ArticleHypertension (Dallas, Tex. : 1979)2025
Cosyntropin-Stimulated Aldosterone Reserve of the Nondominant Adrenal Predicts Surgical Outcomes in Primary Aldosteronism.
Article in Hypertension (Dallas, Tex. : 1979), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Primary aldosteronism.Nature reviews. Disease primers · 2026Review
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Authors and funding
6 authors.
Funding
Abstract
backgroundAdrenal vein sampling (AVS) is commonly used to direct therapy of primary aldosteronism (PA). We hypothesized that cosyntropin stimulation during AVS exposes the reserve of aldosterone-producing cells in the nondominant adrenal gland and might predict postoperative outcomes.
methodsPatients with PA who underwent successful AVS before and after cosyntropin stimulation between January 2015 and December 2024 in a tertiary-referral center were included. The nondominant adrenal aldosterone reserve was assessed with (1) contralateral aldosterone reserve ratio (=aldosterone postcosyntropin-to-baseline ratio in the nondominant adrenal vein) and (2) lateralization index (LI) ratio (=LI
resultsFour hundred thirty-four patients (57% men; mean age, 53±12 years) were included. AVS lateralized only at baseline in 52 (12%) patients, only after cosyntropin in 46 (11%), and in both protocols in 166 (38%); 170 (39%) patients had bilateral PA. PA severity decreased from cases lateralized in both protocols, to postcosyntropin only, baseline only, and consistently bilateral; conversely, the contralateral aldosterone reserve increased across these groups. The contralateral aldosterone reserve ratio was higher in patients without PA cure and bilateral PA (median [interquartile range], 11.2 [5.0-23.5] and 17.8 [9.1-32.0], respectively, versus 4.9 [2.5-9.4] in those cured;
conclusionsCosyntropin stimulation during AVS unveils the aldosterone reserve of the nondominant adrenal gland, exposing the risk of residual disease after adrenalectomy.
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