Bilateral aldosterone suppression and its resolution in adrenal vein sampling of patients with primary aldosteronism: analysis of data from the WAVES‐J study

Shibayama, Yuki; Wada, Norio; Umakoshi, Hironobu; Ichijo, Takamasa; Fujii, Yukihiko; Kamemura, Kohei; Kai, Tatsuya; Sakamoto, Ryuichi; Ogo, Atsushi; Matsuda, Yuichi; Fukuoka, Tatsunari; Tsuiki, Mika; Naruse, Mitsuhide

doi:10.1111/cen.13090

Cited by 20 publications

(19 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of these patients, we excluded those in whom we could not exclude the possibility of having unilateral hyperaldosteronism regardless of whether they were diagnosed with bilateral hyperaldosteronism according to AVS. We excluded patients with apparent bilateral aldosterone suppression, defined as lower aldosterone/cortisol ratios in the bilateral adrenal veins than that in the IVC [ 19 , 20 ]. We also excluded patients diagnosed with unilateral hyperaldosteronism using a repeat AVS or segmental AVS [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

Relationship Between Visceral Fat and Plasma Aldosterone Concentration in Patients With Primary Aldosteronism

Shibayama

Wada

Baba

et al. 2018

Journal of the Endocrine Society

Self Cite

View full text Add to dashboard Cite

ContextThe involvement of visceral fat in aldosterone secretion has not been reported in patients with primary aldosteronism (PA). Patients with PA are complicated by metabolic syndrome more frequently than those without PA. An excess of visceral fat has been hypothesized to cause an elevation of aldosterone secretion in patients with PA.ObjectivesTo clarify the role of visceral fat in the pathophysiology of PA, we investigated the correlation between plasma aldosterone concentration (PAC) and visceral fat parameters in patients with PA.DesignThis retrospective observational study comprised 131 patients diagnosed with PA between April 2007 and April 2017 at Sapporo City General Hospital. We divided participants into two PA subtypes, aldosterone-producing adenoma (APA; n = 47) and idiopathic hyperaldosteronism (IHA, n = 84), utilizing adrenal venous sampling. We analyzed the correlations of PAC with visceral fat percentage (VF%), visceral fat area (VFA), and subcutaneous fat area, by evaluating computed tomography studies in each subtype group.ResultsPatients with IHA showed a positive correlation of PAC with VF% (r = 0.377, P < 0.001) and VFA (r = 0.443, P < 0.001). The correlation was not evident in patients with APA.ConclusionsThis study revealed a relationship between visceral adipose tissue and aldosterone production only in patients with IHA.

show abstract

Section: Resultsmentioning

confidence: 99%

Relationship Between Visceral Fat and Plasma Aldosterone Concentration in Patients With Primary Aldosteronism

Shibayama

Wada

Baba

et al. 2018

Journal of the Endocrine Society

Self Cite

View full text Add to dashboard Cite

show abstract

“…Wolley et al [ 8 ] reported that 2.6% of the patients who underwent AVS without adrenocorticotropic hormone (ACTH) administration showed the same phenomenon. Recently, we demonstrated using the data from the West Japan Adrenal Vein Sampling (WAVES-J) study that this phenomenon was observed in 9.5% of the patients who underwent AVS without ACTH administration, and that in 92% of these patients, it was resolved by ACTH administration [ 9 ]. In this study, we term this phenomenon as apparent bilateral aldosterone suppression (ABAS).…”

mentioning

confidence: 99%

The Occurrence of Apparent Bilateral Aldosterone Suppression in Adrenal Vein Sampling for Primary Aldosteronism

Shibayama

Wada

Naruse

et al. 2018

Journal of the Endocrine Society

Self Cite

View full text Add to dashboard Cite

ContextIn adrenal venous sampling (AVS) for patients with primary aldosteronism (PA), apparent bilateral aldosterone suppression (ABAS), defined as lower aldosterone/cortisol ratios in the bilateral adrenal veins than that in the inferior vena cava, is occasionally experienced. ABAS is uninterpretable with respect to lateralization of excess aldosterone production. We previously reported that ABAS was not a rare phenomenon and was significantly reduced after adrenocorticotropic hormone (ACTH) administration.ObjectiveTo validate the effects of ACTH administration and adding sampling positions in the left adrenal vein on the prevalence of ABAS in the larger Japan Primary Aldosteronism Study.PatientsThe data from 1689 patients with PA who underwent AVS between January 2006 and October 2016 were studied. All patients in the previous study, the West Japan Adrenal Vein Sampling study, were excluded.Outcome MeasurementsThe prevalence of ABAS was investigated at two sampling positions in the left adrenal vein, the central vein and the common trunk, without and with ACTH administration.ResultsThe prevalence of ABAS with ACTH administration was significantly lower than that without ACTH administration [without ACTH vs with ACTH: 79/440 (18.0%) vs 45/591 (7.6%); P < 0.001]. With ACTH administration, the prevalence of ABAS was not different between the sampling position, at the central vein and at the common trunk [33/591 (5.6%) vs 32/591 (5.4%); P = 1.00].ConclusionsThe effectiveness of ACTH administration for the reduction of ABAS in AVS regardless of the sampling position in the left adrenal vein was confirmed in the larger cohort.

show abstract

“…7 In general, explanatory hypotheses of low aldosterone-tocortisol ratios in adrenal veins in PA are fluctuating aldosterone secretion, accidental superselective cannulation of a tributary vein draining only normal adrenal tissue, an ectopic production of aldosterone, or anomalous anatomy of the adrenal veins. 8 An anatomical study showed the presence of duplicate right adrenal veins in 2 of 83 cases, of which one emptied into the vena cava and one joined an accessory hepatic vein. 9 The adenoma contained a mutation in the ATP2B3 gene, which has been associated with PA. 10 It has been suggested that the steroid profile of the adrenal vein draining an APA-containing gland is specific for the presence of somatic mutations.…”

Section: A Pedunculated Aldosterone-producing Adenoma Drained By An Ementioning

confidence: 99%

A pedunculated aldosterone‐producing adenoma drained by an extra vein causing puzzling results of adrenal vein sampling

Velema

Dekkers

Hermus

et al. 2018

Clinical Endocrinology

View full text Add to dashboard Cite

Bilateral aldosterone suppression and its resolution in adrenal vein sampling of patients with primary aldosteronism: analysis of data from the WAVES‐J study

Abstract: BAS sometimes occurs in AVS without ACTH stimulation. ACTH stimulation significantly reduces BAS with a single AVS procedure.

Cited by 20 publications

References 26 publications

Relationship Between Visceral Fat and Plasma Aldosterone Concentration in Patients With Primary Aldosteronism

Relationship Between Visceral Fat and Plasma Aldosterone Concentration in Patients With Primary Aldosteronism

The Occurrence of Apparent Bilateral Aldosterone Suppression in Adrenal Vein Sampling for Primary Aldosteronism

A pedunculated aldosterone‐producing adenoma drained by an extra vein causing puzzling results of adrenal vein sampling

Contact Info

Product

Resources

About