ArticleClinical endocrinology2025
The Utility of Plasma Metanephrines to Optimise Adrenal Vein Sampling for Primary Aldosteronism: A Single Centre Experience.
Article in Clinical endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The trial behind it
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Who cites it
2 citing papers in PubMed.
- Mass Spectrometric Measurements of 11-Deoxycortisol, Androstenedione and Dehydroepiandrosterone Are Superior to Cortisol to Assess Selectivity of Non-Stimulated Adrenal Vein Sampling.Clinical endocrinology · 2026Article
- Metanephrines-corrected adrenal vein sampling in primary aldosteronism concurrent with autonomous cortisol secretion.Journal of endocrinological investigation · 2025Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundPrimary aldosteronism (PA) is a prevalent yet frequently underdiagnosed cause of secondary hypertension, affecting up to 10% of hypertensive individuals and contributing to increased cardiovascular risk. Accurate diagnosis is vital, as unilateral PA cases typically require surgical intervention, while bilateral disease is managed medically. Adrenal vein sampling (AVS) remains the gold standard for diagnosing subtypes of PA; however, the use of cortisol to confirm accuracy of cannulation poses challenges due to its long half-life and potential cortisol co-secretion by aldosterone-producing adenomas.
objectiveThis study evaluates the diagnostic utility of plasma metanephrines (MN) as an alternative to cortisol in assessing cannulation success and lateralisation of aldosterone secretion.
methodsAnalysing 132 unstimulated AVS procedures performed by a single operator on 129 patients with confirmed PA, we established optimal cut-off values for the selectivity index (SI) and lateralisation index (LI) using MN.
resultsA MN SI cut-off of >3 achieved 99% sensitivity and 100% specificity, while an aldosterone/MN LI of >4 indicated unilateral disease with 94% sensitivity and 96% specificity.
conclusionOur findings demonstrate that incorporating MN measurements significantly enhances the accuracy of AVS interpretations, particularly in cases of cortisol co-secretion, thereby minimising diagnostic errors and optimising treatment strategies. This study supports the use of MN as reliable analytes to improve the diagnostic accuracy of AVS.
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