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Letter to the Editor

Response to Implementation of Rapid Cortisol During Adrenal Vein Sampling

Richard J. Auchus, Morris Brown, Jacques W.M. Lenders, Mitsuhide Naruse, Pierre Francois Plouin, Fumitoshi Satoh, William F. Young, Gian Paolo Rossi
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https://doi.org/10.1161/HYPERTENSIONAHA.114.03091
Hypertension. 2014;63:e89
Originally published March 12, 2014
Richard J. Auchus
Division of Metabolism, Endocrinology, and DiabetesDepartment of Internal Medicine, University of Michigan, Ann Arbor
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Morris Brown
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Jacques W.M. Lenders
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Mitsuhide Naruse
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Pierre Francois Plouin
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Fumitoshi Satoh
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William F. Young
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Gian Paolo Rossi
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We thank Hayden et al for sharing their experience and for supporting our consensus statement.1 Intraprocedural cortisol assay is 1 approach to improve the success rate for adrenal vein sampling, particularly while radiologists are gaining experience with the procedure. Several centers have adopted this practice successfully, but logistic problems have prevented its widespread use.2,3

Better biomarkers of selectivity and quicker assays are still desirable for guiding adrenal vein sampling. For example, plasma metanephrine shows a greater selectivity index than cortisol.4 Tandem mass spectrometry assays, when sample preparation from plasma is automated and instrumentation is already calibrated, can yield results in minutes.5

As the methodology to expedite confirmation of catheter placement evolves, economic and practical factors will influence the application of these technologies to the adrenal vein sampling procedure. Nevertheless, we encourage and applaud all efforts to provide reliable adrenal vein sampling results to more patients with primary aldosteronism.

Richard J. Auchus
Division of Metabolism, Endocrinology, and DiabetesDepartment of Internal Medicine
University of Michigan
Ann Arbor
Morris Brown
Clinical Pharmacology UnitDepartment of Medicine
University of Cambridge
Cambridge, United Kingdom
Jacques W.M. Lenders
Department of Internal Medicine
Radboud University Nijmegen Medical Centre
Nijmegen, The Netherlands
Mitsuhide Naruse
Department of Endocrinology, Metabolism, and Hypertension
National Hospital Organization Kyoto Medical Center
Kyoto, Japan
Pierre Francois Plouin
Hypertension Unit
Hôpital Européen G. Pompidou
Paris, France
Fumitoshi Satoh
Division of Nephrology, Endocrinology, and Vascular Medicine
Tohoku University Hospital
Sendai, Japan
William F. Young Jr
Division of Endocrinology, Diabetes, Metabolism, and Nutrition Mayo Clinic
Mayo Clinic College of Medicine
Rochester, MN
Gian Paolo Rossi
Department of Medicine–DIMED
Internal Medicine 4
University of Padova
Padova, Italy

Disclosures

None.

Footnotes

  • Letters to the Editor will be published, if suitable, as space permits. They should not exceed 500 words (typed double-spaced) plus 5 references in length and may be subject to editing or abridgment.

  • © 2014 American Heart Association, Inc.

References

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    8. Young WF Jr..
    An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension. 2014;63:151–160.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Auchus RJ,
    2. Michaelis C,
    3. Wians FH Jr.,
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    5. Josephs SC,
    6. Trimmer CK,
    7. Anderson ME,
    8. Nwariaku FE
    . Rapid cortisol assays improve the success rate of adrenal vein sampling for primary aldosteronism. Ann Surg. 2009;249:318–321.
    OpenUrlCrossRefPubMed
  3. 3.↵
    1. Mengozzi G,
    2. Rossato D,
    3. Bertello C,
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    5. Milan A,
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    7. Veglio F,
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    . Rapid cortisol assay during adrenal vein sampling in patients with primary aldosteronism. Clin Chem. 2007;53:1968–1971.
    OpenUrlAbstract/FREE Full Text
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    1. Dekkers T,
    2. Deinum J,
    3. Schultzekool LJ,
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    6. Hermus AR,
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    . Plasma metanephrine for assessing the selectivity of adrenal venous sampling. Hypertension. 2013;62:1152–1157.
    OpenUrlAbstract/FREE Full Text
  5. 5.↵
    1. Taylor PJ,
    2. van Rosendal SP,
    3. Coombes JS,
    4. Gordon RD,
    5. Stowasser M
    . Simultaneous measurement of aldosterone and cortisol by high-performance liquid chromatography-tandem mass spectrometry: application to dehydration-rehydration studies. J Chromatogr B Analyt Technol Biomed Life Sci. 2010;878:1195–1198.
    OpenUrlCrossRefPubMed
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April 2014, Volume 63, Issue 4
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    Response to Implementation of Rapid Cortisol During Adrenal Vein Sampling
    Richard J. Auchus, Morris Brown, Jacques W.M. Lenders, Mitsuhide Naruse, Pierre Francois Plouin, Fumitoshi Satoh, William F. Young and Gian Paolo Rossi
    Hypertension. 2014;63:e89, originally published March 12, 2014
    https://doi.org/10.1161/HYPERTENSIONAHA.114.03091

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    Response to Implementation of Rapid Cortisol During Adrenal Vein Sampling
    Richard J. Auchus, Morris Brown, Jacques W.M. Lenders, Mitsuhide Naruse, Pierre Francois Plouin, Fumitoshi Satoh, William F. Young and Gian Paolo Rossi
    Hypertension. 2014;63:e89, originally published March 12, 2014
    https://doi.org/10.1161/HYPERTENSIONAHA.114.03091
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