Aldosterone reduction rate after saline infusion may be a novel clinical prediction of determining subtypes of primary aldosteronism

ObjectiveAccurate assessment of the localization of aldosterone-producing adenomas (APAs) is essential for the treatment of primary aldosteronism (PA). Although adrenal venous sampling (AVS) is the standard method of reference for subtype diagnosis in PA, controversy exists concerning the criteria for interpretation. This study aimed to determine better indicators that can reliably predict subtypes of PA. MethodRetrospective analysis in single-cohort including 209 patients with PA who were subjected to AVS. 82 patients whose plasma aldosterone concentrations (PAC) were normalized after surgery were histopathologically or genetically diagnosed with APA. The accuracy of image findings was compared to AVS results. Receiver operating characteristic (ROC) curve analysis between the operated and no apparent laterality groups was performed using AVS parameters and loading test for diagnosis of PA. Result The agreement between image findings and AVS results was 56.3%. ROC curve analysis...研究目的：准确评估醛固酮生成腺瘤（aldosterone-producing adenomas, APAs）的定位，对于原发性醛固酮增多症（primary aldosteronism, PA）的治疗至关重要。尽管肾上腺静脉采样（adrenal venous sampling, AVS）是原发性醛固酮增多症亚型诊断的标准参考方法，但其判读标准仍存在争议。本研究旨在探寻可可靠预测原发性醛固酮增多症亚型的更优指标。 方法：本研究为单队列回顾性分析，纳入209例接受肾上腺静脉采样的原发性醛固酮增多症患者。其中82例患者术后血浆醛固酮浓度（plasma aldosterone concentration, PAC）恢复正常，经组织病理学或基因学确诊为醛固酮生成腺瘤。将影像学检查结果与肾上腺静脉采样结果的诊断准确性进行对比。以肾上腺静脉采样参数及原发性醛固酮增多症诊断负荷试验为指标，对手术组与无明确侧别组开展受试者工作特征（Receiver Operating Characteristic, ROC）曲线分析。 结果：影像学检查结果与肾上腺静脉采样结果的一致性为56.3%。受试者工作特征曲线分析……