Mohamed-Karji Almarzooqi1, Miguel Chagnon2, Gilles Soulez1,3, Marie-France Giroux1, Patrick Gilbert1, Vincent L Oliva1, Pierre Perreault1, Louis Bouchard1, Isabelle Bourdeau4, André Lacroix4, Eric Therasse5. 1. Department of RadiologyCentre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada. 2. Department of Mathematics and StatisticsUniversity of Montreal, Montréal, Quebec, Canada. 3. Centre de RechercheCHUM (CRCHUM), Montréal, Quebec, Canada. 4. Department of MedicineDivision of Endocrinology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada. 5. Department of RadiologyCentre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada eric.therasse.chum@ssss.gouv.qc.ca.
Abstract
OBJECTIVE: Many investigators believe that basal adrenal venous sampling (AVS) should be done simultaneously, whereas others opt for sequential AVS for simplicity and reduced cost. This study aimed to evaluate the concordance of sequential and simultaneous AVS methods. DESIGN AND METHODS: Between 1989 and 2015, bilateral simultaneous sets of basal AVS were obtained twice within 5 min, in 188 consecutive patients (59 women and 129 men; mean age: 53.4 years). Selectivity was defined by adrenal-to-peripheral cortisol ratio ≥2, and lateralization was defined as an adrenal aldosterone-to-cortisol ratio ≥2, the contralateral side. Sequential AVS was simulated using right sampling at -5 min (t = -5) and left sampling at 0 min (t = 0). RESULTS: There was no significant difference in mean selectivity ratio (P = 0.12 and P = 0.42 for the right and left sides respectively) and in mean lateralization ratio (P = 0.93) between t = -5 and t = 0. Kappa for selectivity between 2 simultaneous AVS was 0.71 (95% CI: 0.60-0.82), whereas it was 0.84 (95% CI: 0.76-0.92) and 0.85 (95% CI: 0.77-0.93) between sequential and simultaneous AVS at respectively -5 min and at 0 min. Kappa for lateralization between 2 simultaneous AVS was 0.84 (95% CI: 0.75-0.93), whereas it was 0.86 (95% CI: 0.78-0.94) and 0.80 (95% CI: 0.71-0.90) between sequential AVS and simultaneous AVS at respectively -5 min at 0 min. CONCLUSIONS: Concordance between simultaneous and sequential AVS was not different than that between 2 repeated simultaneous AVS in the same patient. Therefore, a better diagnostic performance is not a good argument to select the AVS method.
OBJECTIVE: Many investigators believe that basal adrenal venous sampling (AVS) should be done simultaneously, whereas others opt for sequential AVS for simplicity and reduced cost. This study aimed to evaluate the concordance of sequential and simultaneous AVS methods. DESIGN AND METHODS: Between 1989 and 2015, bilateral simultaneous sets of basal AVS were obtained twice within 5 min, in 188 consecutive patients (59 women and 129 men; mean age: 53.4 years). Selectivity was defined by adrenal-to-peripheral cortisol ratio ≥2, and lateralization was defined as an adrenal aldosterone-to-cortisol ratio ≥2, the contralateral side. Sequential AVS was simulated using right sampling at -5 min (t = -5) and left sampling at 0 min (t = 0). RESULTS: There was no significant difference in mean selectivity ratio (P = 0.12 and P = 0.42 for the right and left sides respectively) and in mean lateralization ratio (P = 0.93) between t = -5 and t = 0. Kappa for selectivity between 2 simultaneous AVS was 0.71 (95% CI: 0.60-0.82), whereas it was 0.84 (95% CI: 0.76-0.92) and 0.85 (95% CI: 0.77-0.93) between sequential and simultaneous AVS at respectively -5 min and at 0 min. Kappa for lateralization between 2 simultaneous AVS was 0.84 (95% CI: 0.75-0.93), whereas it was 0.86 (95% CI: 0.78-0.94) and 0.80 (95% CI: 0.71-0.90) between sequential AVS and simultaneous AVS at respectively -5 min at 0 min. CONCLUSIONS: Concordance between simultaneous and sequential AVS was not different than that between 2 repeated simultaneous AVS in the same patient. Therefore, a better diagnostic performance is not a good argument to select the AVS method.
Authors: Nicholas Yozamp; Gregory L Hundemer; Marwan Moussa; Johnathan Underhill; Tali Fudim; Barry Sacks; Anand Vaidya Journal: Am J Hypertens Date: 2021-02-18 Impact factor: 3.080
Authors: Gian Paolo Rossi; Valeria Bisogni; Alessandra Violet Bacca; Anna Belfiore; Maurizio Cesari; Antonio Concistrè; Rita Del Pinto; Bruno Fabris; Francesco Fallo; Cristiano Fava; Claudio Ferri; Gilberta Giacchetti; Guido Grassi; Claudio Letizia; Mauro Maccario; Francesca Mallamaci; Giuseppe Maiolino; Dario Manfellotto; Pietro Minuz; Silvia Monticone; Alberto Morganti; Maria Lorenza Muiesan; Paolo Mulatero; Aurelio Negro; Gianfranco Parati; Martino F Pengo; Luigi Petramala; Francesca Pizzolo; Damiano Rizzoni; Giacomo Rossitto; Franco Veglio; Teresa Maria Seccia Journal: Int J Cardiol Hypertens Date: 2020-04-15