Go to the content. | Move to the navigation | Go to the site search | Go to the menu | Contacts | Accessibility

| Create Account

Barisa, Marlena (2014) The Adrenal Vein sampling International Study (AVIS): main results of phase 1 and 2 of the study. [Ph.D. thesis]

Full text disponibile come:

PDF Document

Abstract (english)

Context. Primary aldosteronism (PA) is the most common form of secondary endocrine hypertension. To make a distinction between surgically-curable and surgically-non curable causes, the Endocrine Society guidelines recommend the use of adrenal venous sampling (AVS), which is considered invasive, technically challenging, difficult to interpret, and commonly held to be risky. However, whether and how these guidelines are interpreted in clinical practice is still unknown. Hence, the purpose of this PhD work was to set up a study, the Adrenal Vein sampling International Study (AVIS), to answer several questions concerning AVS.
Design and settings. AVIS is an observational, retrospective, multicenter international study. The eligible centers were identified among those that had published data about PA and/or AVS into English scientific literature during the period between 2005 and 2010. The study is designed in two phases, the first one is aimed to collect the data on AVS while the second one, the data on single patients.
Objective. In the first phase of the study, the main outcomes were to determine the complication rate of AVS and the ways in which it is performed and interpreted at major referral centers. Specifically, the rate of PA patients in whom AVS is performed and the number of AVS studies performed yearly between 2005 and 2010 per each center; the number of radiologists that perform AVS at each center and the rate of complication; the use of bilaterally simultaneous or sequential AVS catheterization and the use of cosyntropin stimulation during AVS; the use of AVS studies not bilaterally selective for diagnosis; the interpretation of AVS results by calculation of the selectivity, lateralization and contralateral suppression index and minimum cutoff value used; the cost of AVS for the National Health System/Insurance and for patients.
The second phase is aimed to collect individual patients data to assess the rate of bilaterally selective AVS studies as a function of the different cutoff values of the selectivity index; to identify the best cutoff value for the identification of the lateralized aldosterone excess; to clarify if contralateral suppression allows diagnosing lateralization when only unilateral (usually left-sided) AVS is successful; to assess the rate of the patients with lateralized aldosterone excess secretion cured by adrenalectomy; to establish whether medical therapy induces improvement of high blood pressure (BP) in PA subtypes characterized by bilateral aldosterone excess secretion; assess the rate of AVS concordant /discordant with results of imaging tests. For reasons of time and brevity in this preliminary analysis the data on contralateral suppression will not be included.
Results. Phase 1: Twenty out of 24 eligible centers from Europe, Asia, Australia and North America participated and provided information on 2604 AVS studies performed between 2005 and 2010. The percentage of PA patients systematically submitted to AVS was 77% (median, range: 19%-100%). The overall rate of adrenal vein rupture was 0.61% and it correlated directly with the number of AVS performed at a particular center (p=0.002) and inversely with the number of AVS performed by each radiologist (p=0.007). The total number of radiologists who performed AVS at the 20 centers was 51 (range, 1 to 7; median,2). Thirteen of the 20 centers used sequential and 7 bilaterally simultaneous catheterization; cosyntropin stimulation was used in 11 centers. No significant correlation has been found between the use of ACTH stimulation and sequential catheterization.
The cutoff values for selectivity and lateralization indices varied markedly among those centers that systematically used them. Selectivity index (SI) results to be calculated in 90% of the centers, and the cut off values varied under non-stimulated condition from 1.1 to 3, and under stimulate conditions between 2 and 10. Lateralization index (LI) is used in 95% of the centers and its cut off values varied under non-stimulated condition from 2 to 5, and under stimulate conditions between 2 and 4. Contralateral suppression index (CSI) was calculated in 65% of the centers and its cut off values varied under non-stimulated condition from 0.5 to 1, and under stimulate conditions between 0.9 and 1.
It was found out that 60% of centers used unilaterally selective studies when bilateral results were unavailable for the diagnosis and there was significant correlation between use of unilateral selective AVS and contralateral suppression (p=0,05). In contrast, no significant correlation was found between the use of ACTH stimulation and contralateral suppression. The costs of AVS showed a wide variability among centers and countries, both for the patient and for the insurance or national health care system. The cost ranged from 80 (€) to 10,532 € for health insurance systems and from 0 to 1,357 € for the patient.
Phase 2: Due to the delay of some centers in providing the data, we performed a preliminary analysis only with the available data. We collected information on 1.030 PA patients who underwent AVS in 13 referral centers worldwide. Resistant hypertension was found in 43% of the patients, 59% were men; the majority were Caucasians.
The analysis of overall improvement at follow up of high BP with either pharmacological or surgical treatment evidenced 19% of patients with cured high BP, 49% of patients with a markedly improved BP control, 25% with only a mild improvement of BP and 8% with no improvement of BP. The analysis evidenced that women, Caucasian and African had better outcomes.
As regards the outcome of BP in the adrenalectomized patients, BP was cured in 34% of cases, markedly improved in 45% of patients, mildly improved in 16% of patients and no improvement in 5% of the patients. Moreover, the rate of patients who underwent adrenalectomy was lower than expected (median 53%) with a high variability among centers. The analysis evidenced that in the patients with bilateral aldosterone excess no cases showed cured o markedly improved control of high BP while on pharmacological treatment. At follow up, the majority of the patients (about 75%) showed only a mildly improved control of BP, and 24% of the patients had no improvement.
The analysis of the rate of bilaterally selective AVS studies as a function of different cutoff values showed that lower SI cutoff values were associated with a higher rate of bilaterally selective studies. To evaluate the best cutoff value for identifying a lateralized aldosterone excess we examined the bilaterally selective studies (by different SI cutoffs), the performance of the different LI used across the centers using as reference index cure or marked improvement of BP at follow up after the adrenalectomy. This evidenced that, at each SI, the higher the LI cutoff the higher the rate of patients who were cured or markedly improved as far as BP control.
As regards the rate of concordance/discordance between AVS results and CT imaging results for the diagnosis of lateralized aldosterone excess, we performed the analysis in patients with bilaterally selective AVS, with evidence of lateralized aldosterone excess, who undergo to adrenalectomy and at follow up presented cured o markedly improved BP. This analysis evidence that in this subgroup of patients the rate of concordance between AVS results and CT imaging results was low, 65% on the left side and 57% on the right side.
Conclusions. Despite the high prevalence of PA, and the fact that AVS is crucial for discriminating between its two major subtypes, and therefore for selecting the most appropriate treatment, this study documented marked dissimilarities in the percentage of use, protocols, interpretation and cost of AVS even among the major referral centers around the world. Importantly, overall the rate of major complications was minimal, 0.61%, which demonstrates that although being generally regarded as a risky procedure, AVS is in truth safe in experienced hands. This observation therefore supports the Endocrine Society recommendation that AVS should be used in all patients with confirmed PA who are candidate for adrenalectomy and seek surgical cure.
In the second phase of the study, analysis of the individual patients data, evidence that a choice of more restrictive values of the selectivity and the lateralization index, translates to increased rates of cured and markedly improved BP at follow up, but this at the price of the exclusion of a greater number of patients from adrenalectomy.

Abstract (italian)

Introduzione. L’iperaldosteronismo primario (PA) è la forma più comune di ipertensione arteriosa secondaria da causa endocrina. Per distinguere le forme chirurgicamente guaribili da quelle che esigono la sola terapia medica, le attuali linee guida dell’Endocrine Society raccomandano l'esecuzione del cateterismo venoso surrenalico (AVS), un’indagine ritenuta invasiva, rischiosa, tecnicamente difficile e di ardua interpretazione. Tuttavia non è ancora del tutto noto, se e come queste linee guida vengano applicate ed interpretate nella pratica clinica. Questo studio, the Adrenal Vein sampling International Study (AVIS), è stato ideato con l’intento di chiarire le modalità di utilizzo ed interpretazione dell’ AVS nei centri mondiali di riferimento.
Materiali e metodi. E’ uno studio retrospettivo, osservazionale, multicentrico, internazionale ed i centri partecipanti sono stati scelti tra quelli che hanno pubblicato dati su PA e AVS nella letteratura scientifica inglese nel periodo compreso tra il 2005 e il 2010. Lo studio prevede 2 fasi: la prima ha lo scopo di raccogliere i dati relativi alle modalità di esecuzione ed interpretazione dell’AVS, mentre la seconda di raccogliere i dati individuali dei pazienti sottoposti al AVS.
Obiettivi dello studio. I principali obiettivi della prima fase dello studio sono stati quelli di chiarire una serie di quesiti irrisolti inerenti all’utilizzo e alla performance diagnostica dell’AVS per la diagnosi di PA. In particolare, ci si è proposti di accertare: 1) la percentuale di pazienti con PA che vengono sottoposti ad AVS ed il numero di AVS eseguiti presso i maggiori centri internazionali di riferimento; 2) il tasso di complicanze (intese come rotture delle vene surrenaliche verificatesi durante l’AVS) e gli eventuali predittori delle stesse; 3) le modalità d’esecuzione dell’AVS; 4) le modalità di interpretazione ed utilizzo dei suoi dati; 5) la percentuale di utilizzo degli indici di selettività, di lateralizzazione e soppressione controlaterale ed i loro valori di riferimento; 6) il costo di AVS per il paziente ed il sistema sanitario dei diversi paesi.
Nella seconda parte dello studio sono stati raccolti i dati individuali dei pazienti sottoposti all’AVS per: valutare il tasso di AVS bilateralmente selettivi in funzione dei diversi valori soglia dell'indice di selettività; identificare il miglior valore soglia che identifica la lateralizzazione dell’aldosterone; chiarire se la soppressione controlaterale permette la diagnosi di lateralizzazione in presenza di AVS solo unilateralmente selettivi; valutare il tasso dei pazienti con ipersecrezione unilaterale dell’ aldosterone curata con la surrenectomia; stabilire se la terapia medica induce ad un miglioramento della pressione arteriosa in soggetti con ipersecrezione bilaterale del aldosterone; valutare la concordanza / discordanza tra test radiologici ed AVS nella diagnosi di lateralizzazione di aldosterone. Per motivi di tempo e di brevità di questa analisi preliminare, i dati sulla soppressione controlaterale non saranno inclusi.
Risultati. Fase 1: sono stati raccolti dati su 2604 AVS eseguiti presso 20 centri mondiali di riferimento sparsi in Europa, Asia, Nord America e Australia. Dall’analisi dei risultati è emerso che la percentuale di pazienti con PA, sistematicamente sottoposti all’AVS, è pari al 77%, con un’ampia variabilità tra i diversi centri (dal 40% al 100%). La percentuale di complicanze è risultata pari allo 0.61%, con correlazione significativa tra il numero di complicanze ed il numero di AVS eseguiti presso ogni singolo centro (p=0.002) e correlazione inversamente proporzionale al numero di AVS eseguiti dal singolo radiologo (p=0.007).
Il numero di radiologi che eseguono l’AVS nei singoli centri è mediamente di 2 radiologi/centro (variabile tra 1 e 7) ad eccezione di 2 centri, dove rispettivamente 6 e 7 radiologi erano coinvolti nell’esecuzione della procedura. La maggior parte dei centri (13/20) utilizza il cateterismo sequenziale e solo 7 centri il cateterismo simultaneo bilaterale. Per quanto riguarda l’impiego del test di stimolazione con ACTH i centri si sono distribuiti quasi equamente tra quelli che utilizzano tale stimolazione (55%) e quelli che non la utilizzano (45%). Dalle analisi non è emersa una correlazione tra il cateterismo sequenziale e l’utilizzo del test di stimolazione con ACTH.
L’indice di selettività (SI) viene calcolato nel 90% dei centri ed i suoi valori di riferimento variano da 1.1 a 3 in condizioni basali e da 2 a 10 dopo la stimolazione con ACTH. Un centro utilizza solo i valori ormonali assoluti, mentre un altro centro non calcola il SI ma solo gli indici di lateralizzazione e soppressione controlaterale. L’indice di lateralizzazione (LI) è calcolato nel 95% dei centri ed i suoi valori di riferimento variano da 2 a 5 in condizioni basali e da 2 a 4 dopo la stimolazione con ACTH. L’indice di soppressione controlaterale (CSI) viene calcolato in 65% dei centri e i suoi valori di riferimento variano da 0.5 a 1 in condizioni basali e da 0.9 a 1 dopo la stimolazione con ACTH. Non è emersa una correlazione significativa tra l’utilizzo della stimolazione con ACTH ed il calcolo del CSI. In caso di non disponibilità di AVS bilateralmente selettivi, il 60 % dei centri utilizza per diagnosi anche gli AVS non selettivi bilateralmente. E’ stata trovata una correlazione significativa (p=0.05) tra l’uso di AVS non selettivi ed il calcolo del CSI. Per quanto riguarda i costi dell’AVS, i risultati di questa analisi hanno evidenziato un’ampia variabilità tra i diversi centri ed i diversi paesi. Il costo del singolo AVS varia da 80 a 10.532 euro per il sistema sanitario nazionale e da 0 a 1.357 euro a carico del paziente.
Fase 2: l’analisi dei dati della seconda fase dello studio è stata eseguita solo su dati parziali, a causa del ritardato inserimento degli stessi da parte di alcuni centri. In questa analisi preliminare sono state raccolte informazioni su 1.030 pazienti con PA sottoposti all’ AVS, provenienti da 15 centri differenti. Il 43% dei pazienti presentava ipertensione arteriosa resistente, il 59% era di sesso maschile e la razza caucasica era quella predominante.
L’analisi del miglioramento della pressione arteriosa, indipendentemente dal tipo di trattamento (medico o chirugico), al follow up ha evidenziato il 19% di pazienti normotesi, il 49% con significativo miglioramento della pressione - definita come pressione arteriosa normale con lo stesso o ridotto numero di farmaci e/o pressione arteriosa simile a quella basale, ma con una marcata diminuzione di farmaci (> 2 farmaci) - , il 25% ha presentato solo un lieve miglioramento della pressione arteriosa - riduzione della pressione arteriosa sistolica o distolica >10%, senza il raggiungimento della normotensione con lo stesso o ridotto numero di farmaci - , mentre, l’ 8% dei casi non ha presentato alcun miglioramento. Le donne ed i soggetti di razza caucasica o africana presentavano un outcome migliore. Per quanto riguarda l’outcome pressorio nei pazienti surrectomizzati, al follow up, il 34% dei pazienti era normoteso, il 45% con significativo miglioramento della pressione, il 16% ha presentato solo un lieve miglioramento e nel 5% dei casi non c’era alcun miglioramento. Dall’analisi è stata evidenziata anche la bassa percentuale di pazienti sottoposti alla surrenectomia, in media il 53% dei pazienti, con ampia variabilità tra i diversi centri. Per quanto riguarda il controllo della pressione arteriosa con la sola terapia medica nei soggetti con ipersecrezione bilaterale di aldosterone, la maggioranza (circa il 75%) ha presentato solo un lieve miglioramento del controllo pressorio, mentre nel 24% dei casi non c’era alcun miglioramento.
La valutazione del tasso di AVS bilateralmente selettivi in funzione dei diversi valori-soglia dell'indice di selettività, ha evidenziato che, l’aumento del numero di AVS bilateralmente selettivi, era inversamente proporzionale al valore soglia del SI, sia in condizioni basali che dopo lo stimolo con ACTH. Per identificare il miglior valore soglia che identifica la lateralizzazione dell’aldosterone, sono stati esaminati i pazienti con AVS bilateralmente selettivi, con evidenza di ipersecrezione unilaterale di aldosterone, sottoposti a surrenectomia, che al follow up presentavano l’ipertensione arteriosa curata o significatamene migliorata. Questa analisi ha evidenziato che, ad ogni SI, maggiore è il valore soglia che identifica la lateralizzazione dell’aldosterone, più alto è il tasso di pazienti con ipertensione arteriosa curata o significatamene migliorata.
Per quanto riguarda la concordanza tra test radiologici ed AVS nella diagnosi di lateralizzazione di aldosterone, l’analisi condotta nel gruppo di pazienti con AVS bilateralmente selettivo, con evidente lateralizzazione dell’aldosterone, sottoposti alla surrenectomia, ha evidenziato concordanza tra i 2 test diagnostici in solo il 57% dei casi a destra e il 65% dei casi a sinistra.
Conclusioni. Nonostante il fatto che il PA sia la forma più comune di ipertensione arteriosa secondaria da causa endocrina e che l’AVS sia ritenuto indagine “gold standard” per la diagnosi differenziale tra i suoi due principali sottotipi, e quindi per la scelta del trattamento più appropriato (medico o chirurgico), i risultati della prima fase dello studio AVIS hanno documentato l’esistenza di marcate diversità nella percentuale di utilizzo, nelle modalità d’esecuzione e d’interpretazione nei diversi centri di riferimento mondiali.
Lo studio ha evidenziato un tasso di complicanze globalmente minimo, pari allo 0.61%. Quindi nonostante l’AVS sia generalmente considerato un’indagine invasiva, in realtà in presenza di mani esperte, esso risulta essere sicuro. Questo dato conferma le raccomandazioni delle attuali linee guida dell’Endocrine Society di sottoporre ad AVS tutti i pazienti con PA in assenza di controindicazioni al trattamento chirurgico.
La fase 2 dello studio attraverso l’analisi dei dati individuali ha evidenziato che la scelta di valori più restrittitivi dell’indice di selettività e dell’indice di lateralizzazione si traduce in maggiori tassi di guarigione e miglioramento dell’ipertensione arteriosa, al prezzo dell’esclusione di un numero maggiore di pazienti dalla surrenectomia.

Statistiche Download - Aggiungi a RefWorks
EPrint type:Ph.D. thesis
Tutor:Rossi, Gian Paolo
Ph.D. course:Ciclo 26 > Corsi 26 > Ipertensione Arteriosa e Biologia Vascolare
Data di deposito della tesi:31 January 2014
Anno di Pubblicazione:31 January 2014
Key Words:iperaldosteronismo primario/adrenal vein sampling
Settori scientifico-disciplinari MIUR:Area 06 - Scienze mediche > MED/09 Medicina interna
Struttura di riferimento:Dipartimenti > Dipartimento di Medicina
Codice ID:6821
Depositato il:07 Nov 2014 15:17
Simple Metadata
Full Metadata
EndNote Format


I riferimenti della bibliografia possono essere cercati con Cerca la citazione di AIRE, copiando il titolo dell'articolo (o del libro) e la rivista (se presente) nei campi appositi di "Cerca la Citazione di AIRE".
Le url contenute in alcuni riferimenti sono raggiungibili cliccando sul link alla fine della citazione (Vai!) e tramite Google (Ricerca con Google). Il risultato dipende dalla formattazione della citazione.

1. Young WF,Jr. Primary aldosteronism: Update on diagnosis and treatment. endocrinologist. Cerca con Google

2. Kono T, Ikeda F, Oseko F, Imura H, Tanimura H 1981 Normotensive primary aldosteronism: Report of a case. J Clin Endocrinol Metab 52(5):1009-1013 Cerca con Google

3. Medeau V, Moreau F, Trinquart L, Clemessy M, Wemeau JL, Vantyghem MC, Plouin PF, Reznik Y 2008 Clinical and biochemical characteristics of normotensive patients with primary aldosteronism: A comparison with hypertensive cases. Clin Endocrinol (Oxf) 69(1):20-28 Cerca con Google

4. Zipser RD, Speckart PF 1978 "Normotensive" primary aldosteronism. Ann Intern Med 88(5):655-656 Cerca con Google

5. Litynski M 1953 Hypertension caused by tumors of the adrenal cortex. Pol Tyg Lek (Wars) 8(6):204-208 Cerca con Google

6. Kucharz EJ 1991 Forgotten description of primary hyperaldosteronism. Lancet 337(8755):1490 Cerca con Google

7. Conn JW 1955 Presidential address. I. painting background. II. primary aldosteronism, a new clinical syndrome. J Lab Clin Med 45(0022-2143; 1):3-17 Cerca con Google

8. Fritsch Neves M, Schiffrin EL 2003 Aldosterone: A risk factor for vascular disease. Curr Hypertens Rep 5(1):59-65 Cerca con Google

9. Pu Q, Neves MF, Virdis A, Touyz RM, Schiffrin EL 2003 Endothelin antagonism on aldosterone-induced oxidative stress and vascular remodeling. Hypertension 42(1524-4563; 1):49-55 Cerca con Google

10. Schupp N, Queisser N, Wolf M, Kolkhof P, Barfacker L, Schafer S, Heidland A, Stopper H 2010 Aldosterone causes DNA strand breaks and chromosomal damage in renal cells, which are prevented by mineralocorticoid receptor antagonists. Horm Metab Res Cerca con Google

11. Rocha R, Rudolph AE, Frierdich GE, Nachowiak DA, Kekec BK, Blomme EA, McMahon EG, Delyani JA 2002 Aldosterone induces a vascular inflammatory phenotype in the rat heart. Am J Physiol Heart Circ Physiol 283(0363-6135; 5):H1802-H1810 Cerca con Google

12. Brilla CG, Maisch B, Weber KT 1992 Myocardial collagen matrix remodelling in arterial hypertension. Eur Heart J 13 Suppl D:24-32 Cerca con Google

13. Brilla CG, Pick R, Tan LB, Janicki JS, Weber KT 1990 Remodeling of the rat right and left ventricles in experimental hypertension. Circ Res 67(6):1355-1364 Cerca con Google

14. Rossi GP, Sacchetto A, Pavan E, Scognamiglio R, Pietra M, Pessina AC 1997 Left ventricular systolic function in primary aldosteronism and hypertension. Journal of Hypertension - Supplement 19 (Suppl. 8):S147-S151 Cerca con Google

15. Rossi GP, Di Bello V, Ganzaroli C, Sacchetto A, Cesari M, Bertini A, Giorgi D, Scognamiglio R, Mariani M, Pessina AC 2002 Excess aldosterone is associated with alterations of myocardial texture in primary aldosteronism. Hypertension 40(1):23-27 Cerca con Google

16. Rossi GP, Sacchetto A, Pavan E, Palatini P, Graniero GR, Canali C, Pessina AC 1997 Remodeling of the left ventricle in primary aldosteronism due to conn's adenoma. Circulation 95(0009-7322; 6):1471-1478 Cerca con Google

17. Farquharson CA, Struthers AD 2002 Aldosterone induces acute endothelial dysfunction in vivo in humans: Evidence for an aldosterone-induced vasculopathy. Clin Sci (Lond) 103(0143-5221; 4):425-431 Cerca con Google

18. Nishizaka MK, Zaman MA, Green SA, Renfroe KY, Calhoun DA 2004 Impaired endothelium-dependent flow-mediated vasodilation in hypertensive subjects with hyperaldosteronism. Circulation 109(1524-4539; 23):2857-2861 Cerca con Google

19. Taddei S, Virdis A, Mattei P, Salvetti A 1993 Vasodilation to acetylcholine in primary and secondary forms of human hypertension. Hypertension 21(0194-911; 6):929-933 Cerca con Google

20. Muiesan ML, Rizzoni D, Salvetti M, Porteri E, Monteduro C, Guelfi D, Castellano M, Garavelli G, Agabiti-Rosei E 2002 Structural changes in small resistance arteries and left ventricular geometry in patients with primary and secondary hypertension. J Hypertens 20(0263-6352; 7):1439-1444 Cerca con Google

21. Rizzoni D, Muiesan ML, Porteri E, Salvetti M, Castellano M, Bettoni G, Tiberio G, Giulini SM, Monteduro C, Garavelli G, Agabiti-Rosei E 1998 Relations between cardiac and vascular structure in patients with primary and secondary hypertension. J Am Coll Cardiol 32(0735-1097; 4):985-992 Cerca con Google

22. Nishimura M, Uzu T, Fujii T, Kuroda S, Nakamura S, Inenaga T, Kimura G 1999 Cardiovascular complications in patients with primary aldosteronism. Am J Kidney Dis 33(2):261-266 Cerca con Google

23. Halimi JM, Mimran A 1995 Albuminuria in untreated patients with primary aldosteronism or essential hypertension. J Hypertens 13:1801-1802 Cerca con Google

24. Rossi GP, Bernini G, Desideri G, Fabris B, Ferri C, Giacchetti G, Letizia C, Maccario M, Mannelli M, Matterello MJ, Montemurro D, Palumbo G, Rizzoni D, Rossi E, Pessina AC, Mantero F, PAPY Study Participants 2006 Renal damage in primary aldosteronism: Results of the PAPY study. Hypertension 48(2):232-238 Cerca con Google

25. Rossi GP, Sechi LA, Giacchetti G, Ronconi V, Strazzullo P, Funder JW 2008 Primary aldosteronism: Cardiovascular, renal and metabolic implications. Trends Endocrinol Metab 19(1043-2760; 3):88-90 Cerca con Google

26. Sechi LA, Novello M, Lapenna R, Baroselli S, Nadalini E, Colussi GL, Catena C 2006 Long-term renal outcomes in patients with primary aldosteronism. JAMA 295(1538-3598; 22):2638-2645 Cerca con Google

27. Takeda R, Matsubara T, Miyamori I, Hatakeyama H, Morise T 1995 Vascular complications in patients with aldosterone producing adenoma in japan: Comparative study with essential hypertension. the research committee of disorders of adrenal hormones in japan. J Endocrinol Invest 18(5):370-373 Cerca con Google

28. Takeda Y, Miyamori I, Inaba S, Furukawa K, Hatakeyama H, Yoneda T, Mabuchi H, Takeda R 1997 Vascular aldosterone in genetically hypertensive rats. Hypertension 29(1):45-48 Cerca con Google

29. Milliez P, Girerd X, Plouin PF, Blacher J, Safar ME, Mourad JJ 2005 Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism. J Am Coll Cardiol 45(0735-1097; 8):1243-1248 Cerca con Google

30. Savard S, Amar L, Plouin PF, Steichen O 2013 Cardiovascular complications associated with primary aldosteronism: A controlled cross-sectional study. Hypertension 62(2):331-336 Cerca con Google

31. Rossi GP, Cesari M, Cuspidi C, Maiolino G, Cicala MV, Bisogni V, Mantero F, Pessina AC 2013 Long-term control of arterial hypertension and regression of left ventricular hypertrophy with treatment of primary aldosteronism. Hypertension Cerca con Google

32. Rossi GP, Chiesura-Corona M, Tregnaghi A, Zanin L, Perale R, Soattin S, Pelizzo MR, Feltrin GP, Pessina AC 1993 Imaging of aldosterone-secreting adenomas: A prospective comparison of computed tomography and magnetic resonance imaging in 27 patients with suspected primary aldosteronism 9. J Hum Hypertens 7(0950-9240; 4):357-363 Cerca con Google

33. Hollenberg NK 2004 Aldosterone in the development and progression of renal injury. Kidney Int 66(0085-2538; 1):1-9 Cerca con Google

34. Greene EL, Kren S, Hostetter TH 1996 Role of aldosterone in the remnant kidney model in the rat. J Clin Invest 98(4):1063-1068 Cerca con Google

35. Reincke M, Rump LC, Quinkler M, Hahner S, Diederich S, Lorenz R, Seufert J, Schirpenbach C, Beuschlein F, Bidlingmaier M, Meisinger C, Holle R, Endres S, Participants of German Conn's Registry 2009 Risk factors associated with a low glomerular filtration rate in primary aldosteronism. J Clin Endocrinol Metab 94(3):869-875 Cerca con Google

36. Sawka AM, Young WF, Thompson GB, Grant CS, Farley DR, Leibson C, van Heerden JA 2001 Primary aldosteronism: Factors associated with normalization of blood pressure after surgery. Ann Intern Med 135(0003-4819; 4):258-261 Cerca con Google

37. Rossi GP, Bolognesi M, Rizzoni D, Seccia TM, Piva A, Porteri E, Tiberio GA, Giulini SM, Agabiti-Rosei E, Pessina AC 2008 Vascular remodeling and duration of hypertension predict outcome of adrenalectomy in primary aldosteronism patients. Hypertension 51(1524-4563; 5):1366-1371 Cerca con Google

38. Catena C, Colussi G, Lapenna R, Nadalini E, Chiuch A, Gianfagna P, Sechi LA 2007 Long-term cardiac effects of adrenalectomy or mineralocorticoid antagonists in patients with primary aldosteronism. Hypertension 50(1524-4563; 5):911-918 Cerca con Google

39. Conn JW, Rovner DR, Cohen EL, Nesbit RM 1966 Normokalemic primary aldosteronism: Its masquerade as "essential" hypertension. JAMA 195:21-26 Cerca con Google

40. Conn JW, Cohen EL, Rovner DR, Nesbit RM 1965 Normokalemic primary aldosteronism: A detectable cause of curable "essential" hypertension. JAMA 193(3):200-206 Cerca con Google

41. Hiramatsu K, Yamada T, Yukimura Y, Komiya I, Ichikawa K, Ishihara M, Nagata H, Izumiyama T 1981 A screening test to identify aldosterone-producing adenoma by measuring plasma renin activity. results in hypertensive patients. Arch Intern Med 141(0003-9926; 12):1589-1593 Cerca con Google

42. Gordon RD, Laragh JH, Funder JW 2005 Low renin hypertensive states: Perspectives, unsolved problems, future research. Trends Endocrinol Metab 16(3):108-113 Cerca con Google

43. Mulatero P, Stowasser M, Loh KC, Fardella CE, Gordon RD, Mosso L, Gomez-Sanchez CE, Veglio F, Young WF,Jr 2004 Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents. J Clin Endocrinol Metab 89(3):1045-1050 Cerca con Google

44. Gordon RD, Stowasser M, Tunny TJ, Klemm SA, Rutherford JC 1994 High incidence of primary aldosteronism in 199 patients referred with hypertension. Clin Exp Pharmacol Physiol 21(0305-1870; 4):315-318 Cerca con Google

45. Gordon RD, Ziesak MD, Tunny TJ, Stowasser M, Klemm SA 1993 Evidence that primary aldosteronism may not be uncommon: 12% incidence among antihypertensive drug trial volunteers 1. Clin Exp Pharmacol Physiol 20(0305-1870; 5):296-298 Cerca con Google

46. Anderson GH,Jr., Blakeman N, Streeten DH 1994 The effect of age on prevalence of secondary forms of hypertension in 4429 consecutively referred patients. J Hypertens 12(0263-6352; 5):609-615 Cerca con Google

47. Rossi GP, Rossi E, Pavan E, Rosati N, Zecchel R, Semplicini A, Perazzoli F, Pessina AC 1998 Screening for primary aldosteronism with a logistic multivariate discriminant analysis. Clin Endocrinol (Oxf) 49(0300-0664; 6):713-723 Cerca con Google

48. Young WF,Jr 2003 Minireview: Primary aldosteronism--changing concepts in diagnosis and treatment. Endocrinology 144(6):2208-2213 Cerca con Google

49. Rossi GP 2004 Primary aldosteronism: A needle in a haystack or a yellow cab on fifth avenue? Curr Hypertens Rep 6(1522-6417; 1):1-4 Cerca con Google

50. Rossi GP, Pessina AC, Heagerty AM 2008 Primary aldosteronism: An update on screening, diagnosis and treatment. J Hypertens 26(4):613-621 Cerca con Google

51. Rossi GP, Bernini G, Caliumi C, Desideri G, Fabris B, Ferri C, Ganzaroli C, Giacchetti G, Letizia C, Maccario M, Mallamaci F, Mannelli M, Mattarello MJ, Moretti A, Palumbo G, Parenti G, Porteri E, Semplicini A, Rizzoni D, Rossi E, Boscaro M, Pessina AC, Mantero F, PAPY Study Investigators 2006 A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. J Am Coll Cardiol 48(11):2293-2300 Cerca con Google

52. Rossi GP, Bernini G, Fabris B, Ferri C, Giacchetti G, Letizia C, Maccario M, Mallamaci F, Mannelli M, Palumbo G, Rizzoni D, Rossi E, Mantero F 2004 Prevalence of primary aldosteronism (PA) in newly diagnosed hypertensive patients: Results of a nationwide survey in italy. Journal of Hypertension - Supplement (22):S148-S148 Cerca con Google

53. Rossi GP, Bernini G, Fabris B, Ferri C, Ganzaroli C, Giacchetti G, Letizia C, Maccario M, Mallamaci F, Mannelli M, Palumbo G, Rossi E, Mantero F 2005 Primary aldosteronism (PA) prevalence in italy (papy) study: Results of a nationwide survey. Am J Hypertens 18 Part 2 Suppl. S(5):235A-235A Cerca con Google

54. Olivieri O, Ciacciarelli A, Signorelli D, Pizzolo F, Guarini P, Pavan C, Corgnati A, Falcone S, Corrocher R, Micchi A, Cressoni C, Blengio G 2004 Aldosterone to renin ratio in a primary care setting: The bussolengo study. J Clin Endocrinol Metab 89(0021-972; 9):4221-4226 Cerca con Google

55. Mosso L, Carvajal C, Gonzalez A, Barraza A, Avila F, Montero J, Huete A, Gederlini A, Fardella CE 2003 Primary aldosteronism and hypertensive disease. Hypertension 42(2):161-165 Cerca con Google

56. Calhoun DA, Nishizaka MK, Zaman MA, Thakkar RB, Weissmann P 2002 Hyperaldosteronism among black and white subjects with resistant hypertension. Hypertension 40(6):892-896 Cerca con Google

57. Gallay BJ, Ahmad S, Xu L, Toivola B, Davidson RC 2001 Screening for primary aldosteronism without discontinuing hypertensive medications: Plasma aldosterone-renin ratio. Am J Kidney Dis 37(4):699-705 Cerca con Google

58. Eide IK, Torjesen PA, Drolsum A, Babovic A, Lilledahl NP 2004 Low-renin status in therapy-resistant hypertension: A clue to efficient treatment. J Hypertens 22(11):2217-2226 Cerca con Google

59. Umpierrez GE, Cantey P, Smiley D, Palacio A, Temponi D, Luster K, Chapman A 2007 Primary aldosteronism in diabetic subjects with resistant hypertension. Diabetes Care 30(7):1699-1703 Cerca con Google

60. Douma S, Petidis K, Doumas M, Papaefthimiou P, Triantafyllou A, Kartali N, Papadopoulos N, Vogiatzis K, Zamboulis C 2008 Prevalence of primary hyperaldosteronism in resistant hypertension: A retrospective observational study. Lancet 371(1474-547; 9628):1921-1926 Cerca con Google

61. Rossi GP 2006 Surgically correctable hypertension caused by primary aldosteronism. Best Pract Res Clin Endocr Metab 20(3):385-400 Cerca con Google

62. Rossi GP 2011 Diagnosis and treatment of primary aldosteronism. Rev Endocr Metab Disord 12(1):27-36 Cerca con Google

63. Funder JW, Carey RM, Fardella C, Gomez-Sanchez CE, Mantero F, Stowasser M, Young WF,Jr, Montori VM, Endocrine Society 2008 Case detection, diagnosis, and treatment of patients with primary aldosteronism: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 93(9):3266-3281 Cerca con Google

64. Rossi GP, Belfiore A, Bernini G, Fabris B, Caridi G, Ferri C, Giacchetti G, Letizia C, Maccario M, Mannelli M, Palumbo G, Patalano A, Rizzoni D, Rossi E, Pessina AC, Mantero F 2008 Body mass index predicts plasma aldosterone concentrations in overweight-obese primary hypertensive patients. J Clin Endocrinol Metab (0021-972) Cerca con Google

65. Fallo F, Veglio F, Bertello C, Sonino N, Della Mea P, Ermani M, Rabbia F, Federspil G, Mulatero P 2006 Prevalence and characteristics of the metabolic syndrome in primary aldosteronism. J Clin Endocrinol Metab 91(2):454-459 Cerca con Google

66. Gonzaga CC, Gaddam KK, Ahmed MI, Pimenta E, Thomas SJ, Harding SM, Oparil S, Cofield SS, Calhoun DA 2010 Severity of obstructive sleep apnea is related to aldosterone status in subjects with resistant hypertension. J Clin Sleep Med 6(4):363-368 Cerca con Google

67. Pratt-Ubunama MN, Nishizaka MK, Boedefeld RL, Cofield SS, Harding SM, Calhoun DA 2007 Plasma aldosterone is related to severity of obstructive sleep apnea in subjects with resistant hypertension. Chest 131(2):453-459 Cerca con Google

68. Dunn PJ, Espiner EA 1976 Outpatient screening tests for primary aldosteronism. Aust N Z J Med 6(2):131-135 Cerca con Google

69. Weinberger MH, Fineberg NS 1993 The diagnosis of primary aldosteronism and separation of two major subtypes. Arch Intern Med 153(18):2125-2129 Cerca con Google

70. Pratt JH, Rebhun JF, Zhou L, Ambrosius WT, Newman SA, Gomez-Sanchez CE, Mayes DF 1999 Levels of mineralocorticoids in whites and blacks. Hypertension 34(0194-911; 2):315-319 Cerca con Google

71. Michelakis AM, Yoshida H, Dormois JC 1975 Plasma renin activity and plasma aldosterone during the normal menstrual cycle. Am J Obstet Gynecol 123(7):724-726 Cerca con Google

72. Weinberger MH, Kramer NJ, Grim CE, Petersen LP 1977 The effect of posture and saline loading on plasma renin activity and aldosterone concentration in pregnant, non-pregnant and estrogen-treated women. J Clin Endocrinol Metab 44(1):69-77 Cerca con Google

73. Fischer E, Beuschlein F, Bidlingmaier M, Reincke M 2011 Commentary on the endocrine society practice guidelines: Consequences of adjustment of antihypertensive medication in screening of primary aldosteronism. Rev Endocr Metab Disord 12(1):43-48 Cerca con Google

74. Stowasser M, Gordon RD, Gunasekera TG, Cowley DC, Ward G, Archibald C, Smithers BM 2003 High rate of detection of primary aldosteronism, including surgically treatable forms, after 'non-selective' screening of hypertensive patients. J Hypertens 21(11):2149-2157 Cerca con Google

75. Rossi GP, Seccia TM, Palumbo G, Belfiore A, Bernini G, Caridi G, Desideri G, Fabris B, Ferri C, Giacchetti G, Letizia C, Maccario M, Mallamaci F, Mannelli M, Patalano A, Rizzoni D, Rossi E, Pessina AC, Mantero F, Primary Aldosteronism in the Prevalence in hYpertension (PAPY) Study Investigators 2010 Within-patient reproducibility of the aldosterone: Renin ratio in primary aldosteronism. Hypertension 55(1):83-89 Cerca con Google

76. Seely EW, Moore TJ, Rogacz S, Gordon MS, Gleason RE, Hollenberg NK, Williams GH 1989 Angiotensin-mediated renin suppression is altered in non-modulating hypertension. Hypertension 13(0194-911; 1):31-37 Cerca con Google

77. Gordon RD, Gomez-Sanchez CE, Hamlet SM, Tunny TJ, Klemm SA 1987 Angiotensin-responsive aldosterone-producing adenoma masquerades as idiopathic hyperaldosteronism (iha:Adrenal hyperplasia) or low-renin hypertension. J Hypertens Suppl 5 (suppl 5):S103-S106 Cerca con Google

78. Irony I, Kater CE, Biglieri EG, Shackleton CH 1990 Correctable subsets of primary aldosteronism. primary adrenal hyperplasia and renin responsive adenoma. Am J Hypertens 3(0895-7061; 7):576-582 Cerca con Google

79. Rossi GP, Vendraminelli R, Cesari M, Pessina AC 2000 A thoracic mass with hypertension and hypokalaemia. Lancet 356(9241):1570 Cerca con Google

80. Seccia TM, Fassina A, Nussdorfer GG, Pessina AC, Rossi GP 2005 Aldosterone-producing adrenocortical carcinoma: An unusual cause of conn's syndrome with an ominous clinical course. Endocr Relat Cancer 12(1351-0088; 1):149-159 Cerca con Google

81. Omura M, Sasano H, Fujiwara T, Yamaguchi K, Nishikawa T 2002 Unique cases of unilateral hyperaldosteronemia due to multiple adrenocortical micronodules, which can only be detected by selective adrenal venous sampling. Metabolism 51(0026-0495; 3):350-355 Cerca con Google

82. Magill SB, Raff H, Shaker JL, Brickner RC, Knechtges TE, Kehoe ME, Findling JW 2001 Comparison of adrenal vein sampling and computed tomography in the differentiation of primary aldosteronism. J Clin Endocrinol Metab 86(3):1066-1071 Cerca con Google

83. Mantero F, Terzolo M, Arnaldi G, Osella G, Masini AM, Ali A, Giovagnetti M, Opocher G, Angeli A 2000 A survey on adrenal incidentaloma in italy. study group on adrenal tumors of the italian society of endocrinology. J Clin Endocrinol Metab 85(0021-972; 2):637-644 Cerca con Google

84. Young WF, Stanson AW, Thompson GB, Grant CS, Farley DR, van Heerden JA 2004 Role for adrenal venous sampling in primary aldosteronism. Surgery 136(0039-6060; 6):1227-1235 Cerca con Google

85. Kempers MJ, Lenders JW, van Outheusden L, van der Wilt GJ, Schultze Kool LJ, Hermus AR, Deinum J 2009 Systematic review: Diagnostic procedures to differentiate unilateral from bilateral adrenal abnormality in primary aldosteronism. Ann Intern Med 151(5):329-337 Cerca con Google

86. Rossi GP 2007 New concepts in adrenal vein sampling for aldosterone in the diagnosis of primary aldosteronism. Curr Hypertens Rep 9(1522-6417; 2):90-97 Cerca con Google

87. Rossi GP, Pitter G, Bernante P, Motta R, Feltrin G, Miotto D 2008 Adrenal vein sampling for primary aldosteronism: The assessment of selectivity and lateralization of aldosterone excess baseline and after adrenocorticotropic hormone (ACTH) stimulation. J Hypertens 26(0263-6352; 5):989-997 Cerca con Google

88. Melby JC, Spark RF, Dale SL, Egdahl RH, Kahn PC 1967 Diagnosis and localization of aldosterone-producing adenomas by adrenal-vein cateterization. N Engl J Med 277(20):1050-1056 Cerca con Google

89. Nishikawa T, Omura M, Satoh F, Shibata H, Takahashi K, Tamura N, Tanabe A, Task Force Committee on Primary Aldosteronism, The Japan Endocrine Society 2011 Guidelines for the diagnosis and treatment of primary aldosteronism--the japan endocrine society 2009. Endocr J 58(9):711-721 Cerca con Google

90. Kupers EM, Amar L, Raynaud A, Plouin PF, Steichen O 2012 A clinical prediction score to diagnose unilateral primary aldosteronism. J Clin Endocrinol Metab 97(10):3530-3537 Cerca con Google

91. Harris DA, Au-Yong I, Basnyat PS, Sadler GP, Wheeler MH 2003 Review of surgical management of aldosterone secreting tumours of the adrenal cortex. Eur J Surg Oncol 29(5):467-474 Cerca con Google

92. Pang TC, Bambach C, Monaghan JC, Sidhu SB, Bune A, Delbridge LW, Sywak MS 2007 Outcomes of laparoscopic adrenalectomy for hyperaldosteronism. ANZ J Surg 77(9):768-773 Cerca con Google

93. Fischer E, Adolf C, Pallauf A, Then C, Bidlingmaier M, Beuschlein F et al. Aldosterone excess impairs first phase insulin secretion in primary aldosteronism. J Clin Endocrinol Metab 2013; 98:2513-2520. Cerca con Google

94. van der Linden P, Steichen O, Zinzindohoue F, Plouin PF 2012 Blood pressure and medication changes following adrenalectomy for unilateral primary aldosteronism: A follow-up study. J Hypertens 30(4):761-769 Cerca con Google

95. Waldmann J, Maurer L, Holler J, Kann PH, Ramaswamy A, Bartsch DK, Langer P 2011 Outcome of surgery for primary hyperaldosteronism. World J Surg 35(11):2422-2427 Cerca con Google

96. Wang JH, Wu HM, Sheu MH, Tseng HS, Chiang JH, Chang CY 2000 High resolution MRI of adrenal glands in patients with primary aldosteronism. Zhonghua Yi Xue Za Zhi (Taipei) 63(6):475-481 Cerca con Google

97. Seccia TM, Miotto D, Battistel M, Motta R, Barisa M, Maniero C, Pessina AC, Rossi GP 2012 A stress reaction affects assessment of selectivity of adrenal venous sampling and of lateralization of aldosterone excess in primary aldosteronism. Eur J Endocrinol 166(5):869-875 Cerca con Google

98. Daunt N 2005 Adrenal vein sampling: How to make it quick, easy, and successful. Radiographics 25 Suppl 1(1527-1323):S143-S158 Cerca con Google

99. Davidson JK, Morley P, Hurley GD, Holford NG 1975 Adrenal venography and ultrasound in the investigation of the adrenal gland: An analysis of 58 cases. Br J Radiol 48(570):435-450 Cerca con Google

100. Miotto D, De Toni R, Pitter G, Seccia TM, Motta R, Vincenzi M, Feltrin G, Rossi GP 2009 Impact of accessory hepatic veins on adrenal vein sampling for identification of surgically curable primary aldosteronism. Hypertension 54(4):885-889 Cerca con Google

101. Gordon RD 1995 Primary aldosteronism. J Endocrinol Invest 18(7):495-511 Cerca con Google

102. Young-WF J, Stanson AW, Grant CS, Thompson GB, van HJ 1996 Primary aldosteronism: Adrenal venous sampling. Surgery 120(6):913-919 Cerca con Google

103. Phillips JL, Walther MM, Pezzullo JC, Rayford W, Choyke PL, Berman AA, Linehan WM, Doppman JL, Gill Jr JR,Jr 2000 Predictive value of preoperative tests in discriminating bilateral adrenal hyperplasia from an aldosterone-producing adrenal adenoma. J Clin Endocrinol Metab 85(12):4526-4533 Cerca con Google

104. Rossi GP, Sacchetto A, Chiesura-Corona M, De Toni R, Gallina M, Feltrin GP, Pessina AC 2001 Identification of the etiology of primary aldosteronism with adrenal vein sampling in patients with equivocal computed tomography and magnetic resonance findings: Results in 104 consecutive cases. J Clin Endocrinol Metab 86(3):1083-1090 Cerca con Google

105. Stowasser M, Gordon RD, Rutherford JC, Nikwan NZ, Daunt N, Slater GJ 2001 Diagnosis and management of primary aldosteronism. J Renin Angiotensin Aldosterone Syst 2(1470-3203; 3):156-169 Cerca con Google

106. Mengozzi G, Rossato D, Bertello C, Garrone C, Milan A, Pagni R, Veglio F, Mulatero P 2007 Rapid cortisol assay during adrenal vein sampling in patients with primary aldosteronism. Clin Chem 53(0009-9147; 11):1968-1971 Cerca con Google

107. Rossi E, Regolisti G, Perazzoli F, Negro A, Grasselli C, Santi R, Cavalieri S, Belloni L, Gemelli G, Della Valle E, Miotto D 2011 Intraprocedural cortisol measurement increases adrenal vein sampling success rate in primary aldosteronism. Am J Hypertens 24(12):1280-1285 Cerca con Google

108. Auchus RJ, Michaelis C, Wians FH,Jr, Dolmatch BL, Josephs SC, Trimmer CK, Anderson ME, Nwariaku FE 2009 Rapid cortisol assays improve the success rate of adrenal vein sampling for primary aldosteronism. Ann Surg 249(2):318-321 Cerca con Google

109. Betz MJ, Degenhart C, Fischer E, Pallauf A, Brand V, Linsenmaier U, Beuschlein F, Bidlingmaier M, Reincke M 2011 Adrenal vein sampling using rapid cortisol assays in primary aldosteronism is useful in centers with low success rates. Eur J Endocrinol 165(2):301-306 Cerca con Google

110. Weinberger MH, Grim CE, Hollifield JW, Kem DC, Ganguly A, Kramer NJ, Yune HY, Wellman H, Donohue JP 1979 Primary aldosteronism: Diagnosis, localization, and treatment. Ann Intern Med 90(0003-4819; 3):386-395 Cerca con Google

111. Young WF,Jr., Stanson AW, Grant CS, Thompson GB, van Heerden JA 1996 Primary aldosteronism: Adrenal venous sampling 3. Surgery 120(0039-6060; 6):913-919 Cerca con Google

112. Rossi GP, Ganzaroli C, Miotto D, De Toni R, Palumbo G, Feltrin GP, Mantero F, Pessina AC 2006 Dynamic testing with high-dose adrenocorticotrophic hormone does not improve lateralization of aldosterone oversecretion in primary aldosteronism patients. J Hypertens 24(2):371-379 Cerca con Google

113. Rossi GP, Pitter G, Miotto D 2007 To stimulate or not to stimulate: Is adrenocorticotrophic hormone testing necessary, or not? J Hypertens 25(0263-6352; 2):481-484 Cerca con Google

114. Seccia TM, Miotto D, De Toni R, Pitter G, Mantero F, Pessina AC, Rossi GP 2009 Adrenocorticotropic hormone stimulation during adrenal vein sampling for identifying surgically curable subtypes of primary aldosteronism. comparison of 3 different protocols. Hypertension (1524-4563) Cerca con Google

115. Webster AC, Cross NB, Mitchell R, Craig JC 2010 How to get the most from the medical literature: Searching the medical literature effectively. Nephrology (Carlton) 15(1):12-19 Cerca con Google

116. Sarlon-Bartoli G, Michel N, Taieb D, Mancini J, Gonthier C, Silhol F, Muller C, Bartoli JM, Sebag F, Henry JF, Deharo JC, Vaisse B 2011 Adrenal venous sampling is crucial before an adrenalectomy whatever the adrenal-nodule size on computed tomography. J Hypertens 29(6):1196-1202 Cerca con Google

117. Zarnegar R, Bloom AI, Lee J, Kerlan RK,Jr., Wilson MW, Laberge JM, Gordon RL, Kebebew E, Clark OH, Duh QY 2008 Is adrenal venous sampling necessary in all patients with hyperaldosteronism before adrenalectomy? J Vasc Interv Radiol 19(1051-0443; 1):66-71 Cerca con Google

118. Letavernier E, Peyrard S, Amar L, Zinzindohoue F, Fiquet B, Plouin PF 2008 Blood pressure outcome of adrenalectomy in patients with primary hyperaldosteronism with or without unilateral adenoma. J Hypertens 26(0263-6352; 9):1816-1823 Cerca con Google

119. Candy Sze WC, Soh LM, Lau JH, Reznek R, Sahdev A, Matson M, Riddoch F, Carpenter R, Berney D, Grossman AB, Chew SL, Akker SA, Druce MR, Waterhouse M, Monson JP, Drake WM 2013 Diagnosing unilateral primary aldosteronism - comparison of a clinical prediction score, computed tomography and adrenal venous sampling. Clin Endocrinol (Oxf) Cerca con Google

120. Doppman JL, Gill JR,Jr 1996 Hyperaldosteronism: Sampling the adrenal veins. Radiology 198(2):309-312 Cerca con Google

121. Auchus RJ, Wians FH,Jr, Anderson ME, Dolmatch BL, Trimmer CK, Josephs SC, Chan D, Toomay S, Nwariaku FE 2010 What we still do not know about adrenal vein sampling for primary aldosteronism. Horm Metab Res 42(6):411-415 Cerca con Google

122. Enberg U, Volpe C, Hoog A, Wedell A, Farnebo LO, Thoren M, Hamberger B 2004 Postoperative differentiation between unilateral adrenal adenoma and bilateral adrenal hyperplasia in primary aldosteronism by mRNA expression of the gene CYP11B2. Eur J Endocrinol 151(0804-4643; 1):73-85 Cerca con Google

123. Shade RE, Grim CE 1975 Suppression of renin and aldosterone by small amounts of DOCA in normal man. J Clin Endocrinol Metab 40(4):652-658 Cerca con Google

124. Mulatero P, Bertello C, Sukor N, Gordon R, Rossato D, Daunt N, Leggett D, Mengozzi G, Veglio F, Stowasser M 2010 Impact of different diagnostic criteria during adrenal vein sampling on reproducibility of subtype diagnosis in patients with primary aldosteronism. Hypertension 55(3):667-673 Cerca con Google

125. Nakamura Y, Satoh F, Morimoto R, Kudo M, Takase K, Gomez-Sanchez CE, Honma S, Okuyama M, Yamashita K, Rainey WE, Sasano H, Ito S 2011 18-oxocortisol measurement in adrenal vein sampling as a biomarker for subclassifying primary aldosteronism. J Clin Endocrinol Metab Cerca con Google

126. Dekkers T, Deinum J, Schultzekool LJ, Blondin D, Vonend O, Hermus AR, Peitzsch M, Rump LC, Antoch G, Sweep FC, Bornstein SR, Lenders JW, Willenberg HS, Eisenhofer G 2013 Plasma metanephrine for assessing the selectivity of adrenal venous sampling. Hypertension 62(6):1152-7 Cerca con Google

127. Young WF 2007 Primary aldosteronism: renaissance of a syndrome. Clin Endocrinol (Oxf). 2007 May;66(5):607-18. Cerca con Google

. Cerca con Google

Download statistics

Solo per lo Staff dell Archivio: Modifica questo record