Abstract
Objective
A stress reaction involving increased adrenal hormone release occurs when starting adrenal venous sampling (AVS). The purpose of the present study was to investigate the effect of single shot venography on adrenal hormone production during AVS.
Subjects and methods
This was a prospective self-controlled study. We enrolled 54 consecutive patients (21 men, 33 women; mean age 52 ± 11 years) with primary aldosteronism who underwent AVS from May 2014 to February 2015. Under non-stimulated conditions, blood samples were obtained from a common trunk of the left adrenal vein before and after single shot venography. The initial plasma aldosterone and cortisol concentration (PAC and PCC) were compared with those measured after venography for each patient.
Results
PAC and PCC were slightly but significantly decreased between before and after venography (after log transformation 2.12 ± 0.73 vs 2.07 ± 0.72, P = 0.00066, 1.89 ± 0.52 vs 1.83 ± 0.53, P = 0.00031, respectively).
Conclusions
During non-stimulated left AVS, adrenal hormone secretion was slightly but significantly decreased after venography, similar to the normal time-related stress reaction. Venography did not increase the adrenal hormone secretion.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Funder JW, Carey RM, Fardella C, Gomez-Sanchez CE, Mantero F, Stowasser M, Young WF Jr, Endocrine Society, et al. Case detection,diagnosis, and treatment of patients with primary aldosteronism: anendocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008;93:3266–81.
Nishikawa T, Omura M, Satoh F, Shibata H, Takahashi K, Tamura N, et al. Task Force Committee on Primary Aldosteronism, The Japan Endocrine Society. Guidelines for the diagnosis and treatment of primary aldosteronism—the Japan Endocrine Society 2009. Endocr J. 2011;58:711–21.
Rossi GP, Barisa M, Allolio B, et al. The Adrenal Vein Sampling International Study (AVIS) for identifying the major subtypes of primary aldosteronism. J Clin Endocrinol Metab. 2012;97:1606–14.
Daunt N. Adrenal vein sampling: how to make it quick, easy and successful. Radiographics. 2005;25:S143–58.
Kohi MP, Agarwal VK, Naeger DM, Taylor AG, Kolli KP, Fidelman N, et al. The inferior emissary vein: a reliable landmark for right adrenal vein sampling. Acta Radiol. 2015;56:454–7.
Oglevie SB, Bookstein JJ. The roles of angiography in adrenal disease. In: Baum S, editor. Abrams’ angiography: vascular and interventional radiology. 4th ed. New York: Little, Brown and Company; 1977. p. 1352–82.
Park SI, Rhee Y, Lim JS, et al. Right adrenal venography findings correlated with C-arm CT for selection during C-arm CT-assisted adrenal vein sampling in primary aldosteronism. Cardiovasc Intervent Radiol. 2014;37:1469–75.
Georgiades CS, Hong K, Geschwind JF, Liddell R, Syed L, Kharlip J, et al. Adjunctive use of C-arm CT may eliminate technical failure in adrenal vein sampling. J Vasc Interv Radiol. 2007;18:1102–5.
Plank C, Wolf F, Langenberger H, Loewe C, Schoder M, Lammer J. Adrenal venous sampling using Dyna-CT—a practical guide. Eur J Radiol. 2012;81:2304–7.
Onozawa S, Murata S, Tajima H, et al. Evaluation of right adrenal vein cannulation by computed tomography angiography in 140 consecutive patients undergoing adrenal venous sampling. Eur J Endocrinol. 2014;170:601–8.
Reardon MA, Angle JF, Abi-Jaoudeh N, Bruns DE, Haverstick DM, Matsumoto AH, et al. Intraprocedural cortisol levels in the evaluation of proper catheter placement in adrenal venous sampling. J Vasc Interv Radiol. 2011;22:1575–80.
Woods JJ, Sampson ML, Ruddel ME, Remaley AT. Rapid intraoperative cortisol assay: design and utility for localizing adrenal tumors by venous sampling. Clin Biochem. 2000;33:501–3.
Auchus RJ, Michaelis C, Wians FH Jr, Dolmatch BL, Josephs SC, Trimmer CK, et al. Rapid cortisol assays improve the success rate of adrenal vein sampling for primary aldosteronism. Ann Surg. 2009;249:318–21.
Rossi GP, Auchus RJ, Lenders JWM, et al. An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension. 2014;63:151–60.
Seccia TM, Miotto D, Battistel M, Motta R, Barisa M, Maniero C, et al. A stress reaction affects assessment of selectivity of adrenal venous sampling and of lateralization of aldosterone excess in primary aldosteronism. Eur J Endocrinol. 2012;166:869–75.
Rossi GP, Pitter G, Bernante P, Motta R, Feltrin G, Miotto D. Adrenal vein sampling for primary aldosteronism: the assessment of selectivity and lateralization of aldosterone excess baseline and after adrenocorticotropic hormone (ACTH) stimulation. J Hypertens. 2008;26:989–97.
Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transpl. 2013;48:452–8.
Toniato A, Bernante P, Rossi GP, Pelizzo MR. The role of adrenal venous sampling in the surgical management of primary aldosteronism. World J Surg. 2006;30:624–7.
Rossi GP, Ganzaroli C, Miotto D, De Toni R, Palumbo G, Feltrin GP, et al. Dynamic testing with high-dose adrenocorticotrophic hormone does not improve lateralization of aldosterone oversecretion in primary aldosteronism patients. J Hypertens. 2006;24:371–9.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflict of interest to disclose.
IRB statement
This study received Institutional Review Board approval.
About this article
Cite this article
Koike, Y., Matsui, S., Omura, M. et al. Adrenal hormones before and after venography during adrenal venous sampling: a self-controlled study. Jpn J Radiol 35, 126–130 (2017). https://doi.org/10.1007/s11604-017-0612-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11604-017-0612-4