Comparison of Adrenal Vein Sampling Methods for Subtyping of Primary Aldosteronism: A Retrospective Observational Study.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CardioVascular and Interventional Radiology Pub Date : 2025-04-02 DOI:10.1007/s00270-025-04005-x

Minfu Bai, Qiuping Zhao, Jiajia Dong, Xiaomo Yang, Xiaohui Wang, Chuanyu Gao

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引用次数: 0

Abstract

Purpose: Although adrenal vein sampling (AVS) is the standard method for subtype diagnosis in patients with primary aldosteronism (PA), the methods used to sample the adrenal vein are not standardized. The aim of this study was to establish the optimal method for sampling the adrenal vein based on the pathological findings after surgery for PA.

Methods: We enrolled 168 consecutive patients who were diagnosed to have PA and underwent AVS at our institution between 2019 and 2023. The impact of sampling by gentle negative pressure (GNP) on the accuracy of diagnosis of the PA subtype was compared with that of sampling by gravity, whereby blood flows out naturally.

Results: AVS was performed successfully on both sides in 139 patients using the two sampling methods. Subtype diagnosis using the two sampling methods was concordant in 128 (92.1%) of the 139 patients and discordant in 11 (7.9%). Among the 11 patients with a discordant subtype diagnosis, unilateral adrenalectomy was performed in three with the right unilateral subtype by gravity and the bilateral subtype by GNP, one with the bilateral subtype by gravity and the right unilateral subtype by GNP, and one with the left unilateral subtype by gravity and the bilateral subtype by GNP. The pathological findings after surgery showed that the false-negative rate was 20% (1/5) with data obtained by the gravity method and 80% (4/5) with data obtained by the GNP method. Bilateral AVS took significantly longer when sampling was performed by the gravity method than when it was performed by GNP (p < 0.01).

Conclusions: The gravity method may be preferable to GNP for AVS in patients with PA.

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原发性醛固酮增多症亚型的肾上腺静脉取样方法比较：一项回顾性观察研究。

目的：虽然肾上腺静脉取样（AVS）是原发性醛固酮增多症（PA）患者亚型诊断的标准方法，但肾上腺静脉取样的方法尚未标准化。本研究的目的是根据PA手术后的病理结果，建立最佳的肾上腺静脉采样方法。方法：我们在2019年至2023年期间连续招募了168名确诊为PA并在我们机构接受AVS治疗的患者。温和负压取样（GNP）对PA亚型诊断准确性的影响与重力取样（即血液自然流出）进行了比较。结果：139例患者采用两种取样方法均成功行双侧AVS。139例患者中有128例（92.1%）亚型诊断一致，11例（7.9%）亚型诊断不一致。在11例亚型诊断不一致的患者中，3例为右单侧重力亚型和双侧GNP亚型，1例为双侧重力亚型和右单侧GNP亚型，1例为左单侧重力亚型和双侧GNP亚型。术后病理结果显示，重力法假阴性率为20% (1/5)，GNP法假阴性率为80%（4/5）。重力法进行双侧AVS比GNP法进行双侧AVS花费的时间明显更长(p)结论：重力法可能比GNP法更适合PA患者的AVS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CardioVascular and Interventional Radiology 医学-核医学

CiteScore

5.50

自引率

13.80%

发文量

306

审稿时长

3-8 weeks

期刊介绍： CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.