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Computed Tomography and Adrenal Venous Sampling in the Diagnosis of Unilateral Primary Aldosteronism
TA. Williams, J. Burrello, LA. Sechi, CE. Fardella, J. Matrozova, C. Adolf, R. Baudrand, S. Bernardi, F. Beuschlein, C. Catena, M. Doumas, F. Fallo, G. Giacchetti, DA. Heinrich, G. Saint-Hilary, PM. Jansen, A. Januszewicz, T. Kocjan, T....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem
NLK
Free Medical Journals
od 1979 do Před 1 rokem
Open Access Digital Library
od 1979-01-01
Open Access Digital Library
od 1979-01-01
- MeSH
- adrenalektomie metody MeSH
- aldosteron krev MeSH
- biologické markery krev MeSH
- dospělí MeSH
- hodnocení výsledků zdravotní péče metody statistika a číselné údaje MeSH
- hyperaldosteronismus krev diagnostické zobrazování chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nadledviny krevní zásobení MeSH
- odběr vzorku krve metody MeSH
- počítačová rentgenová tomografie metody MeSH
- renin krev MeSH
- retrospektivní studie MeSH
- vény MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
Unilateral primary aldosteronism is the most common surgically correctable form of endocrine hypertension and is usually differentiated from bilateral forms by adrenal venous sampling (AVS) or computed tomography (CT). Our objective was to compare clinical and biochemical postsurgical outcomes of patients with unilateral primary aldosteronism diagnosed by CT or AVS and identify predictors of surgical outcomes. Patient data were obtained from 18 internationally distributed centers and retrospectively analyzed for clinical and biochemical outcomes of adrenalectomy of patients with surgical management based on CT (n=235 patients, diagnosed from 1994-2016) or AVS (526 patients, diagnosed from 1994-2015) using the standardized PASO (Primary Aldosteronism Surgical Outcome) criteria. Biochemical outcomes were highly different according to surgical management approach with a smaller proportion in the CT group achieving complete biochemical success (188 of 235 [80%] patients versus 491 of 526 [93%], P<0.001) and a greater proportion with absent biochemical success (29 of 235 [12%] versus 10 of 526 [2%], P<0.001). A diagnosis by CT was associated with a decreased likelihood of complete biochemical success compared with AVS (odds ratio, 0.28; 0.16-0.50; P<0.001). Clinical outcomes were not significantly different, but the absence of a postsurgical elevated aldosterone-to-renin ratio was a strong marker of complete clinical success (odds ratio, 14.81; 1.76-124.53; P=0.013) in the CT but not in the AVS group. In conclusion, patients diagnosed by CT have a decreased likelihood of achieving complete biochemical success compared with a diagnosis by AVS.
2nd Propedeutic Department of Internal Medicine Aristotle University Thessaloniki Greece
3rd Department of Internal Medicine Aristotle University Thessaloniki Greece
Clinical Centre of Endocrinology Medical University Sofia Bulgaria
Departamento Endocrinología Facultad de Medicina Pontificia Universidad Católica de Chile Santiago
Department of Hypertension Institute of Cardiology Warsaw Poland
Department of Medical Sciences University of Trieste Italy
Dipartimento di Scienze Matematiche
Division of Endocrinology Polytechnic University of Marche Ancona Italy
Endocrinology and Diabetes Center Yokohama Rosai Hospital Japan
Citace poskytuje Crossref.org
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- $a Williams, Tracy A $u From the Department of Endocrinology, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany (T.A.W., C.A., F.B., D.A.H., M.R.). Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Italy (T.A.W., J.B., P.M.).
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- $a Computed Tomography and Adrenal Venous Sampling in the Diagnosis of Unilateral Primary Aldosteronism / $c TA. Williams, J. Burrello, LA. Sechi, CE. Fardella, J. Matrozova, C. Adolf, R. Baudrand, S. Bernardi, F. Beuschlein, C. Catena, M. Doumas, F. Fallo, G. Giacchetti, DA. Heinrich, G. Saint-Hilary, PM. Jansen, A. Januszewicz, T. Kocjan, T. Nishikawa, M. Quinkler, F. Satoh, H. Umakoshi, J. Widimský, S. Hahner, S. Douma, M. Stowasser, P. Mulatero, M. Reincke,
- 520 9_
- $a Unilateral primary aldosteronism is the most common surgically correctable form of endocrine hypertension and is usually differentiated from bilateral forms by adrenal venous sampling (AVS) or computed tomography (CT). Our objective was to compare clinical and biochemical postsurgical outcomes of patients with unilateral primary aldosteronism diagnosed by CT or AVS and identify predictors of surgical outcomes. Patient data were obtained from 18 internationally distributed centers and retrospectively analyzed for clinical and biochemical outcomes of adrenalectomy of patients with surgical management based on CT (n=235 patients, diagnosed from 1994-2016) or AVS (526 patients, diagnosed from 1994-2015) using the standardized PASO (Primary Aldosteronism Surgical Outcome) criteria. Biochemical outcomes were highly different according to surgical management approach with a smaller proportion in the CT group achieving complete biochemical success (188 of 235 [80%] patients versus 491 of 526 [93%], P<0.001) and a greater proportion with absent biochemical success (29 of 235 [12%] versus 10 of 526 [2%], P<0.001). A diagnosis by CT was associated with a decreased likelihood of complete biochemical success compared with AVS (odds ratio, 0.28; 0.16-0.50; P<0.001). Clinical outcomes were not significantly different, but the absence of a postsurgical elevated aldosterone-to-renin ratio was a strong marker of complete clinical success (odds ratio, 14.81; 1.76-124.53; P=0.013) in the CT but not in the AVS group. In conclusion, patients diagnosed by CT have a decreased likelihood of achieving complete biochemical success compared with a diagnosis by AVS.
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- $a Burrello, Jacopo $u Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Italy (T.A.W., J.B., P.M.).
- 700 1_
- $a Sechi, Leonardo A $u Hypertension Unit, Internal Medicine, Department of Medicine (DAME), University of Udine, Italy (L.A.S., C.C.).
- 700 1_
- $a Fardella, Carlos E $u Departamento Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago (C.E.F., R.B.).
- 700 1_
- $a Matrozova, Joanna $u Clinical Centre of Endocrinology, Medical University, Sofia, Bulgaria (J.M.).
- 700 1_
- $a Adolf, Christian $u From the Department of Endocrinology, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany (T.A.W., C.A., F.B., D.A.H., M.R.).
- 700 1_
- $a Baudrand, René $u Departamento Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago (C.E.F., R.B.).
- 700 1_
- $a Bernardi, Stella $u Department of Medical Sciences, University of Trieste, Italy (S.B.). ASUITS-Azienda Sanitaria Universitaria Integrata di Trieste, Cattinara Teaching Hospital, Italy (S.B.).
- 700 1_
- $a Beuschlein, Felix $u From the Department of Endocrinology, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany (T.A.W., C.A., F.B., D.A.H., M.R.). Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Switzerland (F.B.).
- 700 1_
- $a Catena, Cristiana $u Hypertension Unit, Internal Medicine, Department of Medicine (DAME), University of Udine, Italy (L.A.S., C.C.).
- 700 1_
- $a Doumas, Michalis $u 2nd Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece (M.D.).
- 700 1_
- $a Fallo, Francesco $u Department of Medicine (DIMED), University of Padova, Italy (F.F.).
- 700 1_
- $a Giacchetti, Gilberta $u Division of Endocrinology, Polytechnic University of Marche, Ancona, Italy (G.G.).
- 700 1_
- $a Heinrich, Daniel A $u From the Department of Endocrinology, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany (T.A.W., C.A., F.B., D.A.H., M.R.).
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- 700 1_
- $a Jansen, Pieter M $u Endocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Greenslopes and Princess Alexandra Hospitals, Brisbane, Australia (P.M.J., M.S.).
- 700 1_
- $a Januszewicz, Andrzej $u Department of Hypertension, Institute of Cardiology, Warsaw, Poland (A.J.).
- 700 1_
- $a Kocjan, Tomaz $u Department of Endocrinology, Diabetes and Metabolic diseases, University Medical Centre, Ljubljana, Slovenia (T.K.).
- 700 1_
- $a Nishikawa, Tetsuo $u Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan (T.N.).
- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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- 700 1_
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