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. 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 index (SI) and lateralization index (LI) affected rate of bilateral success, identification of unilateral aldosteronism, and blood pressure outcomes. 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.
Authors: Giacomo Rossitto, Laurence Amar, Michel Azizi, Anna Riester, Martin Reincke, Christoph Degenhart, Jiri Widimsky, Jr, Mitsuhide Naruse, Jaap Deinum, Leo Schultzekool, Tomaz Kocjan, Aurelio Negro, Ermanno Rossi, Gregory Kline, Akiyo Tanabe, Fumitoshi Satoh, Lars Christian Rump, Oliver Vonend, Holger S Willenberg, Peter Fuller, Jun Yang, Nicholas Yong Nian Chee, Steven B Magill, Zulfiya Shafigullina, Marcus Quinkler, Anna Oliveras, Chin-Chen Chang, Vin Cent Wu, Zusana Somloova, Giuseppe Maiolino, Giulio Barbiero, Michele Battistel, Livia Lenzini, Emilio Quaia, Achille Cesare Pessina, Gian Paolo Rossi
Keywords: subtyping, adrenal venous sampling, AVS, selectivity, lateralization
DOI Number: 10.1210/clinem/dgz017 Publication Year: 2019
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