1,132 results match your criteria Imaging in Hyperaldosteronism


[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

View Article

Download full-text PDF

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

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

View Article

Download full-text PDF

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

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

View Article

Download full-text PDF

Source
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

View Article

Download full-text PDF

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

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

View Article

Download full-text PDF

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

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

View Article

Download full-text PDF

Source
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

View Article

Download full-text PDF

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

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

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1161/JAHA.119.013699DOI Listing
March 2020
2.882 Impact Factor

Mass Spectrometry Imaging Establishes 2 Distinct Metabolic Phenotypes of Aldosterone-Producing Cell Clusters in Primary Aldosteronism.

Hypertension 2020 Mar 20;75(3):634-644. Epub 2020 Jan 20.

Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Germany (L.S.M., M.R., T.A.W.).

Aldosterone-producing adenomas (APAs) are one of the main causes of primary aldosteronism and the most prevalent surgically correctable form of hypertension. Aldosterone-producing cell clusters (APCCs) comprise tight nests of zona glomerulosa cells, strongly positive for CYP11B2 (aldosterone synthase) in immunohistochemistry. APCCs have been suggested as possible precursors of APAs because they frequently carry driver mutations for constitutive aldosterone production, and a few adrenal lesions with histopathologic features of both APCCs and APAs have been identified. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.14041DOI Listing

[The Value of Postural Stimulation Test Combined with Adrenal CT in the Diagnosis of Aldosterone-producing Adenoma].

Sichuan Da Xue Xue Bao Yi Xue Ban 2020 Jan;51(1):87-91

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

Objective: Adrenal vein sampling (AVS) and pathological report were selected as gold standard to assess the value of adrenal CT scan combined with postural stimulation test in diagnosing aldosterone-producing adenoma.

Methods: The clinical data of primary aldosteronism (PA) patients including aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) were retrospectively collected in the West China Hospital of Sichuan University. The sensitivity and specificity of adrenal CT scan combined with postural stimulation test in diagnosing APA were studied. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.12182/20200160604DOI Listing
January 2020

Improved Visualization and Identification of the Right Adrenal Vein in 70-kVp Contrast-Enhanced Computed Tomography.

J Comput Assist Tomogr 2020 Jan/Feb;44(1):153-159

From the Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.

Objective: The aim of this study was to assess the utility of 70-kilovoltage-peak (kVp) contrast-enhanced computed tomography (CECT) for visualization and identification of the right adrenal vein (RAV) in comparison with that of conventional 120-kVp CECT.

Methods: This retrospective study included patients who underwent adrenal venous sampling with concurrent biphasic 120-kVp (120-kVp group, n = 43) or 70-kVp (70-kVp group, n = 47) CECT. Signal-to-noise ratios, contrast-to-noise ratios, longitudinal lengths, conspicuity scores, RAV detection rates, and size-specific dose estimates were compared between the 2 groups. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/RCT.0000000000000960DOI Listing
January 2020

Primary aldosteronism in Klinefelter's syndrome: two cases.

Endocrinol Diabetes Metab Case Rep 2019 Dec 16;2019. Epub 2019 Dec 16.

Departments of Endocrinology and Hypertension, Tokyo, Japan.

Summary: Primary aldosteronism (PA) is more common than expected. Aberrant adrenal expression of luteinizing hormone (LH) receptor in patients with PA has been reported; however, its physiological role on the development of PA is still unknown. Herein, we report two unique cases of PA in patients with untreated Klinefelter's syndrome, characterized as increased serum LH, suggesting a possible contribution of the syndrome to PA development. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1530/EDM-19-0126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935713PMC
December 2019

Primary aldosteronism: Treatment of the disease, and new therapeutic approaches.

Authors:
John Funder

Best Pract Res Clin Endocrinol Metab 2020 Mar 26;34(2):101368. Epub 2019 Nov 26.

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

Primary aldosteronism is currently considered to represent 5-13% of hypertension, yet fewer than 1% of patients with the disorder are ever diagnosed and treated. Current management of patients screened and confirmed positive for primary aldosteronism involves imaging, and with very few exceptions adrenal venous sampling to lateralize (or not) hyperaldosteronism. Unilateral disease is treated by adrenalectomy: bilateral disease by mineralocorticoid receptor antagonists and conventional antihypertensives as/if required. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.beem.2019.101368DOI Listing

Primary Aldosteronism: JACC State-of-the-Art Review.

Authors:
Gian Paolo Rossi

J Am Coll Cardiol 2019 12;74(22):2799-2811

Hypertension Unit, Department of Medicine, DIMED, University of Padova, Padova, Italy. Electronic address:

Primary aldosteronism (PA) is a common, but frequently overlooked, cause of arterial hypertension and excess cardiovascular events, particularly atrial fibrillation. As timely diagnosis and treatment can provide a cure of hyperaldosteronism and hypertension, even when the latter is resistant to drug treatment, strategies to screen patients for PA early with a simplified diagnostic algorithm are justified. They can be particularly beneficial in some subgroups of hypertensive patients, as those who are at highest cardiovascular risk. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jacc.2019.09.057DOI Listing
December 2019

Risk of new-onset autoimmune diseases in primary aldosteronism: a nation-wide population-based study.

J Hypertens 2020 Apr;38(4):745-754

Department of Internal Medicine, National Taiwan University Hospital.

Objective: The association between hyperaldosteronism and autoimmune disorders has been postulated. However, long-term incidence of a variety of new-onset autoimmune diseases (NOAD) among patients with primary aldosteronism has not been well investigated.

Methods: From Taiwan's National Health Insurance Research Database with a 23-million population insurance registry, the identification of primary aldosteronism, essential hypertension and NOAD as well as all-cause mortality were ascertained by a validated algorithm. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/HJH.0000000000002300DOI Listing
April 2020
4.720 Impact Factor

[Secondary hypertension in women].

Presse Med 2019 Nov 13;48(11 Pt 1):1265-1268. Epub 2019 Nov 13.

AP-HP, hôpital européen Georges-Pompidou, unité d'hypertension artérielle, 75015 Paris, France; Université de Paris, Paris-Centre de recherche cardiovasculaire, Inserm UMR-970, 75015 Paris, France; Université de Paris, hôpital européen Georges-Pompidou, Inserm, CIC1418, 75015 Paris, France.

The two main non-iatrogenic causes of secondary hypertension in women of childbearing age are primary aldosteronism and renal fibromuscular dysplasia. It is recommended to look for a secondary hypertension in women who remain hypertensive three months after pregnancy, in patients under 40 years of age or in patients with a grade 3 HTN (BP≥180/110mm Hg) (Professional agreement). It is suggested that the initial assessment of a secondary HTN in women is performed by a HTN specialist; it will include an assessment of renin and aldosterone concentrations and an angio-CT of the renal arteries (or angio-MRI if contraindicated) (Grade C - Class 2). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.lpm.2019.07.029DOI Listing
November 2019

A Unique Combined Ganglioneuroma Schwannoma Tumor Mimicking Adrenal Malignancy.

Cureus 2019 Aug 27;11(8):e5500. Epub 2019 Aug 27.

Surgery, University of Central Florida College of Medicine, Orlando, USA.

A 28-year-old woman with a past medical history significant for cervical cancer was diagnosed with a 2.5 cm adrenal tumor but was lost to follow-up. Two years later, she presented to the emergency room with worsening right upper abdominal and flank pain. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.5500DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6816533PMC
August 2019
1 Read

Laboratory Diagnostics of Primary Hyperaldosteronism and its Peculiarities (Literature Review).

J Med Life 2019 Jul-Sep;12(3):215-220

1st Surgery Department of I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine.

The final stage of the diagnostic of primary hyperaldosteronism is to identify the causes of excessive secretion of aldosterone and determination of its variants. Based on the analysis of literature data, the diagnostic value, sensitivity and specificity of the methods of radiation diagnostics for primary hyperaldosteronism were assessed: ultrasound, computed tomography, magnetic resonance imaging, photon emission tomography, magnetic resonance spectroscopy, scintigraphy with iodine radiopharmaceuticals. The causes of false-positive and false-negative evaluations of changes in adrenal glands in the application of these diagnostics have been analyzed. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.25122/jml-2019-0073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6814876PMC
December 2019

Adrenal Imaging in Patients with Endocrine Hypertension.

Endocrinol Metab Clin North Am 2019 12 17;48(4):667-680. Epub 2019 Sep 17.

Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, 45 Ipsilantou Street, Athens 106 76, Greece. Electronic address:

Hypertension is one of the commonest chronic diseases contributing to cardiovascular disease. Idiopathic (primary) hypertension accounts for approximately 85% of the diagnosed cases, and 15% of hypertensive patients have other contributing conditions leading to elevated blood pressure (secondary hypertension). Endocrine hypertension is a common secondary cause of hypertension. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ecl.2019.08.001DOI Listing
December 2019
1 Read

A case report of idiopathic hyperaldosteronism characterized by bilateral adrenal adenoma.

Medicine (Baltimore) 2019 Oct;98(43):e17418

Department of Endocrinology, First Affiliated Hospital of Baotou Medical Collage, Inner Mongolia University of Science and Technology, Baotou 014010, Inner Mongolia, China.

Rationale: Primary aldosteronism (PA) comprises 2 main subtypes: unilateral aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism or named as bilateral adrenal hyperplasia (BAH). An accurate discrimination between APA and BAH is crucial because the former is treated with adrenalectomy (ADX) and the latter is primarily by aldosterone antagonists. We report a case of idiopathic hyperaldosteronism characterized by BAH. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000017418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824822PMC
October 2019
1 Read
5.723 Impact Factor

Challenges in obesity and primary aldosteronism: Diagnosis and treatment.

Surgery 2020 01 18;167(1):204-210. Epub 2019 Sep 18.

Department of Surgery, Division of Endocrine and Oncologic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA. Electronic address:

Background: Obese patients may have unrecognized primary aldosteronism due to high rates of concomitant hypertension. We hypothesized that obesity impacts the diagnosis and management of patients with primary aldosteronism.

Methods: We conducted a retrospective analysis of all primary aldosteronism patients (n = 418) who underwent adrenal vein sampling (1997-2017). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.surg.2019.03.036DOI Listing
January 2020
1 Read

Diverse Responses of Autoantibodies to the Angiotensin II Type 1 Receptor in Primary Aldosteronism.

Hypertension 2019 10 3;74(4):784-792. Epub 2019 Sep 3.

From the Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany (T.A.W., D.J., Y.Y., P.R., N.N., L.S., M.B., F.B., M.R.).

Primary aldosteronism is a common form of endocrine hypertension mainly caused by a unilateral aldosterone-producing adenoma (APA) or bilateral adrenal hyperplasia (BAH). AT1R-Abs (autoantibodies to the angiotensin II type 1 receptor) have been reported in patients with disorders associated with hypertension. Our objective was to assess AT1R-Ab levels in patients with primary aldosteronism (APA, n=40 and BAH, n=40) relative to patients with primary hypertension (n=40), preeclampsia (n=23), and normotensive individuals (n=25). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.13156DOI Listing
October 2019
2 Reads

Clinical Outcomes of 1625 Patients With Primary Aldosteronism Subtyped With Adrenal Vein Sampling.

Hypertension 2019 10 3;74(4):800-808. Epub 2019 Sep 3.

From the Department of Medicine-DIMED, University of Padova, Hypertension Unit, University Hospital, Padova, Italy (G.P.R., G.R., P.-E.V., A.C.P.).

We sought to measure the clinical benefits of adrenal venous sampling (AVS), a test recommended by guidelines for primary aldosteronism (PA) patients seeking surgical cure, in a large registry of PA patients submitted to AVS. Data of 1625 consecutive patients submitted to AVS in 19 tertiary referral centers located in Asia, Australia, Europe, and North America were collected in a large multicenter international registry. The primary end points were the rate of bilateral success, ascertained lateralization of PA, adrenalectomy, and of cured arterial hypertension among AVS-guided and non AVS-guided adrenalectomy patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.13463DOI Listing
October 2019
3 Reads

Aldosterone-Secreting Adrenocortical Carcinoma Presenting With Cardiac Arrest.

J Endocr Soc 2019 Sep 12;3(9):1678-1681. Epub 2019 Jun 12.

Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, Washington.

Adrenocortical carcinoma (ACC) is a rare malignancy that usually is detected as a result of symptoms of hormone excess or mass effect. We describe a rare presentation of ACC with primary aldosterone production leading to profound hypokalemia and cardiac arrest. The patient was previously asymptomatic with low-grade, untreated hypertension and no documented electrolyte abnormalities. Read More

View Article

Download full-text PDF

Source
https://academic.oup.com/jes/article/3/9/1678/5513494
Publisher Site
http://dx.doi.org/10.1210/js.2019-00092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698141PMC
September 2019
4 Reads

Effectiveness of Thermal Ablation for Aldosterone-Producing Adrenal Adenoma: A Systematic Review and Meta-Analysis of Clinical and Biochemical Parameters.

J Vasc Interv Radiol 2019 Sep 30;30(9):1335-1342.e1. Epub 2019 Jul 30.

Department of Medical Imaging, Chung Shan Medical University Hospital, Taiwan, R.O.C; School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, No.110, Sec.1, Chien-Kuo N. Road, Taichung (402), Taiwan, R.O.C. Electronic address:

Purpose: To assess the effectiveness of thermal ablation for aldosterone-producing adrenal adenoma.

Materials And Methods: A systematic search of the PubMed and CINAHL databases was performed to identify studies of thermal ablation for adrenal adenomas. Random effects meta-analysis models were used to compare pre- and post-treatment values of the following outcomes: systolic blood pressure (SBP), diastolic blood pressure (DBP), use of antihypertensive medications, and biochemical parameters (plasma aldosterone levels, aldosterone-to-renin ratio, and potassium levels). Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S10510443193046
Publisher Site
http://dx.doi.org/10.1016/j.jvir.2019.04.039DOI Listing
September 2019
3 Reads

Aldosterone Induces Vascular Damage.

Hypertension 2019 09 29;74(3):623-629. Epub 2019 Jul 29.

Department of Internal Medicine (C.-S.H., C.-T.P., V.-C.W., Y.-H.L.), National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Primary aldosteronism (PA) is hemodynamically independently associated with arterial wall stiffness as assessed by pulse wave velocity (PWV) compared with essential hypertension. Arterial wave reflection parameters derived from pulse wave analysis, such as forward and backward wave amplitudes (Pf and Pb), are promising vascular markers to predict cardiovascular outcomes in addition to PWV. These vascular parameters have never been studied in patients with PA before. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1161/HYPERTENSIONAHA.118.12342DOI Listing
September 2019
10 Reads
6.480 Impact Factor

Primary Aldosteronism.

Authors:
John W Funder

Hypertension 2019 09 22;74(3):458-466. Epub 2019 Jul 22.

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

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.12935DOI Listing
September 2019
5 Reads

Elevated Plasma Renin Activity Caused by Accelerated-malignant Hypertension in a Patient with Aldosterone-producing Adenoma Complicated with Renal Insufficiency.

Intern Med 2019 Nov 10;58(21):3107-3111. Epub 2019 Jul 10.

Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan.

During the malignant phase of hypertension in patients with primary aldosteronism complicated with severe renal failure, the plasma renin activity may markedly increase with a false negative screening result for primary aldosteronism, thus potentially leading to a missed diagnosis of primary aldosteronism. We herein report the case of 37-year-old man who presented with accelerated-malignant hypertension complicated with severe renal insufficiency. The plasma renin activity was markedly increased in the malignant phase of hypertension, which were atypical results for primary aldosteronism. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.2169/internalmedicine.2327-18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875448PMC
November 2019
7 Reads

[Primary hyperaldosteronism in a population of hypertensive patients].

Medicina (B Aires) 2019 ;79(3):185-190

Servicio de Medicina Interna. Hospital Universitario de Gran Canaria Dr. Negrín, España.

The diagnosis of primary hyperaldosteronism (PHPA) has progressively increased over the last years and some authors consider it as the main cause of secondary hypertension. We studied the prevalence of PHPA in hypertensive patients followed at the Hypertension Unit from July 1999 to July 2017. A total of 2500 patients were included and diagnosis of PHPA was done in 79 of them (3. Read More

View Article

Download full-text PDF

Source
July 2019
6 Reads

Advanced monoenergetic reconstruction technique in dual-energy computed tomography for evaluation of vascular anatomy before adrenal vein sampling.

Acta Radiol 2020 Feb 7;61(2):282-288. Epub 2019 Jul 7.

Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0284185119860226DOI Listing
February 2020

Primary aldosteronism-associated cardiomyopathy: Clinical-pathologic impact of aldosterone normalization.

Int J Cardiol 2019 10 20;292:141-147. Epub 2019 Jun 20.

Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, La Sapienza University, Italy; Cellular and Molecular Cardiology Lab, IRCCS L. Spallanzani, Rome, Italy.

Background: Primary aldosteronism (PA) causes a cardiomyopathy (CM) which substrate and evolution after aldosterone normalization are unreported.

Methods: Four male patients with aldosterone-secreting adrenal adenoma and cardiomyopathy (PACM, group A) were evaluated with 2D-echo, Magnetic Resonance (CMR), coronary angiography and left ventricular endomyocardial biopsy. Biopsy samples were processed for histology, electron microscopy, immunohistochemistry, and Western Blot analysis of myocardial aldosterone receptors and aquaporin 1 and 4. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijcard.2019.06.055DOI Listing
October 2019
7 Reads

Evaluation and Management of Primary Hyperaldosteronism.

Surg Clin North Am 2019 Aug;99(4):731-745

Section of Endocrine Surgery, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 650, Chicago, IL 60611, USA. Electronic address:

Primary hyperaldosteronism is an important and increasingly prevalent cause of hypertension that is characterized by unregulated aldosterone excess. More than 90% of primary hyperaldosteronism cases are attributable to either idiopathic adrenal hyperplasia or aldosterone-producing adenomas. The approach to the diagnosis of primary hyperaldosteronism should be step-wise, starting with screening of at-risk populations, confirmatory testing for positively screened patients, and subtype classification in order to direct surgical or medical management. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.suc.2019.04.010DOI Listing
August 2019
12 Reads

Primary Aldosteronism: Does Underlying Pathology Impact Clinical Presentation and Outcomes Following Unilateral Adrenalectomy?

World J Surg 2019 10;43(10):2469-2476

Department of Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN, 55905, USA.

Introduction: Patients undergoing unilateral adrenalectomy for primary aldosteronism (PA) may have a solitary adenoma, unilateral hyperplasia, or multiple adenomas on final pathology. This study investigated whether the underlying pathological diagnosis was associated with differences in clinical presentation and postoperative outcomes.

Methods: A retrospective cohort study of patients undergoing unilateral adrenalectomy for PA from 2004 to 2015 at our institution was performed. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00268-019-05059-yDOI Listing
October 2019
5 Reads

Aldosterone level after saline infusion test could predict clinical outcome in primary aldosteronism after adrenalectomy.

Surgery 2019 09 15;166(3):362-368. Epub 2019 Jun 15.

TAIPAI, Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taiwan of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.

Background: The saline infusion test is widely used as a confirmatory test for primary aldosteronism, and we hypothesized that post-saline-infusion test aldosterone levels might predict the clinical outcomes in primary aldosteronism patients after adrenalectomy.

Methods: An observational cohort study was performed. We included primary aldosteronism patients who had undergone adrenalectomy from the Taiwan Primary Aldosteronism Investigation database between 1995 and 2017. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.surg.2019.05.001DOI Listing
September 2019
11 Reads
3.380 Impact Factor

Secondary Hypertension and Complications: Diagnosis and Role of Imaging.

Radiographics 2019 Jul-Aug;39(4):1036-1055. Epub 2019 Jun 7.

From the Department of Radiology, Saint Louis University Hospital, St Louis, Mo (M.A.S., E.I.A.); Department of Radiology and Imaging, Medical College of Georgia, Augusta, Ga (P.K.M.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (B.P.L.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (F.H.M.); Department of Radiology, University of Kansas School of Medicine, Wichita, Kan (K.A.); Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India (S.S.); and Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322 (C.C.M.).

Hypertension is a common problem; if left untreated, it can result in significant complications, including those involving the cardiovascular system and end organs. Approximately 10% of patients with hypertension are classified as having , defined as hypertension attributable to a specific and potentially remediable cause. The evaluation for secondary hypertension typically begins with acquiring the patient history and performing a physical examination and screening laboratory tests. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1148/rg.2019180184DOI Listing
May 2020
8 Reads

Left atrial myocardial dysfunction in patients with primary aldosteronism as assessed by speckle-tracking echocardiography.

J Hypertens 2019 10;37(10):2032-2040

The Shanghai Institute of Hypertension, Department of Hypertension, Ruijin Hospital.

Background: We investigated the left atrial myocardial deformation in patients with primary aldosteronism using the speckle-tracking echocardiographic (STE) strain imaging technique.

Methods: Our study included 107 primary aldosteronism patients [52 aldosterone-producing adenoma (APA) and 55 idiopathic hyperaldosteronism (IHA)] and 50 primary hypertensive patients. We performed conventional echocardiography to measure left atrial volume and ejection fraction, and STE to estimate left atrial myocardial deformation including peak velocity, strain and strain rate and calculate the ratio of E/e' to left atrial strain during left ventricular systole as the left atrial stiffness index. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/HJH.0000000000002146DOI Listing
October 2019
24 Reads
4.720 Impact Factor

Diagnostic efficacy of 18F-FDG PET/CT in patients with adrenal incidentaloma.

Endocr Connect 2019 Jul;8(7):838-845

Division of Endocrinology, Internal Medicine and Endocrinology, Cukurova University Medical Faculty, Department of Internal Medicine, Adana, Turkey.

Background: The management of adrenal incidentaloma is still a challenge with respect to determining its functionality (hormone secretion) and malignancy. In this light, we performed 18F-FDG PET/CT scan to assess the SUVmax values in different adrenal masses including Cushing syndrome, pheochromocytoma, primary hyperaldosteronism and non-functional adrenal adenomas.

Methods: Total 109 (73 F, 36 M) patients with adrenal mass (incidentaloma), mean age of 53. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1530/EC-19-0204DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599076PMC
July 2019
7 Reads

A novel case of myxoid variant of adrenocortical carcinoma in a patient with multiple endocrine neoplasia type 1.

Endocr J 2019 Aug 22;66(8):739-744. Epub 2019 May 22.

Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.

Adrenocortical carcinoma (ACC) is a rare malignancy arising from adrenocortical parenchymal cells. Myxoid ACC is one of the newly identified, rare, but important histological variants of ACC, characterized by the presence of abundant extracellular Alcian Blue-positive myxoid material. Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant cancer predisposition syndrome, and the incidence of ACC in MEN1 patients has been reported to be between 1. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1507/endocrj.EJ19-0067DOI Listing
August 2019
16 Reads

A Case of Gitelman Syndrome that Was Difficult to Distinguish from Hypokalemic Periodic Paralysis Caused by Graves' Disease.

J Nippon Med Sch 2019 Dec 17;86(5):301-306. Epub 2019 May 17.

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

A 21-year-old man presented with hyperthyroidism and hypokalemia and was treated for thyrotoxic hypokalemic periodic paralysis caused by Graves' disease. Thyroid function soon normalized but hypokalemia persisted. Laboratory data revealed hyperreninemic hyperaldosteronism and metabolic alkalosis consistent with Gitelman Syndrome. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1272/jnms.JNMS.2019_86-505DOI Listing
December 2019
12 Reads

Improvement of Cardiac Function by Laparoscopic Adrenalectomy in a Patient with Severe Heart Failure Attributable to Primary Aldosteronism.

Tohoku J Exp Med 2019 05;248(1):31-36

Department of Urology, Tohoku University Graduate School of Medicine.

Aldosterone affects various systems and organs, including the cardiovascular system, through mineralocorticoid receptors. We here report a primary aldosteronism patient with severe cardiac dysfunction who showed dramatic improvement after laparoscopic adrenalectomy. The 57-year-old man presented with acute heart failure exacerbation. Read More

View Article

Download full-text PDF

Source
https://www.jstage.jst.go.jp/article/tjem/248/1/248_31/_arti
Publisher Site
http://dx.doi.org/10.1620/tjem.248.31DOI Listing
May 2019
6 Reads

Adrenal vein sampling with and without cosyntropin stimulation for detection of surgically remediable aldosteronism.

Endocrinol Diabetes Metab 2019 Apr 7;2(2):e00066. Epub 2019 Mar 7.

Department of Medicine, Division of Endocrinology and Neag Comprehensive Cancer Center UConn Health Farmington Connecticut.

Context And Objective: Bilateral adrenal vein sampling (AVS), the diagnostic standard for identifying surgically remediable aldosteronism (SRA), is commonly performed after cosyntropin stimulation (post-ACTHstim). The role of AVS without cosyntropin stimulation (pre-ACTHstim) has not been established. The selectivity index (SI), the adrenal vein (av) serum cortisol concentration divided by that in a peripheral vein, confirms av sampling. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1002/edm2.66DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458460PMC
April 2019
6 Reads

[Long-term results after adrenalectomy for Conn's syndrome with tomographic imaging and lateralization by selective catheterization].

Authors:
H Dralle

Chirurg 2019 Jul;90(7):588

Sektion Endokrine Chirurgie, Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00104-019-0959-4DOI Listing
July 2019
3 Reads

Influence of Adrenal Venous Sampling on Management in Patients with Primary Aldosteronism Independent of Lateralization on Cross-Sectional Imaging.

J Am Coll Surg 2019 07 28;229(1):116-124. Epub 2019 Mar 28.

Department of Interventional Radiology, Baylor Scott & White Health, Texas A&M University Health Science Center School of Medicine, Temple, TX.

Background: Patients with primary aldosteronism undergo imaging of the adrenal glands after confirmation of the disease. Adrenal venous sampling (AVS) is a useful adjunct to imaging, and advocates believe that AVS should be performed before surgical management. Others argue that patients with unilateral lesions on imaging do not require AVS. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jamcollsurg.2019.03.012DOI Listing
July 2019
12 Reads

Adrenocortical hypofunction with simultaneous primary aldosteronism: A case report.

Medicine (Baltimore) 2019 Mar;98(13):e15033

Rationale: Cases of adrenocortical hyperfunction combined with primary aldosteronism have been reported in the literature, and the underlying mechanism involves the secretion of aldosterone and glucocorticoids by a tumor or an adenoma. However, adrenocortical hypofunction and coexisting primary aldosteronism have not been reported until now. Herein, we report a case of adrenocortical hypofunction combined with primary aldosteronism. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000015033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456038PMC
March 2019
14 Reads

The Key Role of CT for Success of Adrenal Venous Sampling Illustrated by a Unique Clinical Case.

High Blood Press Cardiovasc Prev 2019 Apr 11;26(2):139-141. Epub 2019 Mar 11.

Institute of Radiology, Department of Medicine, DIMED, University of Padua, Padua, Italy.

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s40292-019-00310-y
Publisher Site
http://dx.doi.org/10.1007/s40292-019-00310-yDOI Listing
April 2019
24 Reads

Screening in adrenal tumors.

Curr Opin Oncol 2019 05;31(3):243-246

Department of Medicine, Division of Endocrinology.

Purpose Of Review: Adrenal tumors are mostly encountered as incidentalomas in patients undergoing imaging not performed for suspected adrenal disease; although the majority are benign and nonfunctioning, malignant tumors and functioning tumors need to be excluded. The purpose of this review is to highlight recent advances in the evaluation of adrenal tumors.

Recent Findings: As a consequence of increased use of technologically improved imaging techniques, the detection of adrenal incidentalomas has continued to increase. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/CCO.0000000000000528DOI Listing
May 2019
10 Reads

Clinical Outcomes After Unilateral Adrenalectomy for Primary Aldosteronism.

JAMA Surg 2019 04 17;154(4):e185842. Epub 2019 Apr 17.

Department of Surgical Oncology and Endocrine Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.

Importance: In addition to biochemical cure, clinical benefits after surgery for primary aldosteronism depend on the magnitude of decrease in blood pressure (BP) and use of antihypertensive medications with a subsequent decreased risk of cardiovascular and/or cerebrovascular morbidity and drug-induced adverse effects.

Objective: To evaluate the change in BP and use of antihypertensive medications within an international cohort of patients who recently underwent surgery for primary aldosteronism.

Design, Setting, And Participants: A cohort study was conducted across 16 referral medical centers in Europe, the United States, Canada, and Australia. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1001/jamasurg.2018.5842DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484800PMC
April 2019
21 Reads

A Case of Primary Aldosteronism Due to A Primary Adrenal Adenoma Diagnosed by Segmental Adrenal Venous Sampling (S-AVS) Using a Modified Catheter System and Lateral Cine Angiography.

Am J Case Rep 2019 Feb 2;20:139-145. Epub 2019 Feb 2.

Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan.

BACKGROUND Before partial adrenalectomy for primary aldosteronism due to a primary adrenal adenoma, the aldosterone-producing tumor can be localized by segmental adrenal vein sampling (S-AVS). Cardiologists, who regularly perform percutaneous coronary intervention (PCI), or coronary angioplasty with stent, may not be familiar with the technique of S-AVS. A case of the use of S-AVS is reported in a patient who presented with primary aldosteronism and a right adrenal adenoma. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.12659/AJCR.913172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368131PMC
February 2019
8 Reads

Diagnostic value of adrenal iodine-131 6-beta-iodomethyl-19-norcholesterol scintigraphy for primary aldosteronism: a retrospective study at a medical center in North Taiwan.

Nucl Med Commun 2019 Jun;40(6):568-575

Department of Internal Medicine, Division of Endocrinology and Metabolism, College of Medicine.

Background: Primary aldosteronism (PA) is a common cause of secondary hypertension. Among the many leading causes of PA, the two most frequent are, bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenomas (APA). Since a solitary APA may be cured surgically, but BAH needs lifelong pharmacologic therapy, confirmation is mandatory before surgery. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MNM.0000000000000987DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553523PMC
June 2019
20 Reads