Clinical determinants of adrenal vein sampling success

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Etat: Public
Version: Final published version
Licence: Non spécifiée
ID Serval
serval:BIB_D932CD249319
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Clinical determinants of adrenal vein sampling success
Périodique
Cardiovascular Medicine
Auteur⸱e⸱s
Berney M., Matter M., Pechère-Bertschi A., Burnier M., Wuerzner G.
Contributeur⸱rice⸱s
Maillard  M., Doenz F.
ISSN
1423-5528
Statut éditorial
Publié
Date de publication
09/2015
Peer-reviewed
Oui
Volume
18
Numéro
9
Pages
246-251
Langue
anglais
Résumé
Background: Primary aldosteronism (PA) is one of the most prevalent
forms of secondary hypertension, which may be cured by unilateral adrenalectomy.
Adrenal vein sampling (AVS) is considered the gold-standard
procedure for distinction between bilateral and unilateral aldosterone hypersecretion.
However, the procedure is viewed as a technical challenge.
The objectives of this study were to define the success rate of AVS, and its
clinical determinants, and to compare the accuracy of high-resolution adrenal
computed tomography (CT) with AVS.
Methods: In this single-centre retrospective study, patients with biologically
proven PA who were referred for AVS between 2009 and 2014
were included. Adrenal vein catheterisation was considered selective if the
selectivity index (adrenal vein / inferior vena cava cortisol) was ≥2.
Results: Data from 68 patients (48% women) were available. The success
rate of catheterisation in bilateral AVS was 60% (41/68). The significant
clinical determinants of success were male sex (r = 0.35, p = 0.004), a
higher body mass index (BMI) (r = 0.54, p = 0.001) and plasma creatinine
(r = 0.25, p = 0.048) in univariate analysis. In multivariate linear regression
analysis, only BMI was associated with success (coefficient  = 0.049,
p = 0.004). CT was discordant with AVS in 53% of patients, and would have
resulted in inappropriate adrenalectomy in 43% of the patients and inappropriate
exclusion from surgery in 10% of the cases.
Conclusion: Clinical characteristics such as BMI and sex may influence the
success rate of AVS. The inaccuracy of CT may result in inappropriate
treatment proposals if the indication for surgical intervention is based on
CT only.
Mots-clé
Hyperaldosteronism, Conn
Création de la notice
12/02/2016 15:32
Dernière modification de la notice
21/11/2022 8:27
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