Search Results

You are looking at 51 - 60 of 189 items for

  • Abstract: Atherosclerosis x
  • Abstract: Carotid x
  • Abstract: Circulation x
  • Abstract: Stroke x
  • Abstract: Veins x
  • Abstract: Heart x
  • Abstract: Myocardial x
  • Abstract: Cardio* x
Clear All Modify Search
Merete Gedde-Dahl
Search for other papers by Merete Gedde-Dahl in
Google Scholar
PubMed
Close
,
Espen Thiis-Evensen
Search for other papers by Espen Thiis-Evensen in
Google Scholar
PubMed
Close
,
Andreas Myklebust Tjølsen Section of Gastroenterology, University of Oslo School of Medicine, Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Postboks 4953, Nydalen, 0424 Oslo, Norway

Search for other papers by Andreas Myklebust Tjølsen in
Google Scholar
PubMed
Close
,
Kjerstin Skrede Mordal
Search for other papers by Kjerstin Skrede Mordal in
Google Scholar
PubMed
Close
,
Morten Vatn
Search for other papers by Morten Vatn in
Google Scholar
PubMed
Close
, and
Deidi S Bergestuen
Search for other papers by Deidi S Bergestuen in
Google Scholar
PubMed
Close

Neuroendocrine tumors (NETs) arising in the small intestine are known to produce vasoactive substances, including serotonin, that may result in the carcinoid syndrome (flushing, diarrhea, bronchoconstriction, and carcinoid heart disease). Measurement of the serotonin breakdown product 5-hydroxyindoleacetic acid (5-HIAA) in urine is important in diagnosing and monitoring of patients with intestinal NETs. Our aim was to compare 5-HIAA measurement in 24-h urine sampling with overnight (∼8-h) sampling in patients with known NETs, or at follow-up of patients potentially cured for their NETs. Twenty-four-hour and overnight urine samples were collected from 34 patients and analyzed for urinary 5-HIAA (U5-HIAA) using HPLC. Comparison of the overnight sampling values with the 24-h values showed no difference, P=0.45, and there was a significant direct correlation between the two samples using linear regression (R=0.97, P<0.001). U5-HIAA sample collection during a nightly interval of ∼8 h appears to have the same accuracy as the 24-h collection in this group of patients.

Open access
Natasha Bergmann Department of Endocrinology, Ull Care A/S, Psychiatric Research Unit, The Cardiovascular Institute, The National Research Center for the Working Environment, Faculty of Health and Medical Sciences, Herlev University Hospital, Herlev, Denmark

Search for other papers by Natasha Bergmann in
Google Scholar
PubMed
Close
,
Søren Ballegaard Department of Endocrinology, Ull Care A/S, Psychiatric Research Unit, The Cardiovascular Institute, The National Research Center for the Working Environment, Faculty of Health and Medical Sciences, Herlev University Hospital, Herlev, Denmark

Search for other papers by Søren Ballegaard in
Google Scholar
PubMed
Close
,
Pernille Holmager Department of Endocrinology, Ull Care A/S, Psychiatric Research Unit, The Cardiovascular Institute, The National Research Center for the Working Environment, Faculty of Health and Medical Sciences, Herlev University Hospital, Herlev, Denmark

Search for other papers by Pernille Holmager in
Google Scholar
PubMed
Close
,
Per Bech Department of Endocrinology, Ull Care A/S, Psychiatric Research Unit, The Cardiovascular Institute, The National Research Center for the Working Environment, Faculty of Health and Medical Sciences, Herlev University Hospital, Herlev, Denmark

Search for other papers by Per Bech in
Google Scholar
PubMed
Close
,
Åke Hjalmarson Department of Endocrinology, Ull Care A/S, Psychiatric Research Unit, The Cardiovascular Institute, The National Research Center for the Working Environment, Faculty of Health and Medical Sciences, Herlev University Hospital, Herlev, Denmark

Search for other papers by Åke Hjalmarson in
Google Scholar
PubMed
Close
,
Finn Gyntelberg Department of Endocrinology, Ull Care A/S, Psychiatric Research Unit, The Cardiovascular Institute, The National Research Center for the Working Environment, Faculty of Health and Medical Sciences, Herlev University Hospital, Herlev, Denmark

Search for other papers by Finn Gyntelberg in
Google Scholar
PubMed
Close
, and
Jens Faber Department of Endocrinology, Ull Care A/S, Psychiatric Research Unit, The Cardiovascular Institute, The National Research Center for the Working Environment, Faculty of Health and Medical Sciences, Herlev University Hospital, Herlev, Denmark
Department of Endocrinology, Ull Care A/S, Psychiatric Research Unit, The Cardiovascular Institute, The National Research Center for the Working Environment, Faculty of Health and Medical Sciences, Herlev University Hospital, Herlev, Denmark

Search for other papers by Jens Faber in
Google Scholar
PubMed
Close

The aim of this study was to test i) whether patients having diabetes and ischemic heart disease (IHD), i.e., patients suffering from two chronic diseases, demonstrate a higher degree of chronic stress when compared with patients suffering from IHD alone, and ii) whether suffering from the two chronic diseases results in an elevation in specific elements of the chronic stress concept. A total of 361 participants with IHD were included, of whom 47 suffered from concomitant diabetes. Stress was measured by pressure pain sensitivity (PPS) and by the following questionnaires: the Major Depression Inventory (MDI), the SF-36 Quality of Life questionnaire (SF-36 QOL), the WHO-5 Well-being Index, and the clinical stress signs (CSSs) scale. Participants with diabetes and IHD had a higher MDI score, a lower SF-36 physical component summary score, and a lower score of several sub-measurements of the SF-36 mental component score when compared with patients with IHD without diabetes. No significant differences were observed regarding stress measured by the PPS measure, the WHO-5 Well-being Index, or the number of CSSs. In conclusion, the combination of diabetes and IHD seems to be associated with increased depressive symptoms, lower overall physical QOL, and reduced mental QOL on several sub-elements of the questionnaire. This should be recognized in the management of patients with double diagnoses.

Open access
S U Jayasinghe
Search for other papers by S U Jayasinghe in
Google Scholar
PubMed
Close
,
S J Torres
Search for other papers by S J Torres in
Google Scholar
PubMed
Close
,
C A Nowson
Search for other papers by C A Nowson in
Google Scholar
PubMed
Close
,
A J Tilbrook Centre for Physical Activity and Nutrition Research, Livestock and Farming Systems, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Melbourne, Victoria 3125, Australia

Search for other papers by A J Tilbrook in
Google Scholar
PubMed
Close
, and
A I Turner
Search for other papers by A I Turner in
Google Scholar
PubMed
Close

We tested the hypothesis that overweight/obese men aged 50–70 years will have a greater salivary cortisol, salivary alpha amylase and heart rate (HR) responses to psychological stress compared with age matched lean men. Lean (BMI=20–25 kg/m2; n=19) and overweight/obese (BMI=27–35 kg/m2; n=17) men (50–70 years) were subjected to a well-characterised psychological stress (Trier Social Stress Test, TSST) at 1500 h. Concentrations of cortisol and alpha amylase were measured in saliva samples collected every 7–15 min from 1400 to 1700 h. HR was recorded using electrocardiogram. Body weight, BMI, percentage body fat, resting systolic and diastolic blood pressure and mean arterial pressure were significantly higher (P<0.05) in overweight/obese men compared with lean men. Both groups responded to the TSST with a substantial elevation in salivary cortisol (372%), salivary alpha amylase (123%) and HR (22%). These responses did not differ significantly between the groups (time×treatment interaction for salivary cortisol, salivary alpha amylase and HR; P=0.187, P=0.288, P=0.550, respectively). There were no significant differences between the groups for pretreatment values, peak height, difference between pretreatment values and peak height (reactivity) or area under the curve for salivary cortisol, salivary alpha amylase or HR (P>0.05 for all). The results showed that, for men with a moderate level of overweight/obesity who were otherwise healthy, the response of salivary cortisol, salivary alpha amylase and HR to acute psychological stress was not impaired.

Open access
Jing Hong Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for other papers by Jing Hong in
Google Scholar
PubMed
Close
,
Wen-Yue Liu Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for other papers by Wen-Yue Liu in
Google Scholar
PubMed
Close
,
Xiang Hu Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for other papers by Xiang Hu in
Google Scholar
PubMed
Close
,
Fei-Fei Jiang Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for other papers by Fei-Fei Jiang in
Google Scholar
PubMed
Close
,
Ze-Ru Xu Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for other papers by Ze-Ru Xu in
Google Scholar
PubMed
Close
,
Fang Li Department of Endocrinology, Ruian Traditional Chinese Medicine Hospital, Wenzhou, China

Search for other papers by Fang Li in
Google Scholar
PubMed
Close
,
Fei-Xia Shen Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for other papers by Fei-Xia Shen in
Google Scholar
PubMed
Close
, and
Hong Zhu Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Search for other papers by Hong Zhu in
Google Scholar
PubMed
Close

Background

A prolonged heart rate-corrected QT interval (QTc) has been associated with peripheral artery disease (PAD) in the general population. However, no study to date has identified a link between prolonged QTc and the severity of PAD in patients with diabetes mellitus and foot ulcers (DFUs). This study aimed to investigate this relationship.

Methods

This multicenter study enrolled 281 patients with DFUs. The severity of PAD was classified into no severe PAD group (without stenosis or occlusion) and severe PAD group (with stenosis or occlusion) based on duplex ultrasonography. The association of prolonged QTc with severe PAD was evaluated in a multivariable mixed-effect logistic regression model, with the hospital as a random effect. Directed acyclic graphs were used to drive the selection of variables to fit the regression model.

Results

Patients with severe PAD had longer QTc than those without. Based on the multivariable mixed-effect logistic regression model, a prolonged QTc was positively associated with severe PAD (odds ratio (OR) = 2.61; 95% CI: 1.07–6.35) and severe DFUs (Wagner grade score ≥ 3) (OR = 2.87; 95% CI: 1.42–5.81).

Conclusions

A prolonged QTc was associated with severe PAD in patients with DFUs. Further research is required to ascertain whether the association is causal.

Open access
Hongyan Wang Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China

Search for other papers by Hongyan Wang in
Google Scholar
PubMed
Close
,
Bin Wu Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China

Search for other papers by Bin Wu in
Google Scholar
PubMed
Close
,
Zichuan Yao Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China

Search for other papers by Zichuan Yao in
Google Scholar
PubMed
Close
,
Xianqing Zhu Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China

Search for other papers by Xianqing Zhu in
Google Scholar
PubMed
Close
,
Yunzhong Jiang Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China

Search for other papers by Yunzhong Jiang in
Google Scholar
PubMed
Close
, and
Song Bai Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China

Search for other papers by Song Bai in
Google Scholar
PubMed
Close

Purpose

Although resection is the primary treatment strategy for pheochromocytoma, surgery is associated with a high risk of morbidity. At present, there is no nomogram for prediction of severe morbidity after pheochromocytoma surgery, thus the aim of the present study was to develop and validate a nomogram for prediction of severe morbidity after pheochromocytoma surgery.

Methods

The development cohort consisted of 262 patients who underwent unilateral laparoscopic or open pheochromocytoma surgery at our center between 1 January 2007 and 31 December 2016. The patients’ clinicopathological characters were recorded. The least absolute shrinkage and selection operator (LASSO) binary logistic regression model was used for data dimension reduction and feature selection, then multivariable logistic regression analysis was used to develop the predictive model. An independent validation cohort consisted of 128 consecutive patients from 1 January 2017 and 31 December 2018. The performance of the predictive model was assessed in regards to discrimination, calibration, and clinical usefulness.

Results

Predictors of this model included sex, BMI, coronary heart disease, arrhythmia, tumor size, intraoperative hemodynamic instability, and surgical duration. For the validation cohort, the model showed good discrimination with an AUROC of 0.818 (95% CI, 0.745, 0.891) and good calibration (Unreliability test, P = 0.440). Decision curve analysis demonstrated that the model was also clinically useful.

Conclusions

A nomogram was developed to facilitate the individualized prediction of severe morbidity after pheochromocytoma surgery and may help to improve the perioperative strategy and treatment outcome.

Open access
Kimberly Kuiper Clinical Neurodevelopmental Sciences, Leiden University, Leiden, The Netherlands
Leiden Institute for Brain and Cognition, Leiden, The Netherlands

Search for other papers by Kimberly Kuiper in
Google Scholar
PubMed
Close
,
Hanna Swaab Clinical Neurodevelopmental Sciences, Leiden University, Leiden, The Netherlands
Leiden Institute for Brain and Cognition, Leiden, The Netherlands

Search for other papers by Hanna Swaab in
Google Scholar
PubMed
Close
,
Nicole Tartaglia eXtraordinarY Kids Clinic, Developmental Pediatrics, Children’s Hospital Colorado, Aurora, Colorado
Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado

Search for other papers by Nicole Tartaglia in
Google Scholar
PubMed
Close
, and
Sophie van Rijn Clinical Neurodevelopmental Sciences, Leiden University, Leiden, The Netherlands
Leiden Institute for Brain and Cognition, Leiden, The Netherlands

Search for other papers by Sophie van Rijn in
Google Scholar
PubMed
Close

The presence of an additional X or Y chromosome (sex chromosome trisomies, SCT) is associated with an increased risk for neurodevelopmental difficulties, including socio-emotional problems, across the life span. Studying emotion regulation in young children with SCT could signal deviations in emotional development that serve as risk markers to guide clinical care. This study explored the presence and variety of emotion regulation strategies in 75 SCT children and 81 population-based controls, aged 1–7 years, during a frustration-inducing event in which physiological (heart rate) and observational data (behavioral responses) were collected. Children with SCT were equally physiologically aroused by the event as compared to controls. However, they showed more emotion regulation difficulties in terms of behavior compared to controls that were not explicable in terms of differences in general intellectual functioning. Specifically, they had a more limited range of behavioral alternatives and tended to rely longer on inefficient strategies with increasing age. The field of practice should be made aware of these early risk findings regarding emotion regulation in SCT, which may potentially lay the foundation for later socio-emotional problems, given the significant impact of emotion regulation on child and adult mental health outcomes. The current results may help to design tailored interventions to reduce the impact of the additional sex chromosome on adaptive functioning, psychopathology, and quality of life.

Open access
Randi Ugleholdt Department of Endocrinology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

Search for other papers by Randi Ugleholdt in
Google Scholar
PubMed
Close
,
Åse Krogh Rasmussen Department of Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

Search for other papers by Åse Krogh Rasmussen in
Google Scholar
PubMed
Close
,
Pernille A H Haderslev Department of Anaesthesiology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark

Search for other papers by Pernille A H Haderslev in
Google Scholar
PubMed
Close
,
Bjarne Kromann-Andersen Department of Urology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark

Search for other papers by Bjarne Kromann-Andersen in
Google Scholar
PubMed
Close
, and
Claus Larsen Feltoft Department of Endocrinology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark

Search for other papers by Claus Larsen Feltoft in
Google Scholar
PubMed
Close

Patients with pheochromocytoma and paraganglioma (PPGL) are treated with α-adrenoceptor antagonists to improve peroperative hemodynamics. However, preoperative blood pressure targets differ between institutions. We retrospectively compared per- and postoperative hemodynamics in 30 patients with PPGL that were pretreated with phenoxybenzamine aiming at different blood pressure targets at two separate endocrine departments. All patients were subsequently undergoing laparoscopic surgery at Department of Urology, Herlev University hospital. Fourteen patients were treated targeting to symptomatic and significant orthostatic hypotension and 16 patients to a seated blood pressure below 130/80 mmHg. As a control group, we included 34 patients undergoing laparoscopic adrenalectomy for other reasons. The group titrated to orthostatic hypotension required a higher dose of phenoxybenzamine to achieve the blood pressure target. This group had less intraoperative systolic and diastolic blood pressure fluctuation (Mann–Whitney U test; P  < 0.05) and less periods with heart rate above 100 b.p.m. (Mann–Whitney U test; P = 0.04) as compared to the group with a preoperative blood pressure target below 130/80 mmHg. Peroperative use of intravenous fluids were similar between the two groups, but postoperatively more intravenous fluids were administered in the group with a target of ortostatism. Overall, the control group was more hemodynamic stable as compared to either group treated for PPGL. We conclude that phenoxybenzamine pretreatment targeting ortostatic hypotension may improve peroperative hemodynamic stability but causes a higher postoperative requirement for intravenous fluids. Overall, PPGL surgery is related to greater hemodynamic instability compared to adrenalectomy for other reasons.

Open access
Ashley N Reeb Department of Otolaryngology, Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, USA

Search for other papers by Ashley N Reeb in
Google Scholar
PubMed
Close
,
Andrea Ziegler Department of Otolaryngology, Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, USA

Search for other papers by Andrea Ziegler in
Google Scholar
PubMed
Close
, and
Reigh-Yi Lin Department of Otolaryngology, Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, USA

Search for other papers by Reigh-Yi Lin in
Google Scholar
PubMed
Close

Follicular thyroid cancer (FTC) is the second most common type of thyroid cancers. In order to develop more effective personalized therapies, it is necessary to thoroughly evaluate patient-derived cell lines in in vivo preclinical models before using them to test new, targeted therapies. This study evaluates the tumorigenic and metastatic potential of a panel of three human FTC cell lines (WRO, FTC-238, and TT1609-CO2) with defined genetic mutations in two in vivo murine models: an orthotopic thyroid cancer model to study tumor progression and a tail vein injection model to study metastasis. All cell lines developed tumors in the orthotopic model, with take rates of 100%. Notably, WRO-derived tumors grew two to four times faster than tumors arising from the FTC-238 and TT2609-CO2 cell lines. These results mirrored those of a tail vein injection model for lung metastasis: one hundred percent of mice injected with WRO cells in the tail vein exhibited aggressive growth of bilateral lung metastases within 35 days. In contrast, tail vein injection of FTC-238 or TT2609-CO2 cells did not result in lung metastasis. Together, our work demonstrates that these human FTC cell lines display highly varied tumorigenic and metastatic potential in vivo with WRO being the most aggressive cell line in both orthotopic and lung metastasis models. This information will be valuable when selecting cell lines for preclinical drug testing.

Open access
H A Booij Department of Neurology, Medisch Spectrum Twente, Enschede, the Netherlands

Search for other papers by H A Booij in
Google Scholar
PubMed
Close
,
W D C Gaykema Roessingh Rehabilitation Center, Enschede, the Netherlands

Search for other papers by W D C Gaykema in
Google Scholar
PubMed
Close
,
K A J Kuijpers Roessingh Rehabilitation Center, Enschede, the Netherlands

Search for other papers by K A J Kuijpers in
Google Scholar
PubMed
Close
,
M J M Pouwels Department of Endocrinology, Medisch Spectrum Twente, Enschede, the Netherlands

Search for other papers by M J M Pouwels in
Google Scholar
PubMed
Close
, and
H M den Hertog Department of Neurology, Medisch Spectrum Twente, Enschede, the Netherlands

Search for other papers by H M den Hertog in
Google Scholar
PubMed
Close

Background

Poststroke fatigue (PSF) is a highly prevalent and debilitating condition. However, the etiology remains incompletely understood. Literature suggests the co-prevalence of pituitary dysfunction (PD) with stroke, and the question raises whether this could be a contributing factor to the development of PSF. This study reviews the prevalence of PD after stroke and other acquired brain injuries and its association with fatigue.

Summary

We performed a bibliographic literature search of MEDLINE and EMBASE databases for English language studies on PD in adult patients with stroke, traumatic brain injury (TBI) or aneurysmatic subarachnoid hemorrhage (aSAH). Forty-two articles were selected for review. Up to 82% of patients were found to have any degree of PD after stroke. Growth hormone deficiency was most commonly found. In aSAH and TBI, prevalences up to 49.3% were reported. However, data differed widely between studies, mostly due to methodological differences including the diagnostic methods used to define PD and the focus on the acute or chronic phase. Data on PD and outcome after stroke, aSAH and TBI are conflicting. No studies were found investigating the association between PD and PSF. Data on the association between PD and fatigue after aSAH and TBI were scarce and conflicting, and fatigue is rarely been investigated as a primary end point.

Key messages

Data according to the prevalence of PD after stroke and other acquired brain injury suggest a high prevalence of PD after these conditions. However, the clinical relevance and especially the association with fatigue need to be established.

Open access
Richard W Carroll Endocrine, Diabetes, and Research Centre, Wellington Regional Hospital, New Zealand

Search for other papers by Richard W Carroll in
Google Scholar
PubMed
Close
,
Brian Corley Endocrine, Diabetes, and Research Centre, Wellington Regional Hospital, New Zealand
Department of Medicine, University of Otago, Wellington, New Zealand

Search for other papers by Brian Corley in
Google Scholar
PubMed
Close
,
Joe Feltham Department of Radiology, Wellington Regional Hospital, New Zealand

Search for other papers by Joe Feltham in
Google Scholar
PubMed
Close
,
Patricia Whitfield Endocrine, Diabetes, and Research Centre, Wellington Regional Hospital, New Zealand
Department of Medicine, University of Otago, Wellington, New Zealand

Search for other papers by Patricia Whitfield in
Google Scholar
PubMed
Close
,
William Park University of Otago, Wellington, New Zealand

Search for other papers by William Park in
Google Scholar
PubMed
Close
,
Rowena Howard Diabetes and Endocrinology Service, Hutt Hospital, New Zealand

Search for other papers by Rowena Howard in
Google Scholar
PubMed
Close
,
Melissa Yssel Department of Biochemistry & Endocrinology, Awanui Labs, New Zealand

Search for other papers by Melissa Yssel in
Google Scholar
PubMed
Close
,
Ian Phillips Department of Biochemistry, Awanui Labs, Dunedin, New Zealand

Search for other papers by Ian Phillips in
Google Scholar
PubMed
Close
,
Simon Harper Department of Surgery & Anaesethesia, University of Otago, Wellington, New Zealand
Department of General Surgery, Wellington Regional Hospital, New Zealand

Search for other papers by Simon Harper in
Google Scholar
PubMed
Close
, and
Jun Yang Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia
Department of Medicine, Monash University, Clayton, Victoria, Australia

Search for other papers by Jun Yang in
Google Scholar
PubMed
Close

Objective

The assessment of primary aldosteronism incorporates adrenal vein sampling (AVS) to lateralize aldosterone excess. Current adrenal vein sampling protocols rely on concurrent cortisol measurements to assess successful cannulation and lateralization and may be inaccurate in the setting of autonomous cortisol secretion. We aimed to compare the measurement of plasma cortisol and metanephrine concentrations to assess cannulation and lateralization during AVS.

Design

This is a diagnostic accuracy study in a tertiary referral endocrinology department.

Methods

Forty-one consecutive patients with confirmed primary aldosteronism undergoing AVS (49 procedures) were included. None had cortisol autonomy. The use of plasma metanephrine-based ratios were compared with standard cortisol-based ratios to assess cannulation and lateralization during ACTH-stimulated AVS.

Results

There was strong agreement between a cortisol selectivity index (SI) ≥5.0 and an adrenal vein (AV) to peripheral vein (PV) plasma metanephrine ratio (AVmet–PVmet) of ≥12.0 to indicate successful cannulation of the AV (n = 117, sensitivity 98%, specificity 89%, positive predictive value (PPV) 95%, negative predictive value (NPV) 94%). There was strong agreement between the standard cortisol-based SI and an AV plasma metanephrine-to-normetanephrine ratio (AVmet–AVnormet) of ≥2.0 to indicate successful cannulation (n = 117, sensitivity 93%, specificity 86%, PPV 94%, NPV 84%). There was strong agreement between the cortisol- or metanephrine-derived lateralization index (LI) > 4.0 for determining lateralization (n = 26, sensitivity 100%, specificity 94.1%, PPV 91.6%, NPV 100%).

Conclusions

Ratios incorporating plasma metanephrines provide comparable outcomes to standard cortisol-based measurements for interpretation of AVS. Further studies are required to assess the use of metanephrine-derived ratios in the context of confirmed cortisol autonomy.

Significance statement

Primary aldosteronism is a common cause of secondary hypertension, and adrenal vein sampling remains the gold standard test to assess lateralization. Cortisol-derived ratios to assess cannulation and lateralization may be affected by concurrent cortisol dysfunction, which is not uncommon in the context of primary aldosteronism. Our study showed comparable outcomes when using accepted cortisol-derived or metanephrine-derived ratios to determine cannulation and lateralization during adrenal vein sampling. Further research is required to validate these findings and to assess the use of metanephrine-derived ratios in the context of confirmed concurrent cortisol dysfunction.

Open access