4,331 results match your criteria Hyperaldosteronism Primary


Markers of potassium homeostasis in salt losing tubulopathies- associations with hyperaldosteronism and hypomagnesemia.

BMC Nephrol 2020 Jul 6;21(1):256. Epub 2020 Jul 6.

Division of Nephrology and Dialysis, Department of Medicine III, Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria.

Background: Renal loss of potassium (K) and magnesium (Mg) in salt losing tubulopathies (SLT) leads to significantly reduced Quality of Life (QoL) and higher risks of cardiac arrhythmia. The normalization of K is currently the most widely accepted treatment target, however in even excellently designed RCTs the increase of K was only mild and rarely normalized. These findings question the role of K as the ideal marker of potassium homeostasis in SLT. Read More

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http://dx.doi.org/10.1186/s12882-020-01905-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336449PMC

A speckle tracking echocardiographic study on right ventricular function in primary aldosteronism.

J Hypertens 2020 Jun 25. Epub 2020 Jun 25.

Centre for Cardiovascular Evaluations, The Shanghai Institute of Hypertension, Department of Hypertension, Shanghai Key Lab of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Objective: We investigated right ventricular function using speckle tracking echocardiography (STE) in patients with primary aldosteronism.

Methods: Our study included 51 primary aldosteronism patients and 50 age and sex-matched primary hypertensive patients. We performed two-dimensional echocardiography to measure cardiac structure and function. Read More

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http://dx.doi.org/10.1097/HJH.0000000000002527DOI Listing

[Primary hyperaldosteronism: difficulties in diagnosis].

Ter Arkh 2019 Oct 15;91(10):91-99. Epub 2019 Oct 15.

Endocrinology Research Centre.

Primary hyperaldosteronism (PA) - is the clinical syndrome, results from autonomous of the major regulators of secretion, aldosterone overproduction by a tumorous or hyperplastic tissue in adrenal cortex. Being the most frequent cause of secondary hypertension, PA may be represented by disorders with unilateral or bilateral aldosterone overproduction and differential diagnosis between them is crucial for choosing a right therapeutic approache: lifelong medical therapy with mineralocorticoid receptor antagonists or unilateral adrenalectomy. Adrenal venous sampling (AVS) is currently the «gold standard» test for identifying laterality of excess hormone production, unlike imaging tests, sensitivity and specificity of which is not enough, due to inability to evaluate functional activity with confidence, and also to limitations in detecting tiny abnormalities of adrenals, such as microadenoma or hyperplasia. Read More

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http://dx.doi.org/10.26442/00403660.2019.10.000138DOI Listing
October 2019

Treatment of primary hyperaldosteronism.

Med Clin (Barc) 2020 Jun 22. Epub 2020 Jun 22.

Unidad de Neuroendocrinología, Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address:

Primary aldosteronism is associated with higher cardiovascular and renal morbidity and mortality than essential hypertension in age- and sex-matched patients with the same degree of blood pressure elevation. Therefore, it is essential to establish a specific treatment to avoid the deleterious effects of aldosterone excess. Although adrenalectomy is generally considered the treatment of choice in cases of primary aldosteronism due to unilateral disease, several aspects and circumstances should be taken into account that may make medical treatment more appropriate. Read More

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http://dx.doi.org/10.1016/j.medcli.2020.04.029DOI Listing

Impact of primary aldosteronism on renal function in patients with type 2 diabetes.

J Diabetes Investig 2020 Jun 24. Epub 2020 Jun 24.

Endocrinology and Diabetes Center, Yokohama Rosai Hospital, 3211 Kozukue-cho, Kouhoku-ku, Yokohama, Kanagawa, 222-0036, Japan.

Aims/introduction: Renal dysfunction may quickly progress in patients with type 2 diabetes (T2DM), when accompanied by hypertension. However, whether primary aldosteronism (PA), which autonomously over-secretes aldosterone, causes additional renal damage in patients with T2DM is unclear. We evaluated the impact of PA on renal function in patients with T2DM. Read More

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http://dx.doi.org/10.1111/jdi.13332DOI Listing

[Clinical Characteristics of Aldosterone Producing Adenoma and Idiopathic Hyperaldosteronism with Obstructive Sleep Apnea Hypopnea Syndrome].

Sichuan Da Xue Xue Bao Yi Xue Ban 2020 May;51(3):298-303

Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China.

Objective: To investigate the clinical characteristics of aldosterone producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) complicated with obstructive sleep apnea hypopnea syndrome (OSAHS) and the effect of OSAHS on renin-angiotensin-aldosterone system (RAAS) in APA and IHA patients.

Methods: The clinical data of 127 patients with primary aldosteronism (PA) diagnosed from May 2010 to Aug. 2019 were retrospectively analyzed. Read More

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http://dx.doi.org/10.12182/20200560602DOI Listing

[The Value of Serum Potassium and Ratio of Sodium to Potassium after Saline Infusion Test in Differential Diagnosis of Primary Hyperaldosteronism].

Sichuan Da Xue Xue Bao Yi Xue Ban 2020 May;51(3):287-291

Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China.

Objective: To explore the electrolyte characteristics between different types of primary aldosteronism (PA), especially the value of serum potassium and the ratio of sodium to potassium after saline infusion test (SIT) in differential diagnosis of PA.

Methods: The clinical data was collected from 135 patients who received screening for the causes of hypertension from Jan. 2009 to Dec. Read More

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http://dx.doi.org/10.12182/20200560101DOI Listing

Hemodynamics of primary aldosteronism associated with adrenocortical adenoma: Insights from bioimpedance cardiography measurements.

J Intern Med 2020 Jun 13. Epub 2020 Jun 13.

Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), Università degli studi di Palermo, Italy.

In mid 1950s, Dr Jerome Conn described a patient with hypertension, and renal potassium wasting associated with adrenocortical adenoma and increased urinary excretion of a sodium-retaining hormone, initially termed electrocortin, which was subsequently shown to be aldosterone. This was the first full report of primary hyperaldosteronism associated with an aldosterone-producing adenoma (APA). It subsequently became apparent that similar abnormalities can occur in the absence of an adrenocortical tumor, and it is now recognized that the APA is just one of many subtypes of primary aldosteronism (PA). Read More

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http://dx.doi.org/10.1111/joim.13127DOI Listing

Hypertension resolution after adrenalectomy for primary hyperaldosteronism: Which is the best predictive model?

Surgery 2020 Jun 2. Epub 2020 Jun 2.

Department of Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA. Electronic address:

Background: We aimed to compare the predictive performance of three distinct clinical models purported to predict the resolution of aldosteronoma-associated hypertension after adrenalectomy.

Methods: A tri-institutional database of aldosteronoma patients who underwent adrenalectomy between 2004 and 2019 was retrospectively reviewed. The three models of interest incorporate various preoperative clinical factors, such as age and sex. Read More

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http://dx.doi.org/10.1016/j.surg.2020.04.017DOI Listing
June 2020
3.380 Impact Factor

Different pathogenesis of glucose intolerance in two subtypes of primary aldosteronism: Aldosterone-producing adenoma and idiopathic hyperaldosteronism.

J Diabetes Investig 2020 May 29. Epub 2020 May 29.

Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.

Aims/introduction: An increased risk of diabetes mellitus has been reported in primary aldosteronism, but the pathogenesis of glucose intolerance between the primary aldosteronism subtypes remains unclear. This study aimed to evaluate glucose metabolism in oral glucose tolerance test between aldosterone-producing adenoma and idiopathic hyperaldosteronism, and characterize patients with improved glucose intolerance after primary aldosteronism treatment.

Materials And Methods: Oral glucose tolerance test was carried out in 116 patients who were diagnosed with primary aldosteronism and received adrenal venous sampling for subtyping. Read More

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http://dx.doi.org/10.1111/jdi.13312DOI Listing

Prospective evaluation of aldosterone LC-MS/MS-specific cutoffs for the saline infusion test.

Eur J Endocrinol 2020 Aug;183(2):191-201

Medical Department III, Endocrinology, Nephrology, Rheumatology, University Hospital of Leipzig, Leipzig, Germany.

Objective: Liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) has become state of the art for the quantitative analysis of steroid hormones. Although method comparisons show that aldosterone measurement using LC-MS/MS yields considerably lower levels than immunoassays (IAs), method-specific cutoff values for primary aldosteronism (PA) are largely missing. Objective of this study was to analyze the diagnostic accuracy of proposed LC-MS/MS-specific cutoff values for the saline infusion test (SIT). Read More

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http://dx.doi.org/10.1530/EJE-20-0030DOI Listing

Sensitivity of total body electrical resistance measurements in detecting extracellular volume expansion induced by infusion of NaCl 0.9.

Eur J Clin Nutr 2020 May 18. Epub 2020 May 18.

Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands.

Background: Fluid balance management in hospitalized patients is hampered by the limited sensitivity of currently available tools. The aim of this study was to assess the sensitivity of total body electrical resistance (TBER) measurements for the detection of extracellular volume (ECV) expansion.

Methods: TBER and plasma resistivity (ρ) were measured during a 4-h infusion of NaCl 0. Read More

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http://dx.doi.org/10.1038/s41430-020-0655-yDOI Listing

Adrenal Vein Sampling to Distinguish Between Unilateral and Bilateral Primary Hyperaldosteronism: To ACTH Stimulate or Not?

J Clin Med 2020 May 13;9(5). Epub 2020 May 13.

Department of Surgery and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USA.

The aim of this study is to determine the accuracy of adrenal vein sampling (AVS) with and without adrenocorticotropic hormone (ACTH) stimulation to distinguish between unilateral and bilateral primary hyperaldosteronism (PA). Retrospective analysis of a prospective database from a referral center between 1984 and 2009, 76 patients had simultaneous cannulation of bilateral adrenal veins and AVS with and without ACTH stimulation. All patients had adrenalectomies. Read More

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http://dx.doi.org/10.3390/jcm9051447DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291054PMC

Safety of outpatient adrenalectomy across 3 minimally invasive approaches at 2 academic medical centers.

Surgery 2020 May 11. Epub 2020 May 11.

Department of Surgery, University of Alabama at Birmingham, AL.

Background: Outpatient adrenalectomy has the potential to decrease costs, improve inpatient capacity, and decrease patient exposure to hospital-acquired conditions. Still, the practice has yet to be widely adopted and current studies demonstrating the safety of outpatient adrenalectomy are limited by sample size, extensive exclusion criteria, and no comparison to inpatient cases. We aimed to study the characteristics and safety of outpatient adrenalectomy using the largest such sample to date across 2 academic medical centers and 3 minimally invasive approaches. Read More

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http://dx.doi.org/10.1016/j.surg.2020.03.026DOI Listing

Clinical efficacy of potassium canreonate-canrenone in sinus rhythm restoration among patients with atrial fibrillation - a protocol of a pilot, randomized, double -blind, placebo-controlled study (CANREN-AF trial).

Trials 2020 May 12;21(1):397. Epub 2020 May 12.

National Institute of Cardiology, ul. Alpejska 42, Warsaw, 04-628, Poland.

Background: Atrial fibrillation (AF) is the most frequent cardiac arrhythmia which increases the risk of thromboembolic complications and impairs quality of life. An important part of a therapeutic approach for AF is sinus rhythm restoration. Antiarrhythmic agents used in pharmacological cardioversion have limited efficacy and potential risk of proarrhythmia. Read More

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http://dx.doi.org/10.1186/s13063-020-04277-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218584PMC

Preoperative non-stimulated adrenal venous sampling index for predicting outcomes of adrenalectomy for unilateral primary aldosteronism.

J Formos Med Assoc 2020 Jul 5;119(7):1185-1192. Epub 2020 May 5.

Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department and Graduate Institute of Forensic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address:

Background/purpose: The aim of this study was to predict outcomes of adrenalectomy for unilateral primary aldosteronism (PA) using non-stimulated adrenal venous sampling (AVS) indices and the standardized Primary Aldosteronism Surgical Outcome (PASO) criteria.

Methods: Patients with unilateral PA who underwent adrenalectomy based on non-stimulated AVS and had follow-up data regarding surgical outcomes between 2011 and 2016 were enrolled. Demographic data and non-stimulated AVS indices, including lateralization index (LI) and contralateral suppression, were collected for analysis. Read More

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http://dx.doi.org/10.1016/j.jfma.2020.04.016DOI Listing
July 2020
1.695 Impact Factor

Primary Aldosteronism: Where Are We Now? Where to from Here?

Horm Metab Res 2020 Jun 4;52(6):459-466. Epub 2020 May 4.

Hudson Institute of Medical Research and Monash University, Clayton, Victoria, Australia.

The past nine years have seen major advances in establishing the etiology of unilateral primary aldosteronism, and very possibly that of bilateral hyperaldosteronism, in response to somatic mutations in aldosterone synthase expressing cells. Though there have been important advances in the management of primary aldosteronism, in small but convincing studies, they represent minor changes to current guidelines. What has been totally absent is consideration of the public health issue that primary aldosterone represents, and the public policy issues that would be involved in addressing the disorder. Read More

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http://dx.doi.org/10.1055/a-1120-8623DOI Listing

Performance of the unilateral AV/IVC index in primary hyperaldosteronism subtype prediction: A validation study in a single tertiary centre.

Clin Endocrinol (Oxf) 2020 Apr 29. Epub 2020 Apr 29.

Endocrinology and Metabolism Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.

Background: Failure of cannulation of the right adrenal vein is frequent during AVS for investigation of primary aldosteronism (PA). The aldosterone:cortisol ratio of either adrenal vein compared with the inferior vena cava (AV/IVC index) has been proposed to differentiate between unilateral and bilateral disease, and aid in lateralization of unilateral disease.

Methods: Sixty-two patients with unilateral or bilateral PA identified by either successful bilateral (45 patients) or unilateral (17 patients) adrenal vein cannulation, and with biochemical remission following surgery were enrolled into the analysis. Read More

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http://dx.doi.org/10.1111/cen.14210DOI Listing

EXPLORATION OF THE SEATED SALINE SUPPRESSION TEST FOR THE DIAGNOSIS OF PRIMARY ALDOSTERONISM IN CHINESE POPULATION.

Endocr Pract 2020 Apr 27. Epub 2020 Apr 27.

From: Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.

We prospectively investigated the accuracy of the seated saline suppression test (SSST) in 113 patients with hypertension (including 93 PA and 20 essential hypertension (EH)) in the Department of Endocrinology and Metabolism. Each patient underwent an recumbent saline suppression test (RSST) and SSST. The accuracy of the SSST for a confirmative primary aldosteronism (PA) diagnosis and subtype classification was evaluated and compared with the RSST. Read More

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http://dx.doi.org/10.4158/EP-2020-0064DOI Listing
April 2020
2.811 Impact Factor

Disease monitoring of Primary Aldosteronism.

Best Pract Res Clin Endocrinol Metab 2020 Mar 10;34(2):101417. Epub 2020 Mar 10.

Clinica dell'Ipertensione Arteriosa, Department of Medicine - DIMED, University of Padua, Italy. Electronic address:

Primary aldosteronism (PA) is a highly prevalent cause of arterial hypertension featuring excess cardiovascular events. A timely diagnosis and treatment of PA cures hyperaldosteronism and can provide resolution or improvement of arterial hypertension, even when the latter is resistant to drug treatment. Accordingly, strategies to screen early and widely the hypertensive patients for PA by means of simplified diagnostic algorithms are justified. Read More

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http://dx.doi.org/10.1016/j.beem.2020.101417DOI Listing

A de novo CACNA1D missense mutation in a patient with congenital hyperinsulinism, primary hyperaldosteronism and hypotonia.

Channels (Austin) 2020 Dec;14(1):175-180

Pediatric Endocrinology Unit, Hospital Universitario la Fe, Valencia, Spain.

Congenital hyperinsulinemic hypoglycemia is the most frequent cause of persistent and recurrent hypoglycemia in the first years of life and in many patients rare genetic variants can be identified. Recently a case of congenital hyperinsulinemic hypoglycemia and a severe neurodevelopmental syndrome due to a mutation in the voltage-gated Cav1.3 Ca channel gene has been reported which required long-term treatment with diazoxide. Read More

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http://dx.doi.org/10.1080/19336950.2020.1761171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219433PMC
December 2020

Preeclampsia: A Diagnosis-Nondiagnosis That Is Too Easily Made: The Case of Primary Hyperaldosteronism.

Kidney Blood Press Res 2020 23;45(3):363-367. Epub 2020 Apr 23.

Néphrologie, Centre Hospitalier Le Mans, Le Mans, France.

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http://dx.doi.org/10.1159/000507116DOI Listing

Tetraparesis with Major Hypokalaemia and Rhabdomyolysis Induced by Chronic Liquorice Ingestion.

Eur J Case Rep Intern Med 2020 9;7(4):001375. Epub 2020 Mar 9.

Chronic ingestion of liquorice induces a syndrome with findings similar to those for primary hyperaldosteronism. This is characterized by hypokalaemia, hypertension, metabolic alkalosis and suppression of the renin-aldosterone system. We describe a 30-year-old woman who, with a plasma potassium level of 1. Read More

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http://dx.doi.org/10.12890/2020_001375DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162572PMC

Age- and sex-specific reference ranges are needed for the aldosterone/renin ratio.

Clin Endocrinol (Oxf) 2020 Apr 19. Epub 2020 Apr 19.

Department of Endocrinology, Monash Health, Clayton, Vic., Australia.

Objective: Current Endocrine Society Clinical Practice Guidelines use a specific aldosterone/renin ratio (ARR) threshold to screen for primary aldosteronism (a treatable disease causing up to 15% of hypertension in primary care) in all patients. We sought to characterize demographic variations in the ARR, hypothesizing a need for age- and sex-specific reference ranges to improve the accuracy of the test.

Design: Retrospective cross-sectional analysis of ARR measurements at a single tertiary hospital from December 2016 to June 2018. Read More

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http://dx.doi.org/10.1111/cen.14199DOI Listing

Immunohistochemistry of the Human Adrenal CYP11B2 in Normal Individuals and in Patients with Primary Aldosteronism.

Horm Metab Res 2020 Jun 14;52(6):421-426. Epub 2020 Apr 14.

Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan.

The CYP11B2 enzyme is the terminal enzyme in the biosynthesis of aldosterone. Immunohistochemistry using antibodies against CYP11B2 defines cells of the adrenal ZG that synthesize aldosterone. CYP11B2 expression is normally stimulated by angiotensin II, but becomes autonomous in primary hyperaldosteronism, in most cases driven by recently discovered somatic mutations of ion channels or pumps. Read More

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http://dx.doi.org/10.1055/a-1139-2079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299743PMC

Bilateral Aldosterone Suppression in Patients With Right Unilateral Primary Aldosteronism and Review of the Literature.

J Endocr Soc 2020 Apr 12;4(4):bvaa033. Epub 2020 Mar 12.

Department of Endocrinology, Changi General Hospital, Singapore.

Introduction: Adrenal vein sampling (AVS) identifies unilateral primary aldosteronism but may occasionally show paradoxically low aldosterone-cortisol ratios bilaterally. Postulated reasons include venous anomalies, fluctuating aldosterone secretion, or superselective cannulation. We report our findings in patients who underwent repeat AVS and reviewed the current literature. Read More

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http://dx.doi.org/10.1210/jendso/bvaa033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138278PMC

Salt Appetite and its Effects on Cardiovascular Risk in Primary Aldosteronism.

Horm Metab Res 2020 Jun 6;52(6):386-393. Epub 2020 Apr 6.

Medizinische Klinik und Poliklinik IV, LMU München, Munich, Germany.

First described in 1955 by Jerome W. Conn, primary aldosteronism (PA) today is well established as a relevant cause of secondary hypertension and accounts for about 5-10 % of hypertensives. The importance of considering PA is based on its deleterious target organ damage far beyond the effect of elevated blood pressure and on PA being a potentially curable form of hypertension. Read More

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http://dx.doi.org/10.1055/a-1116-2407DOI Listing

Nadir Aldosterone Levels After Confirmatory Tests Are Correlated With Left Ventricular Hypertrophy in Primary Aldosteronism.

Hypertension 2020 Jun 6;75(6):1475-1482. Epub 2020 Apr 6.

Clinical Researh Institute of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center and Endocrine Center, Ijinkai Takeda General Hospital, Kyoto, Japan (M.N.).

Left ventricular hypertrophy (LVH) is often seen in patients with primary aldosteronism (PA), and the prevalence of LVH is reportedly higher among patients with PA than patients with essential hypertension. However, the correlation between aldosterone levels and LVH is undefined, and how aldosterone affects LVH in patients with PA remains unclear. We, therefore, retrospectively assessed a large PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) to reveal the factors associated with LVH in patients with PA without suspected autonomous cortisol secretion. Read More

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http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.14601DOI Listing

The Potential Role of Aldosterone-Producing Cell Clusters in Adrenal Disease.

Horm Metab Res 2020 Jun 30;52(6):427-434. Epub 2020 Mar 30.

Departments of Molecular, Integrative Physiology and Internal Medicine, University of Michigan, Ann Arbor, MI, USA.

Primary aldosteronism (PA) is the most common cause of secondary hypertension. The hallmark of PA is adrenal production of aldosterone under suppressed renin conditions. PA subtypes include adrenal unilateral and bilateral hyperaldosteronism. Read More

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http://dx.doi.org/10.1055/a-1128-0421DOI Listing

Primary Aldosteronism and Obstructive Sleep Apnea: Casual Association or Pathophysiological Link?

Horm Metab Res 2020 Jun 27;52(6):366-372. Epub 2020 Mar 27.

Division of Internal Medicine 4 and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy.

The coexistence of aldosterone oversecretion and obstructive sleep apnea is frequently observed, especially in patients with resistant hypertension, obesity, and metabolic syndrome. Since aldosterone excess and sleep apnea are both independently associated with an increased risk of cardiovascular disease, to investigate whether their coexistence might be attributed to common predisposing conditions, such as metabolic disorders, or to an actual pathophysiological interconnection appears of great importance. Fluid overload and metabolic abnormalities relating to aldosterone oversecretion may be implicated in obstructive sleep apnea development. Read More

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http://dx.doi.org/10.1055/a-1133-7255DOI Listing

The risk factors for hepatic steatosis in patients with primary aldosteronism.

Endocr J 2020 Jun 24;67(6):623-629. Epub 2020 Mar 24.

Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, 060-8648 Sapporo, Japan.

Patients with primary aldosteronism (PA) are complicated by metabolic syndrome more frequently than those without PA. Hyperaldosteronism has been reported to be associated with a higher prevalence of non-alcoholic fatty liver disease (NAFLD). We aimed to clarify the risk factors for hepatic steatosis in the two subtypes of PA, comparing the status of hepatic steatosis in each of these subtypes. Read More

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http://dx.doi.org/10.1507/endocrj.EJ19-0600DOI Listing

Imaging CXCR4 expression in patients with suspected primary hyperaldosteronism.

Eur J Nucl Med Mol Imaging 2020 Mar 23. Epub 2020 Mar 23.

Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.

Purpose: It is challenging to differentiate unilateral aldosterone-producing adenoma (APA) from bilateral idiopathic adrenal hyperplasia (IAH) and nonfunctional adrenal adenoma (NFA) in primary aldosteronism (PA). In a first primarily ex vivo study detection, CXC chemokine receptor type 4 (CXCR4) expression has been shown to be a valuable tool for the detection of APA. In this study, we aimed to clinically evaluate CXCR4 imaging with Ga-pentixafor PET/CT for detecting APA. Read More

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http://dx.doi.org/10.1007/s00259-020-04722-0DOI Listing

Surgical approach to patients with primary aldosteronism.

Gland Surg 2020 Feb;9(1):25-31

Department of Surgery, Section of Endocrine Surgery, Columbia University Medical Center, New York, NY, USA.

Primary hyperaldosteronism (PA) is one of the most common causes of hypertension that is amenable to surgical cure. Once a patient has a biochemical diagnosis of PA, workup should proceed with tumor lateralization to determine whether the patient has unilateral or bilateral disease. Tumor lateralization can be done with noninvasive imaging such as a CT or MRI. Read More

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http://dx.doi.org/10.21037/gs.2019.10.19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082277PMC
February 2020

Primary aldosteronism diagnostics: mutations and hybrid steroid synthesis in aldosterone-producing adenomas.

Gland Surg 2020 Feb;9(1):3-13

Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA.

Primary aldosteronism (PA) is characterized by autonomous aldosterone production by renin-independent mechanisms and is most commonly sporadic. While 60-70% of sporadic PA can be attributed to bilateral hyperaldosteronism, the remaining 30-40% is caused by a unilateral aldosterone-producing adenoma (APA). Somatic mutations in or near the selectivity filter the gene (encoding the potassium channel GIRK4) have been implicated in the pathogenesis of both sporadic and familial PA. Read More

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http://dx.doi.org/10.21037/gs.2019.10.22DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082274PMC
February 2020

[Hyperpothemasia and functional hypoaldosteronism after unilateral adrenalectomy for primary hyperaldosteronism in monorrene patient with chronic renal insufficiency].

Hipertens Riesgo Vasc 2020 Jul - Sep;37(3):137-138. Epub 2020 Mar 18.

Servicio de Nefrología, Complejo Asistencial de Segovia, Segovia, España.

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http://dx.doi.org/10.1016/j.hipert.2020.02.004DOI Listing

The cardiovascular consequences of hyperaldosteronism.

Ann Endocrinol (Paris) 2020 Feb 28. Epub 2020 Feb 28.

Hypertension Unit, Department of Medicine, DIMED, University of Padova, Padova, Italy.

Primary aldosteronism (PA), the most common form of secondary hypertension, has been considered for decades as a "benign" form of hypertension, but evidences progressively built up to show that patients with PA had an excess rate of cardiovascular damage as compared to blood pressure-matched essential hypertensive patients. This review provides an updated view of structural and electrical cardiac remodeling and of vascular changes in hyperaldosteronism, and how they can favor development of cardiovascular events. The link between hyperaldosteronism and resistant hypertension is also examined, and the impact of targeted treatment of hyperaldosteronism on cardiovascular changes is finally discussed. Read More

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http://dx.doi.org/10.1016/j.ando.2020.02.006DOI Listing
February 2020

Persistent severe hyperkalemia following surgical treatment of aldosterone-producing adenoma.

J Res Med Sci 2020 20;25:17. Epub 2020 Feb 20.

Department of Endocrinology, University of Medicine and Pharmacy "Grigore T. Popa", Iaşi, Romania.

Primary aldosteronism is one of the most common causes of secondary hypertension. This condition is characterized by autonomous hypersecretion of aldosterone which produces sodium retention and potassium excretion, resulting in high blood pressure and potential hypokalemia. Transient postoperative hyporeninemic hypoaldosteronism with an increased risk of hyperkalemia may occur in some patients. Read More

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http://dx.doi.org/10.4103/jrms.JRMS_603_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053163PMC
February 2020

Postoperative renal impairment and longitudinal change in renal function after adrenalectomy in patients with Cushing's syndrome.

Int J Urol 2020 May 11;27(5):395-400. Epub 2020 Mar 11.

Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan.

Objectives: To evaluate the renal function after adrenalectomy in patients with Cushing's syndrome in comparison with that in patients with primary aldosteronism.

Methods: This retrospective study included 35 patients with Cushing's syndrome and 51 patients with primary aldosteronism who underwent unilateral adrenalectomy and were followed up for >6 months. The renal function was analyzed before and after adrenalectomy using the estimated glomerular filtration rate. Read More

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http://dx.doi.org/10.1111/iju.14205DOI Listing

Lipoprotein insulin resistance score and branched-chain amino acids increase after adrenalectomy for unilateral aldosterone-producing adenoma: a preliminary study.

Endocrine 2020 May 4;68(2):420-426. Epub 2020 Mar 4.

Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Background And Aims: Primary aldosteronism (PA) due to unilateral aldosterone-producing adenoma (APA) is preferentially treated by unilateral adrenalectomy (ADX), but little is known about the changes in lipid and glucose metabolism that may occur after ADX.

Methods: We studied 19 non-diabetic patients who did not use lipid-lowering drugs with PA due to APA before and 6 months after unilateral ADX. Fasting plasma lipids, lipoprotein subfractions, branched-chain amino acids (BCAA), and GlycA, a pro-inflammatory glycoprotein biomarker, were measured by nuclear magnetic resonance (NMR) spectroscopy. Read More

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http://dx.doi.org/10.1007/s12020-020-02235-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266834PMC

Utility of microcatheter in adrenal venous sampling for primary aldosteronism.

Br J Radiol 2020 May 28;93(1109):20190636. Epub 2020 Feb 28.

Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.

Objective: To evaluate the utility of microcatheter in adrenal venous sampling (AVS) for assessing aldosterone hypersecretion and the laterality in patients with primary aldosteronism.

Methods: This retrospective study was approved by the institutional review board of Gifu University Hospital, and written informed consent was waived. A total of 37 consecutive patients with primary aldosteronism underwent AVS by inserting a microcatheter into the right adrenal central vein (RCV), left adrenal central vein (LCV), and left adrenal common trunk (CT) followed by AVS with 5-French (5-Fr) catheter. Read More

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http://dx.doi.org/10.1259/bjr.20190636DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217570PMC

Unique Sex Steroid Profiles in Estrogen-Producing Adrenocortical Adenoma Associated With Bilateral Hyperaldosteronism.

J Endocr Soc 2020 Feb 23;4(2):bvaa004. Epub 2020 Jan 23.

Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Miyagi, Japan.

Because of its rarity, our understanding of steroidogenesis in estrogen-producing adrenocortical adenoma, including the response to adrenocorticotropic hormone (ACTH) stimulation, remains limited. A 65-year-old man was referred to us because of primary aldosteronism and a right adrenal tumor. Endocrinological evaluations revealed secondary hypogonadism due to hyperestrogenemia. Read More

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http://dx.doi.org/10.1210/jendso/bvaa004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7031070PMC
February 2020

The effect of vitamin D treatment on clinical and biochemical outcomes of primary aldosteronism.

Clin Endocrinol (Oxf) 2020 Jun 17;92(6):509-517. Epub 2020 Mar 17.

Endocrine Unit, Department of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia.

Introduction: Primary aldosteronism (PA) contributed to the cardiovascular disease and metabolic alterations independent of the blood pressure level. Evidence exists that aldosterone excess also affects calcium and mineral homeostasis. PA subjects have been shown to have greater prevalence of vitamin D deficiency. Read More

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http://dx.doi.org/10.1111/cen.14177DOI Listing

Influence of Different Treatment Strategies on New-Onset Atrial Fibrillation Among Patients With Primary Aldosteronism: A Nationwide Longitudinal Cohort-Based Study.

J Am Heart Assoc 2020 Mar 19;9(5):e013699. Epub 2020 Feb 19.

Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan.

Background Primary aldosteronism (PA) is associated with higher atrial fibrillation prevalence and other cardiovascular complications. However, the effect of target treatment to prevent new-onset atrial fibrillation (NOAF) remains unclear. This study investigated incidence of NOAF under different treatment strategies in patients with PA. Read More

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http://dx.doi.org/10.1161/JAHA.119.013699DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335564PMC
March 2020
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Effect of cosyntropin during adrenal venous sampling on subtype of primary aldosteronism: analysis of surgical outcome.

Eur J Endocrinol 2020 Mar;182(3):265-273

Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

Objectives: We investigated the clinical significance of ACTH stimulation during adrenal venous sampling (AVS) by surgical outcome of primary aldosteronism (PA).

Design: Multicenter retrospective study by Japan PA study.

Method: We allocated 314 patients with both basal and ACTH-stimulated AVS data who underwent adrenalectomy to three groups: basal lateralization index (LI) ≥2 with ACTH-stimulated LI ≥4 on the ipsilateral side (Unilateral (U) to U group, n = 245); basal LI <2 with ACTH-stimulated LI ≥4 (Bilateral (B) to U group, n = 15); and basal LI ≥2 with ACTH-stimulated LI <4 (U to B group, n = 54). Read More

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http://dx.doi.org/10.1530/EJE-19-0860DOI Listing

Topical Diagnosis and Determination of the Primary Hyperaldosteronism Variant.

J Med Life 2019 Oct-Dec;12(4):322-328

Department of Clinical Immunology, Allergology and Endocrinology, Bukovinian State Medical University, Chernivtsi, Ukraine.

Laboratory diagnosis of primary hyperaldosteronism is based on determining blood levels of aldosterone, renin on request, potassium, and sodium. The results of these studies are significantly influenced by drugs, preparation for the study and blood collection methods, age, gender, and concomitant diseases. The work analyzes the factors influencing the results of the study of aldosterone and identifies the main ways of their exclusion at each stage of the diagnosis. Read More

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http://dx.doi.org/10.25122/jml-2019-0072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993286PMC

Old and new genes in primary aldosteronism.

Best Pract Res Clin Endocrinol Metab 2020 Mar 22;34(2):101375. Epub 2020 Jan 22.

Université de Paris, PARCC, INSERM, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France.

Primary aldosteronism (PA) is the most common form of secondary hypertension affecting 5%-10% of patients with arterial hypertension. In PA, high blood pressure is associated with high aldosterone and low renin levels, and often hypokalemia. In a majority of cases, autonomous aldosterone production by the adrenal gland is caused by an aldosterone producing adenoma (APA) or bilateral adrenal hyperplasia (BAH). Read More

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http://dx.doi.org/10.1016/j.beem.2020.101375DOI Listing

Molecular and Electrophysiological Analyses of ATP2B4 Gene Variants in Bilateral Adrenal Hyperaldosteronism.

Horm Cancer 2020 Feb 30;11(1):52-62. Epub 2020 Jan 30.

Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, 1150 West Medical Center Drive, Ann Arbor, MI, 48109, USA.

Primary aldosteronism (PA) is the most common cause of secondary hypertension with a high prevalence among patients with resistant hypertension. Despite the recent discovery of somatic variants in aldosterone-producing adenoma (APA)-associated PA, causes for PA due to bilateral aldosterone production (bilateral hyperaldosteronism; BHA) remain unknown. Herein, we identified rare gene variants in ATP2B4, in a cohort of patients with BHA. Read More

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http://dx.doi.org/10.1007/s12672-019-00375-0DOI Listing
February 2020

Hyperaldosteronism from a large adrenal adenoma in a patient with bilateral adrenal nodules.

Clin Case Rep 2020 Jan 4;8(1):55-60. Epub 2019 Dec 4.

Saint Agnes Medical Center Fresno CA USA.

Primary aldosteronism (PA) is a potentially reversible cause of uncontrolled hypertension. Early diagnosis and timely management of PA can prevent end-organ damage. Aldosteronoma Resolution Score (ARS) is a useful tool to predict cure rates and resolution of hypertension after adrenalectomy. Read More

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http://dx.doi.org/10.1002/ccr3.2560DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982498PMC
January 2020

Somatic Mutation As a Cause of Aldosterone-Producing Adenoma.

Hypertension 2020 Mar 27;75(3):645-649. Epub 2020 Jan 27.

From the Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor (K.N., A.R.B., J.R., W.E.R.).

Driver somatic mutations for aldosterone excess have been found in ≈90% of aldosterone-producing adenomas (APAs) using an aldosterone synthase (CYP11B2)-guided sequencing approach. In the present study, we identified a novel somatic mutation (c.T4289C, p. Read More

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http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.14349DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059016PMC