Effect of body mass index on the location of the right adrenal vein in patients with primary aldosteronism

Abstract Background To investigate the imaging anatomy and variations of bilateral adrenal veins to improve the success rate during adrenal venous sampling (AVS) and reduce the incidence of complications. Methods A total of 120 patients who underwent AVS from June 2017 to January 2019 were collected. RadiAnt Viewer software was used to retrospectively analyze the intraoperative imaging data, intraoperative anatomical variation data, the success rate, and complications of AVS. Results The ostium of the right adrenal vein was located mainly between the lower 1/3 of the 11th thoracic vertebra and the middle 1/3 of the 12th thoracic vertebra, accounting for 75.5% of the cases. Most of the ostium (83.3%) was transversely distributed between 9 o’clock and 12 o’clock. The main morphology of the right adrenal venography was a triangular pattern (48.2%). As the body mass index increased, the ostium was higher, and the distance between the ostium and the spine was greater (P < 0.05). The success rate of the right AVS, the left AVS, and the bilateral AVS was 95.0%, 97.5%, and 92.5%, respectively. The anatomical variation rate of the right adrenal vein was 5.3%. All cases showed that the right adrenal vein entered the accessory right hepatic vein and then into the inferior vena cava. The anatomical variation rate of the left adrenal vein was 4.3%. Conclusions Body mass index can be used to predict the location of the right adrenal vein ostium. Understanding of the anatomy and variation of the adrenal vein and right adrenal venography is essential to a successful AVS.

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Normal values of coronary arteries branching height in women

Reports of Morphology ◽

10.31393/morphology-journal-2021-27(4)-06 ◽

2021 ◽

Vol 27 (4) ◽

pp. 41-46

Author(s):

U.Ye. Pidvalna ◽

D.M. Beshley ◽

M.Z. Mirchuk ◽

L.R. Mateshuk-Vatseba

Keyword(s):

Body Mass Index ◽

Coronary Artery ◽

Body Mass ◽

Coronary Arteries ◽

Body Surface ◽

Left Coronary Artery ◽

Statistical Significance ◽

Lower Edge ◽

The Mean ◽

The Right

Morphometric analysis of the structures of the aortic bulb and coronary arteries is necessary for the planning of cardiac surgery and endovascular interventions. The aim of the study was to determine the height of the coronary arteries branching in healthy women of Lviv city and Lviv region and to determine the relationship between the height of the location of the orifice of the coronary artery with anthropometric indicators. Fifteen computed tomography images with contrast of female thorax without heart and ascending aortic lesions (normal) were selected for the study. The height of the upper and lower edges of the coronary arteries was measured; height of Valsalva sinuses. The comparison of the mean values was performed according to the Student’s t-test. The correlation between the observed variables (age, height, body weight, body mass index, body surface area, height of the sinuses of Valsalva) was calculated using the Pearson linear correlation method (r). According to the study, the population group consisted of persons of the second period of adulthood (46.67 %) and the elderly (53.33 %). According to the body mass index, 80 % were overweight or obese I-II degree. The mean height of the coronary artery orifice in women without structural changes of the heart and ascending aorta was: 11.19±1.96 mm for the left and 11.68±1.80 mm for the right. The height of the orifice of the right and left coronary arteries were almost the same, without statistical significance (p=0.26). Analysis of the correlation between the values of the height of the orifice of the coronary artery did not show a probable dependence on height, weight, age, body mass index and body surface area. There is a direct relationship between the parameters of the height of the lower edge of the right coronary artery and the height of the upper edge of the right coronary artery (r=+0.75, p=0.001) and between the value of the lower edge of the left coronary artery and the upper edge of the left coronary artery (r=+0.63, p=0.01). Thus, the analysis of the correlation between the values of the height of the orifice of the coronary artery in women in norm and anthropometric indicators did not show a significant relationship. There was no statistical significance between the indicators of the height of the orifice of the right and left coronary arteries in women.

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Adrenal Venous Sampling in Primary Aldosteronism: The Usefulness of Contralateral Suppression Index

Case Reports in Medicine ◽

10.1155/2019/1604367 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Natalia Treistman ◽

Aline Barbosa Moraes ◽

Stéphanie Cozzolino ◽

Patrícia de Fatima dos Santos Teixeira ◽

Leonardo Vieira Neto

Keyword(s):

Primary Aldosteronism ◽

Vena Cava ◽

Adrenal Vein ◽

Adrenal Venous Sampling ◽

Venous Sampling ◽

Successful Cannulation ◽

Contralateral Suppression ◽

The Right ◽

Cortisol Ratio ◽

Suppression Index

Adrenal venous sampling (AVS) is the gold standard test to differentiate the unilateral from the bilateral form in patients with primary aldosteronism (PA) although it may be a difficult procedure, especially the successful cannulation of the right adrenal vein. In this report, we describe a 49-year-old female patient diagnosed with PA, after investigating resistant hypertension and refractory hypokalemia. Abdominal computed tomography scan revealed a 2.5 cm adenoma on the right adrenal vein. AVS was performed under cosyntropin infusion. Aldosterone and cortisol concentrations were obtained from the right and left adrenal veins and inferior vena cava (IVC). Cortisol on each adrenal vein divided by cortisol on IVC confirmed successful cannulation of the left side only, which makes it impossible to calculate the lateralization index (LI). From the data on the left adrenal vein and IVC, the aldosterone-to-cortisol ratio divided by the IVC aldosterone-to-cortisol ratio was less than 1.0, suggesting that the left adrenal vein was suppressed with the excess aldosterone originating from the contralateral side (contralateral suppression index (CSI)). Right adrenalectomy was performed; postoperative hypoaldosteronism was confirmed. This report highlights the importance of CSI obtained in AVS when technical difficulties occur making it impossible to obtain LI, which is most commonly used to decide between surgical and clinical management of PA.

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Reduced gray matter volume in the orbitofrontal cortex is associated with greater body mass index: a coordinate-based meta-analysis

10.1101/359919 ◽

2018 ◽

Author(s):

Eunice Y. Chen ◽

Susan Murray ◽

Tania Giovannetti ◽

David V. Smith

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Gray Matter ◽

Default Mode Network ◽

Orbitofrontal Cortex ◽

Meta Analysis ◽

Gray Matter Volume ◽

Default Mode ◽

Matter Volume ◽

The Right

AbstractMeta-analyses of neuroimaging studies have not found a clear relationship between the orbitofrontal cortex and obesity, despite animal and human studies suggesting the contrary. Our primary meta-analysis examined what regions are associated with reduced gray matter volume, given increased body mass index. We identified 23 voxel-based morphometry studies examining the association between gray matter volume and body mass index. In a sample of 6,788 participants, we found that greater body mass index is associated with decreased gray matter volume in the right Brodmanns’ area 10 and 11, forming part of the right orbitofrontal cortex (FWE, p=0.05). Use of Brodmanns’ areas 10 and 11 as seeds in a Neurosynth network coactivation and text decoding analysis revealed that these regions are associated with studies of emotional regulation and processing, clinical symptoms and disorder, ‘mentalizing’ and social cognition, and the Default mode network. Our finding uniquely contributes to the literature in showing a relationship between the orbitofrontal cortex and obesity and showing the wide-ranging impact these differences may have on social, mental, and emotional functioning as well as on the Default mode network. Exploratory analyses suggest the need for studies examining the effect of age on these findings.

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Inflammatory agents partially explain changes in cortical thickness and surface area related to body mass index in adolescence

10.1101/698696 ◽

2019 ◽

Author(s):

X. Prats-Soteras ◽

M.A. Jurado ◽

J. Ottino-González ◽

I. García-García ◽

B. Segura ◽

...

Keyword(s):

Body Mass Index ◽

Surface Area ◽

Body Mass ◽

Cortical Thickness ◽

Serum Levels ◽

Fusiform Gyrus ◽

Precentral Gyrus ◽

Superior Frontal Gyrus ◽

Tnf Α ◽

The Right

ABSTRACTBackground/ObjectivesExcessive body mass index (BMI) has been linked to a low-grade chronic inflammation state. Unhealthy BMI has also been related to neuroanatomical changes in adults. However, research in adolescents is relatively limited and has produced conflicting results. This study aims to address the relationship between BMI and adolescents’ brain structure as well as to test the role that inflammatory adipose-related agents might have over this putative link.MethodsWe studied structural MRI and serum levels of interleukin-6, tumor necrosis factor alpha (TNF-α), C-reactive protein and fibrinogen in 65 adolescents (aged 12-21 years). Relationships between BMI, cortical thickness and surface area were tested with a vertex-wise analysis. Subsequently, we used backward multiple linear regression models to explore the influence of inflammatory parameters in each brain-altered area.ResultsWe found a negative association between cortical thickness and BMI in the left lateral occipital cortex (LOC), the left fusiform gyrus and the right precentral gyrus as well as a positive relationship between surface area and BMI in the left rostral middle frontal gyrus and the right superior frontal gyrus. In addition, we found that higher fibrinogen serum concentrations were related to thinning within the left LOC (β = −0.45, p < 0.001) and the left fusiform gyrus (β = - 0.33, p = 0.035), while higher serum levels of TNF-α were associated to a greater surface area in the right superior frontal gyrus (β = 0.32, p = 0.045).ConclusionsThese results suggest that adolescents’ body mass increases are related with brain abnormalities in areas that could play a relevant role in some aspects of feeding behavior. Likewise, we have evidenced that these cortical changes were partially driven by inflammatory agents such as fibrinogen and TNF-α.

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Comparison of Cortisol, Androstenedione and Metanephrines to Assess Selectivity and Lateralization of Adrenal Vein Sampling in Primary Aldosteronism

Journal of Clinical Medicine ◽

10.3390/jcm10204755 ◽

2021 ◽

Vol 10 (20) ◽

pp. 4755

Author(s):

Giulio Ceolotto ◽

Giorgia Antonelli ◽

Brasilina Caroccia ◽

Michele Battistel ◽

Giulio Barbiero ◽

...

Keyword(s):

Decision Making ◽

Primary Aldosteronism ◽

Inferior Vena ◽

Clinical Decision Making ◽

Vena Cava ◽

Clinical Decision ◽

Selectivity Index ◽

Adrenal Vein ◽

Adrenal Vein Sampling ◽

The Right

Success of adrenal vein sampling (AVS) is verified by the selectivity index (SI), i.e., by a step-up of cortisol levels between the adrenal vein and the infrarenal inferior vena cava samples, beyond a given cut-off. We tested the hypothesis that androstenedione, metanephrine, and normetanephrine, which have higher gradients than cortisol, could increase the rate of AVS studies judged to be bilaterally successful and usable for the clinical decision making. We prospectively compared within-patient, head-to-head, the selectivity index of androstenedione (SIA), metanephrine (SIM), and normetanephrine (SINM), and cortisol (SIC) in consecutive hypertensive patients with primary aldosteronism submitted to AVS. Main outcome measures were rate of bilateral success, SI values, and identification of unilateral PA. We recruited 136 patients (55 + 10 years, 35% women). Compared to the SIC, the SIA values were 3.5-fold higher bilaterally, and the SIM values were 7-fold and 4.4-fold higher on the right and the left side, respectively. With the SIA and the SIM the rate of bilaterally successful AVS increased by 14% and 15%, respectively without impairing the identification of unilateral PA. We concluded that androstenedione and metanephrine outperformed cortisol for ascertaining AVS success, thus increasing the AVS studies useable for the clinical decision making.

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Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism

Journal of the Endocrine Society ◽

10.1210/js.2019-00131 ◽

2019 ◽

Vol 3 (7) ◽

pp. 1393-1402 ◽

Cited By ~ 1

Author(s):

Norio Wada ◽

Yui Shibayama ◽

Takashi Yoneda ◽

Takuyuki Katabami ◽

Isao Kurihara ◽

...

Keyword(s):

Primary Aldosteronism ◽

Diagnostic Techniques ◽

Concordance Rate ◽

Adrenal Vein ◽

Ct Scans ◽

Adrenal Vein Sampling ◽

Adrenal Imaging ◽

Significant Difference ◽

Nodular Lesions ◽

The Right

Abstract Context In patients with primary aldosteronism (PA), it remains unclear whether aldosterone-producing adenomas are likely to develop in the left or right adrenal gland. Objective To investigate left-right differences of PA laterality diagnoses via CT imaging and adrenal vein sampling (AVS). Design Retrospective, observational study. Patients From the Japan Primary Aldosteronism Study, 1493 patients with PA were enrolled who underwent CT and ACTH-stimulated AVS. Measurements Left or right adrenal nodular lesion distribution and laterality observed on CT scans and from AVS were noted. Results Both on CT scans and AVS, unilateral results were observed more frequently on the left side than on the right side (25.1% vs 15.4% and 17.3% vs 13.5%, respectively; P < 0.01for both diagnostic techniques). There was no significant difference in the concordance rate for CT and AVS between patients with left and right unilateral nodular lesions observed on CT scans (44.1% and 50.9%, respectively; P = 0.15). In patients with nodules <20 mm, the concordance rate was significantly greater on the right side than the left side (45.8% vs 56.4%; P = 0.03). In patients with bilateral results of AVS, unilateral nodular lesions were detected more frequently on the left side than the right side (17.8% vs 9.4%; P < 0.01). Conclusion These results suggest aldosterone-producing adenomas and nonfunctioning tumors are more likely to develop on the left side in patients with PA and that misdiagnosis of CT-based lateralization may occur more frequently on the left side.

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42 COST-EFFECTIVE AND FEASIBLE SCREENING OF PRIMARY ALDOSTERONISM WITH POTASSIUM EXCRETION CAPACITY/ BODY MASS INDEX RATIO

The Journal of Urology ◽

10.1016/j.juro.2012.02.086 ◽

2012 ◽

Vol 187 (4S) ◽

Author(s):

Shih-Chieh Jeff Chueh ◽

VinCent Wu ◽

Kwan-Dun Wu ◽

Chin-Chi Kuo ◽

Bashir Sankari ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Primary Aldosteronism ◽

Cost Effective ◽

Potassium Excretion ◽

Index Ratio

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[PP.25.10] BODY MASS INDEX AND CONTRALATERAL RATIO PREDICT BLOOD PRESSURE OUTCOME FOLLOWING UNILATERAL ADRENALECTOMY IN PRIMARY ALDOSTERONISM

Journal of Hypertension ◽

10.1097/01.hjh.0000492119.85323.c0 ◽

2016 ◽

Vol 34 ◽

pp. e268

Author(s):

K. Bokuda ◽

A. Ichihara ◽

M. Yatabe ◽

J. Yatabe ◽

T. Ando ◽

...

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Body Mass ◽

Primary Aldosteronism ◽

Unilateral Adrenalectomy

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Anthropometric and Psychomotor Development Factors Linked to Foot Valgus in Children Aged 6 to 9 Years

Journal of the American Podiatric Medical Association ◽

10.7547/16-108 ◽

2019 ◽

Vol 109 (1) ◽

pp. 30-35

Author(s):

Jose Miguel Morales Asencio ◽

Miguel F. Medina-Alcántara ◽

Ana Belen Ortega-Avila ◽

Ana María Jimenez-Cebrian ◽

Joaquin Paez Moguer ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Age At Onset ◽

Valgus Deformity ◽

Overweight And Obesity ◽

Lower Limbs ◽

Psychomotor Development ◽

Anthropometric Parameters ◽

Increased Risk ◽

The Right

Background: Planovalgus foot prevalence estimates vary widely (0.6%–77.9%). Among the many factors that may influence planovalgus foot development, much attention has been given to body mass index, especially that of children's feet; factors related to psychomotor development have been less studied. We sought to determine the presence of planovalgus foot in children and its association with anthropometric parameters and psychomotor development. Methods: A case-control study was conducted in Málaga, Spain, 2012–2013, of 104 schoolchildren (mean ± SD age, 7.55 ± 0.89 years; 45.2% were boys). Age, sex, body mass index, presence of valgus (valgus index, by pedigraphy), and personal history related to psychomotor development of the lower limbs (presence/absence of crawling, age at onset of crawling, age at onset of walking, use of mobility aids) were evaluated. Results: Of the children with obesity, 53.7% had valgus deformity in the left hindfoot (odds ratio [OR], 6.94; 95% confidence interval [CI], 2.72–17.70; P < .0001). In the right foot, the corresponding values were 54.5% (OR, 9.08; 95% CI, 3.38–24.36; P < .0001). Multivariate logistic regression showed an increased risk of left planovalgus foot in boys, in children with overweight or obesity, and in those who began walking later. For the right foot, the same risk factors applied except age at onset of walking. Conclusions: These results corroborate data from previous studies, which report an association between overweight and obesity and the onset of planovalgus foot in children. In addition, we identify a new risk factor: age at onset of walking.

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