Surgical treatment outcome of primary aldosteronism assessed using new modified diagnostic tests
| Autor: | Christos Gravvanis, George P. Chrousos, Krystallenia I Alexandraki, Chara Kapsali, Gregory Kaltsas, Athina Markou, Ernestini Tyfoxylou, George Piaditis, George N Zografos, Labrini Papanastasiou, Pinelopi Katsiveli |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adenoma
Dichlorodiphenyldichloroethane medicine.medical_specialty Captopril Endocrinology Diabetes and Metabolism Urology 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Dexamethasone 03 medical and health sciences 0302 clinical medicine Primary aldosteronism Hyperaldosteronism medicine Humans Adrenal adenoma Retrospective Studies Diagnostic Tests Routine business.industry General Medicine medicine.disease Treatment Outcome Blood pressure Defined daily dose Valsartan Hypertension Cohort business medicine.drug |
| Zdroj: | Hormones. 20:359-368 |
| ISSN: | 2520-8721 1109-3099 |
| Popis: | Primary aldosteronism (PA) is the most frequent type of endocrine hypertension. In our previous studies, we introduced two modified diagnostic tests for PA, the post-dexamethasone saline infusion test (DSIT) and the overnight dexamethasone, captopril, and valsartan test (DCVT). In this study, we aimed to validate both tests in respect to the biochemical and clinical response of a cohort of hypertensive patients in pre- and post-surgical setting. We retrospectively studied 41 hypertensive patients (16 males), with a median (IQR, range) age of 50 (16, 35–74) years and positive histology for adrenal adenoma. Preoperatively, all patients had a single adenoma on CT and a diagnosis of PA with either DSIT or DCVT. The defined daily dose (DDD) of hypertensive drugs was assessed pre- and postoperatively. DSIT or DCVT and basal ARR were reassessed postoperatively. Two of the 41 patients failed to suppress aldosterone post-surgery, leading to a post-adrenalectomy biochemical cure rate of 95%, while blood pressure was improved in 36 patients, leading to a clinical cure rate of 88% as assessed by the DDD methodology. The present study was a proof-of-concept process to validate two modified diagnostic tests for PA in clinical practice. These tests, used to diagnose a group of patients with PA, successfully assessed their biochemical cure post-adrenalectomy at rates similar to those reported in the literature. |
| Databáze: | OpenAIRE |
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