Introduction: Adrenal vein sampling (AVS) is a gold standard in the assessment of the cause of primary aldosteronism (PA). It is technically demanding procedure having the high rate of failure, even in expert centres. Our study aimed to investigatewhether the data on aldosterone and cortisol concentration from successfully cannulated adrenal vein could determine the subtype of PA in certain patients with partially successful AVS.
Materials and methods: The study included 36 AVS procedures performed in 35 patients (one patient undergone AVS twice). Unilateral aldosterone secretion was confirmed in 12 patients who were all surgically treated and achieved biochemical remission of the disease. In the remaining 23 patients, AVS results were consistent with bilateral adrenal hyperplasia. In all patients aldosterone/cortisol ratio between the peripheral and adrenal veins, as well as aldosterone/cortisol ratio in adrenal veins were analysed.
Results: Statistical analysis, using ROC curve, showed that peripheral/adrenal vein aldosterone/cortisol ratio > 2.3 (100 % sensitivity, 88% specificity) OR aldosterone/cortisol ratio in adrenal vein < 0.64 (92% sensitivity, 93% specificity) indicate unaffected adrenal gland.
Conclusions: Aldosterone/cortisol ratio in adrenal vein of < 0.64 and aldosterone/cortisol ratio between the peripheral and adrenal vein of > 2.3 are consistent with unaffected adrenal gland indicating that excess aldosterone secretion originates from the opposite side.
05 Sep 2020 - 09 Sep 2020