Why the study?
Previous studies suggested that plasma aldosterone response to ACTH stimulation could predict primary aldosteronism subtypes and avoid adrenal venous sampling.
Can peripheral plasma aldosterone concentration response to ACTH stimulation predict the source of aldosterone secretion in primary aldosteronism and avoid adrenal venous sampling?
Can peripheral plasma aldosterone concentration response to ACTH stimulation predict the source of aldosterone secretion in primary aldosteronism and avoid adrenal venous sampling?
Peripheral plasma aldosterone response to ACTH cannot replace adrenal venous sampling for identifying the source of aldosterone in primary aldosteronism.
Peripheral ACTH-stimulated PAC lacks accuracy to avoid AVS; leaves open whether refined thresholds or combinations merit prospective validation.
CONTEXT: Previous studies suggested that plasma aldosterone (PAC) response to ACTH stimulation could predict the subtypes of primary aldosteronism (PA) and avoid adrenal venous sampling (AVS). OBJECTIVE: Assess the usefulness of peripheral (P) PAC response to ACTH stimulation during AVS to identify the source of aldosterone in patients with PA. METHODS: /C), PAC absolute increase, PAC relative increase following ACTH bolus (250 mcg IV) and maximal variation of PAC/C ratio between post-ACTH and basal measures. RESULTS: /C (AUC: 0.750 95% IC: 0.646-0.853). CONCLUSION: /C are higher in basal and ACTH lateralized PA than in other groups. Peripheral PAC cut-off values fail to adequately distinguish all groups and cannot replace the requirement to conduct AVS.
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St‐Jean et al. (2019) studied this question.
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