AbstractThe aim of the study was to investigate the significance and influence of
adrenocorticotropic hormone (ACTH) stimulation in primary aldosteronism (PA)
patients with simultaneous bilateral adrenal vein sampling (AVS). All patients
diagnosed with PA underwent simultaneous bilateral AVS with ACTH. In 95
patients, the post-ACTH SI significantly increased (p<0.001), and it
gradually decreased from t10–t30 after ACTH stimulation
(p<0.001). The unsuccessful catheterization decreased after ACTH
stimulation. Time points within 20 min after ACTH stimulation were better for
sampling, and the selectivity did not increase over longer periods. According to
lateralization before and after ACTH stimulation, the patients could be divided
into 3 groups (U, unilateral; B, bilateral): U/U , U/B or
B/U, and B/B. Compared with the U/U group, in the
U/B or B/U and B/B groups, the lateralization index (LI)
was lower both at baseline and after ACTH stimulation (p<0.0001), the
contralateral index (CLI) was higher after ACTH stimulation (p<0.003),
the serum potassium level was higher (p<0.001), and the carbon dioxide
combining power (CO2CP) and base excess (BE) levels were lower. In conclusion,
in simultaneous bilateral AVS, ACTH stimulation had significant effects on
increasing the catheterization selectivity. Lateralization change was observed
after stimulation. After ACTH stimulation, fewer patients could be diagnosed
with lateralized PA. Patients with consistent lateralized PA showed a more
serious phenotype.
Effect of Adrenocorticotropic Hormone Stimulation During Adrenal Vein Sampling in Primary Aldosteronism
