Impact of Conducting Adrenal Venous Sampling in the Morning Versus Afternoon in Primary Aldosteronism
Open Access
- 6 January 2023
- journal article
- research article
- Published by The Endocrine Society in Journal of the Endocrine Society
- Vol. 7 (3), bvad007
- https://doi.org/10.1210/jendso/bvad007
Abstract
Purpose Adrenal venous sampling (AVS) is the gold standard technique for subtype differentiation of primary aldosteronism (PA) and to obtain aldosterone and cortisol measurements; however, their secretion patterns show fluctuations during the day. We aimed to examine the effects of AVS timing on AVS results. Methods This multicenter, retrospective, observational study included a total of 753 patients who were diagnosed with PA and underwent AVS in four centers in Japan. Among them, 504 and 249 patients underwent AVS in the morning (AM-AVS) and in the afternoon (PM-AVS), respectively. The outcome measures were the impact of AVS timing and hormone fluctuations in a day on AVS results. Results There were no differences in the success rate of AVS, diagnostic rate of disease type, or frequency of discrepancy in PA subtypes between the AM-AVS and PM-AVS groups. Regarding patients with unilateral PA, aldosterone concentrations in adrenal venous blood did not differ between the two groups on the dominant or non-dominant side. Conversely, regarding patients with bilateral PA, aldosterone concentrations in adrenal venous blood were significantly higher in the AM-AVS than in the PM-AVS group. Conclusions The timing of AVS did not seem to have a significant impact on subtype diagnosis. The aldosterone levels in adrenal venous blood were significantly higher in patients with bilateral PA in the AM-AVS group, but there was no such difference between patients with unilateral PA in the AM-AVS and PM-AVS groups. Each subtype may have a different hormone secretion pattern in a day.Funding Information
- Japan Society for the Promotion of Science (19111212)
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