Adrenal vein sampling (AVS) is required to identify a lateralized or bilateral aldosterone source in primary aldosteronism. The objectives of the study were to compare basal and post-ACTH selectivity ratio (SR) and lateralization ratio (LR) and to determine the prevalence of basal contralateral suppression and its effect on surgical outcome. Stimulation with ACTH is useful to improve selectivity of AVS but can frequently modify interpretation of lateralization. Basal ratios are as important as post-ACTH ratios to set an indication of adrenalectomy. AOPP/AP is superior to (A/C)OPP/(A/C)P to assess contralateral suppression. Infrequent CL suppression reveals frequent occurrence of contralateral hyperplasia in lateralized cases and helps predict postoperative outcomes.

Authors: Nada El Ghorayeb, Tânia L Mazzuco, Isabelle Bourdeau, Jean-Philippe Mailhot, Ping Shi Zhu, Eric Thérasse, André Lacroix
Keywords: adrenal venous sampling (AVS), ACTH selectivity ratio, contralateral suppression ratio
DOI Number: 10.1210/jc.2015-3915      Publication Year: 2016

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