EYES2019 7th ESE Young Endocrinologists and Scientists (EYES) Meeting Oral Presentations (67 abstracts)
Partially successful adrenal vein sampling can in some cases reveal the etiology of primary aldosteronism
Karin Zibar Tomšić 1 , Vilim Molnar 2 , Tina Dušek 1, , Ivana Kraljević 1 , Tanja Škorić Polovina 1 , Annemarie Balaško 1 , Mirsala Solak 1 & Darko Kaštelan 1,
1Department of Endocrinology, University Clinical Hospital Center, Zagreb, Croatia; 2School of Medicine, University of Zagreb, Croatia.
Introduction: Adrenal vein sampling (AVS) represents the gold standard in the identification of the source of aldosterone hypersecretion in patients with primary aldosteronism (PA). It is a technically demanding procedure and, in some cases, only one adrenal vein is successfully cannulated. Our study aimed to examine the aldosterone/cortisol ratio between the peripheral and adrenal veins in order to determine peripheral/adrenal vein aldosterone/cortisol ratio cut-off value that differentiates between hyperfunctional and unaffected adrenal gland.
Materials and methods: The study included 31 patients with PA. AVS confirmed unilateral aldosterone secretion in 15 patients who were all surgically treated and achieved biochemical remission of the disease afterwards. In the remaining 16 patients, AVS results were consistent with bilateral adrenal hyperplasia and they were treated conservatively. In all patients aldosterone/cortisol ratio between the peripheral veins and both adrenal veins was analyzed.
Results: Statistical analysis, using ROC curve, showed that peripheral/adrenal vein aldosterone/cortisol ratio ≥3 indicates unaffected adrenal gland with the 90% sensitivity and 100% specificity. On the other hand, peripheral/adrenal vein aldosterone/cortisol ratio ≤0.6 is 90% sensitive and 100% specific for the affected gland.
Conclusions: Using the diagnostic algorithm based on aldosterone/cortisol ratio between the peripheral and adrenal vein it is possible to determine whether the aldosterone overproduction is caused by the related adrenal gland. Accordingly, this algorithm enables us to accurately detect the source of aldosterone overproduction in the case when only adrenal vein on the unaffected side is cannulated successfully.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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