Primary Hyperaldosteronism: Effect of Adrenal Vein Sampling on Surgical Outcome | Endocrinology | JAMA Surgery | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 35.170.64.36. Please contact the publisher to request reinstatement.
1.
Loh  KCKoay  ESKhaw  MCEmmanuel  SCYoung  WF  Jr Prevalence of primary aldosteronism among Asian hypertensive patients in Singapore.  J Clin Endocrinol Metab 2000;852854- 2859PubMedGoogle Scholar
2.
Rossi  ERegolisti  GNegro  ASani  CDavoli  SPerazzoli  F High prevalence of primary aldosteronism using postcaptopril plasma aldosterone to renin ratio as a screening test among Italian hypertensives.  Am J Hypertens 2002;15896- 902PubMedGoogle ScholarCrossref
3.
Fardella  CEMosso  LGomez-Sanchez  C  et al.  Primary hyperaldosteronism in essential hypertensives: prevalence, biochemical profile, and molecular biology.  J Clin Endocrinol Metab 2000;851863- 1867PubMedGoogle Scholar
4.
Young  WF  Jr Minireview: primary aldosteronism–changing concepts in diagnosis and treatment.  Endocrinology 2003;1442208- 2213PubMedGoogle ScholarCrossref
5.
White  EASchambelan  MRost  CRBiglieri  EGMoss  AAKorobkin  M Use of computed tomography in diagnosing the cause of primary aldosteronism.  N Engl J Med 1980;3031503- 1507PubMedGoogle ScholarCrossref
6.
Nwariaku  FEChampine  JKim  LTBurkey  SO'keefe  GSnyder  WH  III Radiologic characterization of adrenal masses: the role of computed tomography–derived attenuation values.  Surgery 2001;1301068- 1071PubMedGoogle ScholarCrossref
7.
Korobkin  M CT characterization of adrenal masses: the time has come.  Radiology 2000;217629- 632PubMedGoogle ScholarCrossref
8.
Boland  GWLee  MJGazelle  GSHalpern  EFMcNicholas  MMMueller  PR Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature.  AJR Am J Roentgenol 1998;171201- 204PubMedGoogle ScholarCrossref
9.
Francis  IRKorobkin  M Incidentally discovered adrenal masses.  Magn Reson Imaging Clin N Am 1997;5147- 164PubMedGoogle Scholar
10.
Bastounis  EAKarayiannakis  AJAnapliotou  MLNakopoulou  LMakri  GGPapalambros  EL Incidentalomas of the adrenal gland: diagnostic and therapeutic implications.  Am Surg 1997;63356- 360PubMedGoogle Scholar
11.
Ganguly  A Primary aldosteronism.  N Engl J Med 1998;3391828- 1834PubMedGoogle ScholarCrossref
12.
Nomura  KKusakabe  KMaki  MIto  YAiba  MDemura  H Iodomethylnorcholesterol uptake in an aldosteronoma shown by dexamethasone-suppression scintigraphy: relationship to adenoma size and functional activity.  J Clin Endocrinol Metab 1990;71825- 830PubMedGoogle ScholarCrossref
13.
Rossi  GPChiesura-Corona  MTregnaghi  A  et al.  Imaging of aldosterone-secreting adenomas: a prospective comparison of computed tomography and magnetic resonance imaging in 27 patients with suspected primary aldosteronism.  J Hum Hypertens 1993;7357- 363PubMedGoogle Scholar
14.
Geisinger  MAZelch  MGBravo  ELRisius  BFO'Donovan  PBBorkowski  GP Primary hyperaldosteronism: comparison of CT, adrenal venography, and venous sampling.  AJR Am J Roentgenol 1983;141299- 302PubMedGoogle ScholarCrossref
15.
Young  WFStanson  AWThompson  GBGrant  CSFarley  DRvan Heerden  JA Role for adrenal venous sampling in primary aldosteronism.  Surgery 2004;1361227- 1235PubMedGoogle ScholarCrossref
16.
Rossi  GPSacchetto  AChiesura-Corona  M  et al.  Identification of the etiology of primary aldosteronism with adrenal vein sampling in patients with equivocal computed tomography and magnetic resonance findings: results in 104 consecutive cases.  J Clin Endocrinol Metab 2001;861083- 1090PubMedGoogle ScholarCrossref
17.
Magill  SBRaff  HShaker  JL  et al.  Comparison of adrenal vein sampling and computed tomography in the differentiation of primary aldosteronism.  J Clin Endocrinol Metab 2001;861066- 1071PubMedGoogle Scholar
18.
Doppman  JLGill  JR  JrMiller  DL  et al.  Distinction between hyperaldosteronism due to bilateral hyperplasia and unilateral aldosteronoma: reliability of CT.  Radiology 1992;184677- 682PubMedGoogle ScholarCrossref
19.
Young  WF  JrKlee  GG Primary aldosteronism: diagnostic evaluation.  Endocrinol Metab Clin North Am 1988;17367- 395PubMedGoogle Scholar
20.
Young  WF  JrStanson  AWGrant  CSThompson  GBvan Heerden  JA Primary aldosteronism: adrenal venous sampling.  Surgery 1996;120913- 919PubMedGoogle ScholarCrossref
21.
Doppman  JLGill  JR  Jr Hyperaldosteronism: sampling the adrenal veins.  Radiology 1996;198309- 312PubMedGoogle ScholarCrossref
22.
Rossi  GPSacchetto  AVisentin  P  et al.  Changes in left ventricular anatomy and function in hypertension and primary aldosteronism.  Hypertension 1996;271039- 1045PubMedGoogle ScholarCrossref
23.
Sawka  AMYoung  WFThompson  GB  et al.  Primary aldosteronism: factors associated with normalization of blood pressure after surgery.  Ann Intern Med 2001;135258- 261PubMedGoogle ScholarCrossref
24.
Celen  OO'Brien  MJMelby  JCBeazley  RM Factors influencing outcome of surgery for primary aldosteronism.  Arch Surg 1996;131646- 650PubMedGoogle ScholarCrossref
25.
Rocha  RMartin-Berger  CLYang  PScherrer  RDelyani  JMcMahon  E Selective aldosterone blockade prevents angiotensin II/salt-induced vascular inflammation in the rat heart.  Endocrinology 2002;1434828- 4836PubMedGoogle ScholarCrossref
26.
Rocha  RRudolph  AEFrierdich  GE  et al.  Aldosterone induces a vascular inflammatory phenotype in the rat heart.  Am J Physiol Heart Circ Physiol 2002;283H1802- H1810PubMedGoogle Scholar
27.
Rocha  RFunder  JW The pathophysiology of aldosterone in the cardiovascular system.  Ann N Y Acad Sci 2002;97089- 100PubMedGoogle ScholarCrossref
28.
Rocha  RWilliams  GH Rationale for the use of aldosterone antagonists in congestive heart failure.  Drugs 2002;62723- 731PubMedGoogle ScholarCrossref
29.
Stier  CT  JrChander  PNRocha  R Aldosterone as a mediator in cardiovascular injury.  Cardiol Rev 2002;1097- 107PubMedGoogle ScholarCrossref
30.
Martinez  DVRocha  RMatsumura  M  et al.  Cardiac damage prevention by eplerenone: comparison with low sodium diet or potassium loading.  Hypertension 2002;39614- 618PubMedGoogle Scholar
31.
Ghose  RPHall  PMBravo  EL Medical management of aldosterone-producing adenomas.  Ann Intern Med 1999;131105- 108PubMedGoogle ScholarCrossref
32.
Bravo  EL Medical management of primary hyperaldosteronism.  Curr Hypertens Rep 2001;3406- 409PubMedGoogle ScholarCrossref
33.
Sywak  MPasieka  JL Long-term follow-up and cost benefit of adrenalectomy in patients with primary hyperaldosteronism.  Br J Surg 2002;891587- 1593PubMedGoogle ScholarCrossref
Paper
May 1, 2006

Primary Hyperaldosteronism: Effect of Adrenal Vein Sampling on Surgical Outcome

Author Affiliations

Author Affiliations: Departments of Surgery (Drs Nwariaku, Miller, Holt, Livingston, and Snyder), Medicine (Drs Auchus, Nesbitt, Vongpatanasin, and Victor), Radiology (Drs Watumull and Dolmatch), and Pathology (Dr Wians), University of Texas Southwestern Medical Center, Dallas.

Arch Surg. 2006;141(5):497-503. doi:10.1001/archsurg.141.5.497
Abstract

Hypothesis  Adrenal vein sampling is superior to computed tomography for subtype differentiation of primary hyperaldosteronism.

Design  Retrospective review.

Setting  University medical center.

Patients  Forty-eight patients (32 men and 16 women) with biochemically confirmed primary hyperaldosteronism.

Main Outcome Measures  We compared demographic factors, results of biochemical and imaging studies (computed tomography and adrenal vein sampling), therapy, and patient outcomes.

Results  Mean ± SEM adrenal nodule size was 1.54 ± 0.2 cm. Adrenal vein sampling was performed in 41 (85%) of 48 patients, and it was successful in 39 (95%) of those 41 patients. Concordance between computed tomography and adrenal vein sampling was observed in 22 (54%) of the 41 patients. Thirty-two patients underwent successful laparoscopic adrenalectomy. There was 1 complication and no deaths. All 32 patients were cured of hypokalemia.

Conclusion  Adrenal vein sampling is superior to image-based techniques for subtype differentiation of primary hyperaldosteronism.

×