Primary aldosteronism subtyping in the setting of partially successful adrenal vein sampling.
Primary aldosteronism subtyping in the setting of partially successful adrenal vein sampling.
复制标题
DOI：
10.1177/2042018821989239
复制
发表时间：
2021
影响因子：
3.8
通讯作者：
Kim JH
中科院分区：
文献类型：
--
作者：
Lee SE;Park SW;Choi MS;Kim G;Yoo JH;Ahn J;Jun JE;Park HS;Hyun D;Cho SK;Ko SE;Kim BJ;Kim JW;Yoon HK;Koh JM;Lee SH;Kim JH
肾上腺静脉（AV）插管的频繁失败是普遍使用肾上腺静脉取样（AVS）对原发性醛固酮增多症（PA）进行亚型分型的主要障碍。本研究旨在确认和修改之前报告的一侧插管失败情况下用于PA亚型分型的AVS参数值。回顾性分析了来自两家三级医院的157例患者（121例患者作为衍生队列，36例患者作为验证队列）的成功插管AVS研究。AV/下腔静脉（IVC）指数定义为AV的醛固酮/皮质醇比率（ACR）除以IVC的ACR。偏侧PA的截止值从两种方法获得：散点图和对应于受试者工作特征（ROC）曲线中的Youden指数的值，假设一侧导管插入失败。由于在单次AVS手术中进行了多次采样，计算了252个左侧AV/IVC比值（LIR）和272个右侧AV/IVC比值（RIR）。散点图截断值LIR >5.4或<0.5预测单侧PA的敏感性为42.1%，特异性为98.6%。RIR 7.0的散点图<0.5 or >截止值显示敏感性为55.1%，特异性为98.6%。ROC曲线截断值LIR ≥ 0.8或>3.1预测单侧PA的敏感性为82.5%，特异性为69.6%。ROC曲线截断值RIR ≤ 0.8或>3.9导致87.4%的敏感性和80.7%的特异性。在单侧AVS失败的情况下，AV/IVC指数可能有助于诊断PA亚型。
Frequent failure of adrenal vein (AV) cannulation is a major obstacle to the universal use of adrenal vein sampling (AVS) for subtyping primary aldosteronism (PA). This study aimed to confirm and modify the value of a previously reported AVS parameter for PA subtyping in the case of cannulation failure on one side. Successfully catheterized AVS studies in 157 patients (121 patients as a derivation cohort and 36 patients as a validation cohort) from two tertiary hospitals were retrospectively reviewed. The AV/inferior vena cava (IVC) index was defined by dividing the aldosterone/cortisol ratio (ACR) of AV by the ACR of the IVC. Cutoff values for lateralized PA were obtained from two methods: scatterplots and the values corresponding to Youden’s index in receiver operating characteristic (ROC) curves, on the assumption of catheterization failure on one side. Due to multiple samplings in a single AVS procedure, 252 left AV/IVC ratios (LIRs) and 272 right AV/IVC ratios (RIRs) were calculated. Scatterplot cutoffs of LIR >5.4 or <0.5 predicted unilateral PA with a sensitivity of 42.1% and a specificity of 98.6%. Scatterplot cutoffs of RIR <0.5 or >7.0 showed a sensitivity of 55.1% and a specificity of 98.6%. ROC curve cutoffs of LIR ⩽0.8 or >3.1 predicted unilateral PA with a sensitivity of 82.5% and a specificity of 69.6%. ROC curve cutoffs of RIR ⩽0.8 or >3.9 resulted in 87.4% sensitivity and 80.7% specificity. In the case of unilateral AVS failure, the AV/IVC index may help in diagnosing PA subtype.
登录
查看更多内容
影响因子：
3.8
作者：
Strajina, Veljko;Al-Hilli, Zahraa;McKenzie, Travis J.
通讯作者：
McKenzie, Travis J.
影响因子：
5.8
作者：
Funder, John W.;Carey, Robert M.;Young, William F., Jr.
通讯作者：
Young, William F., Jr.
影响因子：
3.2
作者：
Umakoshi, Hironobu;Tanase-Nakao, Kanako;Naruse, Mitsuhide
通讯作者：
Naruse, Mitsuhide
影响因子：
2
作者：
Kline, Gregory A.;Harvey, Adrian;Pasieka, Janice L.
通讯作者：
Pasieka, Janice L.
影响因子：
19.7
作者：
Doppman, JL;Gill, JR
通讯作者：
Gill, JR