TY - JOUR
T1 - Adrenal venous sampling for primary aldosteronism and clinical outcomes after unilateral adrenalectomy
T2 - A single-center experience
AU - Murashima, Miho
AU - Trerotola, Scott O.
AU - Fraker, Douglas L.
AU - Han, Dale
AU - Townsend, Raymond R.
AU - Cohen, Debbie L.
PY - 2009/6
Y1 - 2009/6
N2 - Adrenal venous sampling (AVS) remains controversial in the management of primary aldosteronism. Retrospective chart review was conducted at the Hospital of the University of Pennsylvania from July 2001 to September 2007. A total of 113 patients underwent AVS, 16 patients were excluded as records were unavailable. Among 97 remaining patients, 61 had unilateral disease and 57 underwent unilateral adrenalectomy. Blood pressure (BP) improved significantly with less antihypertensive medication requirement. Among those with different BP responses to adrenalectomy (cure, improvement, or no change), a higher number of preoperative antihypertensive medications was associated with persistent hypertension (P = .03). There were no significant differences in age (P = .14), duration of hypertension (P = .60), family history of hypertension (P = .68), or serum creatinine (P = .34). When AVS shows lateralization, age, duration of hypertension, family history, or renal dysfunction did not predict BP response to adrenalectomy. Results suggest that these factors should not preclude AVS and subsequent adrenalectomy. Further studies are indicated to confirm these findings.
AB - Adrenal venous sampling (AVS) remains controversial in the management of primary aldosteronism. Retrospective chart review was conducted at the Hospital of the University of Pennsylvania from July 2001 to September 2007. A total of 113 patients underwent AVS, 16 patients were excluded as records were unavailable. Among 97 remaining patients, 61 had unilateral disease and 57 underwent unilateral adrenalectomy. Blood pressure (BP) improved significantly with less antihypertensive medication requirement. Among those with different BP responses to adrenalectomy (cure, improvement, or no change), a higher number of preoperative antihypertensive medications was associated with persistent hypertension (P = .03). There were no significant differences in age (P = .14), duration of hypertension (P = .60), family history of hypertension (P = .68), or serum creatinine (P = .34). When AVS shows lateralization, age, duration of hypertension, family history, or renal dysfunction did not predict BP response to adrenalectomy. Results suggest that these factors should not preclude AVS and subsequent adrenalectomy. Further studies are indicated to confirm these findings.
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U2 - 10.1111/j.1751-7176.2009.00120.x
DO - 10.1111/j.1751-7176.2009.00120.x
M3 - Article
C2 - 19527322
AN - SCOPUS:67749084220
SN - 1524-6175
VL - 11
SP - 316
EP - 323
JO - Journal of Clinical Hypertension
JF - Journal of Clinical Hypertension
IS - 6
ER -