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
https://doi.org/10.1161/HYPERTENSIONAHA.114.03091
Hypertension. 2014;63:e89
Originally published March 12, 2014

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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.

References

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    An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension. 2014;63:151–160.
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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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