Abstract
In this retrospective study, we aimed to estimate the influence of fluctuating peripheral plasma cortisol concentration (PCC) on the success rate of non-stimulated adrenal venous sampling (AVS) and to demonstrate its fluctuating pattern. Overall, 107 consecutive patients with primary aldosteronism undergoing AVS between July 2015–January 2017 were included. The peripheral vein was sampled at 4 separate time points during the procedure: after femoral puncture, during left adrenal sampling, during right adrenal sampling, and before procedural ending. The selectivity index (SI) was calculated using the highest, the lowest, and the simultaneous sampled peripheral PCC. The highest and lowest peripheral PCC significantly differed (p < 0.001) ranging from a 113% increase to a 55% decrease, respectively, and significant correlation between the degree of the peripheral PCC fluctuation and the inter-sampling time length was found (p < 0.001). There was significant difference in the success rate of the groups using different peripheral PCC: highest and lowest (SI cutoff value 2 and 3), highest and simultaneous (2 and 3), and lowest and simultaneous (3). Altogether, we found significant variation of the peripheral PCC during AVS and the success rate for non-stimulated AVS altered significantly using the peripheral PCC at different time points.
Highlights
Adrenal venous sampling (AVS) is the test of choice to identify patients with a surgically curable subtype of primary aldosteronism (PA), the primary cause for secondary hypertension[1,2,3,4,5,6]
We examined the time-dependent variation of peripheral plasma aldosterone concentration (PAC), which ranged from a 113% increase to an 80% decrease (Fig. 4b)
The prominent variability of the peripheral plasma cortisol concentration (PCC) during sequential adrenal venous sampling (AVS) support the notion that using the peripheral PCC at different time points resulted in significant discrepancies in the selectivity index (SI) and success rate of AVS
Summary
Adrenal venous sampling (AVS) is the test of choice to identify patients with a surgically curable subtype of primary aldosteronism (PA), the primary cause for secondary hypertension[1,2,3,4,5,6]. It is interpreted differently between centers and its protocol is not standardized. There is no evidence to support this practice or previously published studies focusing on the time-dependent variation of the peripheral PCC and its influence on the success rate of AVS when using the sequential sampling technique. We sought to estimate the influence of the fluctuating peripheral PCC on the outcome of sequential AVS without ACTH stimulation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
