Mika 2 ; Ichijo, Takamasa 5 ; Fukuda, Hisashi 6 ; Katabami, Takuyuki 6 ; Yoshimoto, Takanobu 7 ; Ogawa, Yoshihiro 8 ; Kawashima, Junji 9 ; Ohno, Yuichi 10 ; Sone, Masakatsu 10 ; Fujita, Megumi 11 ; Takahashi, Katsutoshi 12 ; Shibata, Hirotaka 13 ; Kamemura, Kohei 14 ; Fujii, Yuichi 15 ; Yamamoto, Koichi 16 ; Suzuki, Tomoko 17 

 Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan 
 Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan 
 Division of Endocrinology, Metabolism, and Nephrology, Keio University, Tokyo, Japan 
 Division of Endocrinology and Hypertension, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan 
 Department of Diabetes and Endocrinology, Saiseikai Yokohama Tobu Hospital, Yokohama, Japan 
 Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan 
 Department of Molecular Endocrinology and Metabolism, Graduate School of Medicine, Tokyo Medical Dental University, Tokyo, Japan 
 Department of Molecular Endocrinology and Metabolism, Graduate School of Medicine, Tokyo Medical Dental University, Tokyo, Japan; Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan 
 Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan 
10  Department of Diabetes, Endocrinology, and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan 
11  Division of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan 
12  Division of Nephrology and Endocrinology, The University of Tokyo, Tokyo, Japan; Department of Metabolism, Showa General Hospital, Kodaira, Japan 
13  Department of Endocrinology, Metabolism, Rheumatology, and Nephrology, Faculty of Medicine, Oita University, Yuhu, Japan 
14  Department of Cardiology, Akashi Medical Center, Akashi, Japan 
15  Department of Cardiology, JR Hiroshima Hospital, Hiroshima, Japan 
16  Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan 
17  Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan 
Pages
398-407
Publication year
2018
Publication date
May 2018
Publisher
Oxford University Press
e-ISSN
24721972
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3170632579
Copyright
Copyright © 2018 Endocrine Society. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.