Image-Derived Enzymatic Adrenal Lateralisation of Primary Hyperaldosteronism (IDEAL)

原发性醛固酮增多症的图像衍生酶促肾上腺侧化 (IDEAL)

• 批准号: MR/T005769/1
• 负责人: Erik Arstad
• 金额: $ 146.37万
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FT005769%2F1
• 关键词: Image; Derived; Enzymatic; Adrenal; Lateralisation

High blood pressure is a serious medical condition that, over time, causes damage to the heart and blood vessels. If left untreated, high blood pressure often leads to life threatening conditions, such as heart attack, stroke (bleeding in the brain), kidney disease and dementia (memory problems). For most people, lifestyle changes, and treatment with blood pressure lowering medication, return the blood pressure to healthy levels. However, sometimes high blood pressure cannot easily be controlled. This is particularly the case when there are other underlying conditions that raise the blood pressure. In about 1 out of 10 patients with high blood pressure (over half a million people in the UK), the condition is caused by too high production of a chemical, known as aldosterone, in the body. This condition (hyperaldosteronism) is very difficult to treat, and those affected have a particularly high risk of damaging the heart, kidneys and suffering from dementia. Patients with hyperaldosteronism will often need to take a number of medications (3-5 drugs) for the rest of their life, and are likely to have reduced life quality. However, for some of these patients (about one in four), removal of the gland (adrenal) that produces too much aldosterone can cure the high blood pressure, or at the very least, help reduce the need for blood pressure reducing medication. Unfortunately, very few patients with hyperaldosteronism (about 300 per year in the UK) are offered the chance to be treated with surgery as there are no practical methods to identify those who are likely to benefit. For surgery to be successful, it is of outmost importance to know which gland to remove - the one on the left or right side of the body. This can only be determined by taking blood samples from tiny blood vessels within the left and right adrenal glands, a procedure so difficult that it can only be performed by a handful of people in the UK. The goal of our research is to make it much easier to identify those patients with hyperaldosteronism who are likely to benefit from surgery, and to determine which gland (left or right) to remove, so that more people can be offered surgical treatment. We have developed a kind of 'chemical dye' for use with an advanced type of medical imaging, known as positron emission tomography (PET). If the 'dye' works as we hope, the PET scan will allow us to see how much aldosterone that each of the two adrenal glands (left and right) produce. This will make it possible to identify the patients who are most likely to benefit from surgery, and to determine which adrenal gland to remove. For this study, we will investigate if PET scanning with the 'dye' can be used to measure aldosterone production in adrenal glands in patients with hyperaldosteronism.

高血压是一种严重的疾病，随着时间的推移，会对心脏和血管造成损害。如果不及时治疗，高血压往往会导致危及生命的疾病，如心脏病发作、中风（脑出血）、肾病和痴呆（记忆问题）。对大多数人来说，生活方式的改变和降压药的治疗可以使血压恢复到健康水平。然而，有时高血压不容易控制。当有其他潜在条件导致血压升高时，情况尤其如此。大约十分之一的高血压患者（在英国超过50万人），这种情况是由体内一种叫做醛固酮的化学物质分泌过多引起的。这种情况（高醛固酮增多症）很难治疗，患者有特别高的风险损害心脏、肾脏和患上痴呆症。高醛固酮增多症患者通常需要服用多种药物（3-5种药物），并且可能会降低生活质量。然而，对于其中一些患者（大约四分之一），切除产生过多醛固酮的腺体（肾上腺）可以治愈高血压，或者至少有助于减少对降血压药物的需求。不幸的是，很少有高醛固酮增多症患者（英国每年约300例）有机会接受手术治疗，因为没有实用的方法来确定哪些患者可能受益。手术要想成功，最重要的是要知道要切除哪个腺体——是身体左边的还是右边的。这只能通过从左肾上腺和右肾上腺的微小血管中采集血液样本来确定，这一过程非常困难，在英国只有少数人可以完成。我们研究的目的是为了更容易地识别那些可能从手术中受益的高醛固酮增多症患者，并确定切除哪个腺体（左或右），以便更多的人可以接受手术治疗。我们开发了一种“化学染料”，用于一种先进的医学成像，即正电子发射断层扫描（PET）。如果“染料”像我们希望的那样起作用，PET扫描将允许我们看到两个肾上腺（左和右）分别产生多少醛固酮。这将使识别最有可能从手术中获益的患者成为可能，并确定要切除哪一个肾上腺。在这项研究中，我们将研究使用“染料”的PET扫描是否可以用于测量高醛固酮增多症患者肾上腺醛固酮的产生。