Clinical impact of strict criteria for selectivity and lateralization in adrenal vein sampling.
Hormones (Athens)
; 15(2): 264-270, 2015 Apr.
Article
em En
| MEDLINE
| ID: mdl-27376419
ABSTRACT
INTRODUCTION:
Selectivity index (SI) and lateralization index (LI) thresholds determine the adequacy of adrenal vein sampling (AVS) and the degree of lateralization. The purpose of this study was investigate the clinical outcome of patients whose adrenal vein sampling was interpreted using "strict criteria" (SC) (SIpre-stimuli≥3, SIpost-stimuli≥5 and LIpre-stimuli≥4, LIpost-stimuli≥4). MATERIALS ANDMETHODS:
A retrospective review of 73 consecutive AVS procedures was performed and 67 were technically successful. Forty-three patients showed lateralization and underwent surgery, while 24 did not lateralize and were managed conservatively. Systolic blood pressure (SBP), diastolic blood pressure (DBP), kalemia (K(+)), and the change in number of blood pressure (BP) medications were recorded for each patient before and after AVS and potential surgery were performed.RESULTS:
In the surgery group, BP and K(+) changed respectively from 160±5.3/100±2.0 mmHg to 127±3.3/80±1.9 (p <0.001) and from 3.00±0.10 to 4.4±0.09 (p <0.001). In the medically managed group, BP and K(+) changed respectively from 148±7.3/93±4.3 to 135±3.3/86±1.9 (p <0.001) and from 2.68±0.10 to 4.3±0.09. After surgery or AVS, the patients who took ≥3 blood pressure medications were six (14.0%) in the lateralized group and 22 (91.7%) in the non-lateralized group (p <0.001).CONCLUSIONS:
AVS interpretation with SC leads to significant clinical improvement in both patients who underwent surgery and those managed conservatively.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Potássio
/
Pressão Sanguínea
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Guias de Prática Clínica como Assunto
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Glândulas Suprarrenais
/
Hiperaldosteronismo
Tipo de estudo:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Hormones (Athens)
Assunto da revista:
ENDOCRINOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Estados Unidos