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1Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
2Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
3Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
4Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Copyright © 2018 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS: Conception or design: C.H.P., N.H., Y.R. Acquisition, analysis, or interpretation of data: C.H.P., N.H., K.H., S.W.K., C.R.L., S.P., Y.R. Drafting the work or revising: C.H.P., N.H., Y.R. Final approval of the manuscript: C.H.P., N.H., K.H., S.W.K., C.R.L., S.P., Y.R.
Values are expressed as median (interquartile range) or number (%).
AVS, adrenal venous sampling; CT, computed tomography; C-AVS, C-arm computed tomography-assisted AVS; PA, primary aldosteronism.
aUnilateral PA includes aldosterone-producing adenomas and unilateral adrenal hyperplasia; bBilateral PA includes bilateral adrenal hyperplasia or bilateral idiopathic hyperaldosteronism; cConcordant findings include unilateral lesions on CT and ipsilateral lateralization on AVS, and bilateral lesions on CT and no lateralization on AVS; dDiscordant findings include unilateral lesions on CT and contralateral or no lateralization on AVS.
Variable | Pre-C-AVS (n=32) | Post-C-AVS (n=124) | P value |
---|---|---|---|
Age, yr | 46.2±10.5 | 50.0±11.4 | 0.093 |
Sex | 0.438 | ||
Male | 14 (43.7) | 45 (36.2) | |
Female | 18 (56.2) | 79 (63.7) | |
Body mass index, kg/m2 | 24.7±3.1 | 24.8±3.8 | 0.879 |
Systolic blood pressure, mm Hg | 157±21 | 146±14 | 0.001 |
Diastolic blood pressure, mm Hg | 94±14 | 91±12 | 0.333 |
Serum potassium, mmol/L | 3.1±0.6 | 3.7±0.5 | <0.001 |
PRA, ng/mL/hr | 0.11 (0.07–0.20) | 0.21 (0.10–0.42) | 0.006 |
PAC, ng/dL | 24.7 (18.4–55.5) | 34.4 (20.5–56.3) | 0.329 |
ARR, ng/dL per ng/mL/hr | 389 (157–1,068) | 121 (55–428) | 0.002 |
Variable | Pre-C-AVS (n=32) | Post-C-AVS (n=124) | P value |
---|---|---|---|
Median selectivity index | |||
Left | 5.4 (1.9–7.4) | 15.5 (9.1–24.6) | <0.001 |
Right | 4.0 (1.4–18.6) | 26.1 (16.2–34.1) | <0.001 |
Subtype | 0.176 | ||
Unilateral PAa | 12 (66.6) | 61 (49.5) | |
Bilateral PAb | 6 (33.3) | 62 (50.4) | |
AVS-CT concordance | 0.934 | ||
Concordantc | 12 (60.0) | 75 (60.9) | |
Discordantd | 8 (40.0) | 48 (39.0) |
Variable | Univariate | Multivariate | ||
---|---|---|---|---|
OR (95% CI) | P value | OR (95% CI) | P value | |
C-AVS (vs. AVS) | 11.48 (4.67–28.19) | <0.001 | 9.01 (2.50–32.40) | <0.001 |
Adjusted right side SI | 1.07 (1.03–1.12) | <0.001 | 1.07 (1.03–1.12) | <0.001 |
Age, yr | 1.01 (0.97–1.04) | 0.672 | 0.98 (0.93–1.03) | 0.560 |
Women (vs. men) | 1.27 (0.58–2.79) | 0.540 | 1.48 (0.50–4.40) | 0.474 |
BMI, kg/m2 | 1.03 (0.92–1.16) | 0.571 | 1.10 (0.95–1.29) | 0.188 |
Lateralization on CT | 0.83 (0.35–1.97) | 0.687 | 0.62 (0.17–2.16) | 0.456 |
SBP, mm Hg | 0.98 (0.96–1.00) | 0.216 | 1.01 (0.97–1.04) | 0.566 |
Serum potassium, mmol/L | 2.31 (1.25–4.28) | 0.007 | 1.40 (0.57–3.42) | 0.453 |
ARR | ||||
Lowest tertile | 1.00 (1.00–1.00) | Reference | 1.00 (1.00–1.00) | Reference |
Middle tertile | 0.87 (0.27–2.81) | 0.823 | 0.64 (0.15–2.74) | 0.552 |
Highest tertile | 0.45 (0.15–1.36) | 0.161 | 1.13 (0.24–5.32) | 0.875 |
Values are expressed as mean±SD, number (%), or median (interquartile range). C-AVS, C-arm computed tomography-assisted adrenal venous sampling; PRA, plasma renin activity; PAC, plasma aldosterone concentration; ARR, aldosterone to renin ratio.
Values are expressed as median (interquartile range) or number (%). AVS, adrenal venous sampling; CT, computed tomography; C-AVS, C-arm computed tomography-assisted AVS; PA, primary aldosteronism. aUnilateral PA includes aldosterone-producing adenomas and unilateral adrenal hyperplasia; bBilateral PA includes bilateral adrenal hyperplasia or bilateral idiopathic hyperaldosteronism; cConcordant findings include unilateral lesions on CT and ipsilateral lateralization on AVS, and bilateral lesions on CT and no lateralization on AVS; dDiscordant findings include unilateral lesions on CT and contralateral or no lateralization on AVS.
C-AVS, C-arm CT-assisted AVS; OR, odds ratio; CI, confidence interval; AVS, adrenal venous sampling; SI, selectivity index; BMI, body mass index; CT, computed tomography; SBP, systolic blood pressure; ARR, aldosterone-to-renin ratio.