Subtyping of Primary Aldosteronism in the AVIS-2 Study: Assessment of Selectivity and Lateralization
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F20%3A10403312" target="_blank" >RIV/00216208:11110/20:10403312 - isvavai.cz</a>
Alternative codes found
RIV/00064165:_____/20:10403312
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=eR1d8V6J23" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=eR1d8V6J23</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1210/clinem/dgz017" target="_blank" >10.1210/clinem/dgz017</a>
Alternative languages
Result language
angličtina
Original language name
Subtyping of Primary Aldosteronism in the AVIS-2 Study: Assessment of Selectivity and Lateralization
Original language description
CONTEXT: Adrenal venous sampling (AVS) is the key test for subtyping primary aldosteronism (PA), but its interpretation varies widely across referral centers and this can adversely affect the management of PA patients. OBJECTIVES: To investigate in a real life study the rate of bilateral success, identification of unilateral aldosteronism and blood pressure outcomes in PA subtyped by AVS. DESIGN AND SETTINGS: in a retrospective analysis of the largest international registry of individual AVS data (AVIS-2 study) we investigated how different cut-off values of the selectivity (SI) and lateralization index (LI) affected rate of bilateral success, identification of unilateral aldosteronism and blood pressure outcomes. RESULTS: AVIS-2 recruited 1625 individual AVS studies performed between 2000 and 2015 in 19 tertiary referral centers. Under unstimulated conditions, the rate of biochemically confirmed bilateral AVS success progressively decreased with increasing SI cut-offs; furthermore, with currently used LI cut-offs the rate of identified unilateral PA leading to adrenalectomy was as low as < 25%. A within-patient pairwise comparison of 402 AVS performed both under unstimulated and cosyntropin-stimulation conditions showed that cosyntropin increased the confirmed rate of bilateral selectivity for SI cut-offs >= 2.0, but with reduced lateralization rates (p < 0.001). Post-adrenalectomy outcomes were not improved by use of cosyntropin or more restrictive diagnostic criteria. CONCLUSION: Commonly used SI and LI cut-offs are associated with disappointingly low rates of biochemically defined AVS success and identified unilateral PA. Evidence-based protocols entailing less restrictive interpretative cut-offs might optimize the clinical use of this costly and invasive test.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
—
Continuities
V - Vyzkumna aktivita podporovana z jinych verejnych zdroju
Others
Publication year
2020
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
The Journal of Clinical Endocrinology & Metabolism
ISSN
0021-972X
e-ISSN
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Volume of the periodical
105
Issue of the periodical within the volume
6
Country of publishing house
US - UNITED STATES
Number of pages
11
Pages from-to
2042-2052
UT code for WoS article
000553452200062
EID of the result in the Scopus database
2-s2.0-85085617652