Differentiation of unilateral from bilateral forms of primary aldosteronism by adrenal venous sampling

Differentiation of unilateral from bilateral forms of primary aldosteronism by adrenal venous sampling: Adrenal venous sampling is performed according to a defined standardized protocol in patients with confirmed PA after withdrawal of interfering medication (see text for details). Adrenal veins are sequentially catheterized via the femoral veins and blood is sampled from the inferior vena cava and from the right and left adrenal veins. The success of catheterization of each adrenal vein is indicated by the selectivity index (Tables 3 and 4) that can be determined by a rapid-onset cortisol assay (41, 42, 43). Plasma aldosterone and cortisol concentrations are measured in all blood samples. Adrenal venous plasma aldosterone concentrations are corrected for any dilution by blood from the inferior phrenic vein (on the left side) or from the inferior vena cava (on the right side) by dividing by the respective plasma cortisol concentrations (aldosterone-to-cortisol ratios). The measurements of aldosterone and cortisol are used to derive the lateralization index and the contralateral ratio | European Journal of Endocrinology 179, 1; 10.1530/EJE-17-0990

Differentiation of unilateral from bilateral forms of primary aldosteronism by adrenal venous sampling

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