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primary aldosteronism

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https://www.readbyqxmd.com/read/29781840/cardiovascular-autonomic-profile-in-women-with-constitutional-hypotension
#1
Giris Jacob, Franca Barbic, Meytal Glago, Franca Dipaola, Alberto Porta, Raffaello Furlan
BACKGROUND: Constitutional hypotension (CHT) is defined as a SBP below 105 mmHg. As autonomic-related symptoms are frequently reported in CHT, these symptoms suggest that the cardiovascular autonomic control is perturbed in individuals with CHT. METHODS: We investigated the autonomic cardiovascular control of 15 women with CHT and 12 women with NBP (SBP >110 mmHg). We monitored BP and ECG for autonomic function test. Supine and head up tilt (HUT) spectral analysis of RR interval and BP variability, baroreflex sensitivity and plasma levels of plasma renin activity and aldosterone were determined...
May 16, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29779118/change-in-kidney-function-after-unilateral-adrenalectomy-in-patients-with-primary-aldosteronism-identification-of-risk-factors-for-decreased-kidney-function
#2
Il Young Kim, In Seong Park, Min Jeong Kim, Miyeun Han, Harin Rhee, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak, Sang Heon Song, Hyun Chul Chung
PURPOSE: Glomerular filtration rate (GFR) has been reported to decrease after unilateral adrenalectomy in patients with primary aldosteronism (PA). The aim of this study was to identify clinical predictors for decreased GFR after adrenalectomy in patients with PA. METHODS: The records of 187 patients (98 patients with PA and 89 with non-PA adrenal disease) who were followed up for at least 6 months after unilateral adrenalectomy were retrospectively analyzed. Estimated GFR (eGFR) was investigated at 1, 3, and 6 months postoperatively...
May 19, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29772966/variability-of-serum-aldosterone-concentrations-in-pet-ferrets-mustela-putorius-furo
#3
Nicola Di Girolamo, Kellie Fecteau, Alessandra Carnimeo, Laura Bongiovanni, Federico Fracassi, Gloria Isani, Paolo Selleri
OBJECTIVE To explore sources of serum aldosterone concentration variability in a population of healthy and diseased ferrets, determine a preliminary 1 -sided reference interval for serum aldosterone concentration in healthy ferrets, and identify a decision limit to differentiate healthy from diseased ferrets on the basis of serum aldosterone concentration. DESIGN Prospective threshold definition and diagnostic accuracy study. ANIMALS 78 healthy (n = 56) and diseased (22) ferrets. PROCEDURES Serum aldosterone concentrations were measured on consecutively admitted ferrets, and an upper reference limit for aldosterone concentrations was established...
June 1, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29770148/clinical-characteristics-of-aldosterone-and-cortisol-coproducing-adrenal-adenoma-in-primary-aldosteronism
#4
Lu Tang, Xintao Li, Baojun Wang, Xin Ma, Hongzhao Li, Yu Gao, Liangyou Gu, Wenyuan Nie, Xu Zhang
Aldosterone- and cortisol-coproducing adrenal adenoma (A/CPA) cases have been observed in patients with primary aldosteronism (PA). This study investigated the incidence, clinical characteristics, and molecular biological features of patients with A/CPAs. We retrospectively identified 22 A/CPA patients from 555 PA patients who visited the Chinese People's Liberation Army General Hospital between 2004 and 2015. Analysis of clinical parameters revealed that patients with A/CPAs had larger tumors than those with pure APAs ( P < 0...
2018: International Journal of Endocrinology
https://www.readbyqxmd.com/read/29766680/c-arm-computed-tomography-assisted-adrenal-venous-sampling-improved-right-adrenal-vein-cannulation-and-sampling-quality-in-primary-aldosteronism
#5
Chung Hyun Park, Namki Hong, Kichang Han, Sang Wook Kang, Cho Rok Lee, Sungha Park, Yumie Rhee
BACKGROUND: Adrenal venous sampling (AVS) is a gold standard for subtype classification of primary aldosteronism (PA). However, this procedure has a high failure rate because of the anatomical difficulties in accessing the right adrenal vein. We investigated whether C-arm computed tomography-assisted AVS (C-AVS) could improve the success rate of adrenal sampling. METHODS: A total of 156 patients, diagnosed with PA who underwent AVS from May 2004 through April 2017, were included...
May 4, 2018: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29761293/stable-but-progressive-nature-of-heart-failure-considerations-for-primary-care-physicians
#6
REVIEW
Inder Anand
Primary care physicians play a significant role in managing heart failure (HF), with the goals of reducing mortality, avoiding hospitalization, and improving patients' quality of life. Most HF-related hospitalizations and deaths occur in patients with New York Heart Association functional class II or III, many of whom are perceived to have stable disease, which often progresses without clinical symptoms due to underlying deleterious effects of neurohormonal imbalance and endothelial dysfunction. Management includes lifestyle changes and stepped pharmacological therapy directed at the four stages of HF, with aggressive uptitration of therapies, including beta-blockers and inhibitors of the renin-angiotensin-aldosterone system...
May 14, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29757946/role-of-venous-sampling-in-the-diagnosis-of-endocrine-disorders
#7
REVIEW
Ryan W England, Eliza B Geer, Amy R Deipolyi
Venous sampling is the gold standard for localizing abnormal hormone secretion in several endocrine disorders. The most common indication for venous sampling is in the workup of primary aldosteronism, adrenocorticotropic hormone-dependent Cushing's syndrome, and hyperparathyroidism. In experienced hands, venous sampling is safe and accurate. This review discusses the role of venous sampling in the workup of endocrine disease, describing the underlying anatomy and pathophysiology, as an understanding of these concepts is essential for technical and clinical success...
May 14, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29749133/characteristics-of-adrenal-incidentalomas-in-a-large-prospective-computed-tomography-based-multicenter-study-the-coar-study-in-korea
#8
Seong Hee Ahn, Jae Hyeon Kim, Seung Hee Baek, Hyeonmok Kim, Yoon Young Cho, Sunghwan Suh, Beom Jun Kim, Seongbin Hong, Jung Min Koh, Seung Hun Lee, Kee Ho Song
PURPOSE: Previous studies on adrenal incidentalomas (AIs) are limited by their retrospective design, small numbers of patients, Western populations, or use of an outdated imaging technique. We investigated the characteristics of AIs in Korean patients and compared them with those reported in the largest retrospective study in Italy to discover the effects of improved imaging techniques and ethnicity differences. MATERIALS AND METHODS: This was a prospective, multicenter, cross-sectional observational study including 1005 Korean patients...
June 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29742971/insufficiency-of-the-zona-glomerulosa-of-the-adrenal-cortex-and-progressive-kidney-insufficiency-following-unilateral-adrenalectomy-case-report-and-discussion
#9
Joanna Kanarek-Kucner, Adrian Stefański, Rufus Barraclough, Tomasz Gorycki, Jacek Wolf, Krzysztof Narkiewicz, Michał Hoffmann
BACKGROUND: Primary aldosteronism (PA) is the most common cause of secondary hypertension and bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenoma (APA) seem to be the most common causes of PA. Unilateral adrenalectomy (UA) is the preferred treatment for APA, although the benefits are still difficult to assess. CASE REPORT: We present a case report of a 69-year old man with a 30 year history of hypertension and probably long-standing PA due to APA, with typical organ complications...
May 9, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29741297/a-pedunculated-aldosterone-producing-adenoma-drained-by-an-extra-vein-causing-puzzling-results-of-adrenal-vein-sampling
#10
Marieke S Velema, Tanja Dekkers, Ad R M M Hermus, Henri J L M Timmers, Johan Langenhuijsen, Mark Arntz, Benno Kusters, Graeme Eisenhofer, Jacques W M Lenders, Jaap Deinum
Primary aldosteronism (PA) is a common cause of endocrine hypertension in which two main subtypes are distinguished: bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenomas (APA).1 Computed tomography (CT) and adrenal vein sampling (AVS) are used to differentiate between these subtypes. There are two basic conditions for AVS. First, aldosterone concentrations should be corrected for peripheral blood admixture by normalizing for cortisol concentration. Second, it is assumed that either adrenal is drained by one vein...
May 9, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29737255/should-all-hypertensive-patients-be-screened-for-primary-aldosteronism
#11
Stelina Alkagiet, Konstantinos Tziomalos
Primary aldosteronism (PA) is not only a leading cause of secondary and resistant hypertension, but is also quite frequent in unselected hypertensive patients. Moreover, PA is associated with increased cardiovascular risk, which is disproportionate to BP levels. In addition, timely diagnosis of PA and prompt initiation of treatment attenuates this increased risk. On the other hand, there are limited data regarding the usefulness of screening for PA in all asymptomatic or normokalemic hypertensive patients. More importantly, until now, no well-organized, large-scale, prospective, randomized controlled trial has proved the effectiveness of screening for PA for improving clinical outcome...
May 7, 2018: Current Hypertension Reviews
https://www.readbyqxmd.com/read/29726953/genetic-characterization-of-gnrh-lh-responsive-primary-aldosteronism
#12
Nadia Gagnon, Katia Caceres, Gilles Corbeil, Nada El Ghorayeb, Natasha Ludwig, Mathieu Latour, André Lacroix, Isabelle Bourdeau
Background: Recently, somatic beta-catenin mutations (CTNNB1) identified in aldosterone-producing adenomas (APA) from 3 women, were suggested to be responsible for the aberrant overexpression of LHCGR and GNRHR in the APA. Objective: To genetically characterize patients with primary aldosteronism (PA) evaluated in vivo for GnRH/LH responsive aldosterone secretion. Method: Patients with PA were evaluated in vivo to determine the possible regulation of aldosterone secretion by GnRH or LH...
May 2, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29724188/the-effect-of-spironolactone-on-calcineurin-inhibitor-induced-nephrotoxicity-a-multicenter-randomized-double-blind-clinical-trial-the-spiren-trial
#13
Line Aas Mortensen, Helle C Thiesson, Birgitte Tougaard, Martin Egfjord, Anne Sophie Lind Fischer, Claus Bistrup
BACKGROUND: Calcineurin inhibitor induced nephrotoxicity contributes to late allograft failure in kidney transplant patients. Evidence points towards aldosterone to play a role in the development of fibrosis in multiple organs. Animal studies have indicated a beneficial effect of mineralocorticoid receptor antagonists preventing calcineurin inhibitor induced nephrotoxicity. Only few studies have explored this effect in humans. The objective of this study is to evaluate the effect of spironolactone on glomerular filtration rate and fibrosis in kidney transplant patients...
May 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29723896/mineralocorticoid-receptor-blockers-and-aldosterone-to-renin-ratio-a-randomized-controlled-trial-and-observational-data
#14
Stefan Pilz, Christian Trummer, Nicolas Verheyen, Verena Schwetz, Marlene Pandis, Felix Aberer, Martin R Grübler, Andreas Meinitzer, Antonia Bachmann, Jakob Voelkl, Ioana Alesutan, Cristiana Catena, Leonardo A Sechi, Winfried März, Barbara Obermayer-Pietsch, Andreas Tomaschitz
Current guidelines recommend to withdraw mineralocorticoid receptor (MR) blocker treatment for at least 4 weeks when measuring the aldosterone to renin ratio (ARR) as a screening test for primary aldosteronism (PA). We aimed to evaluate the effect of MR blocker treatment on ARR and its components, plasma aldosterone concentration (PAC), and direct renin concentration (DRC). First, we performed a post-hoc analysis of the effect of eplerenone on parathyroid hormone levels in primary hyperparathyroidism (EPATH) study, a randomized controlled trial (RCT) in 110 patients with primary hyperparathyroidism (pHPT)...
May 3, 2018: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29722113/primary-aldosteronism-in-patients-with-adrenal-incidentaloma-is-screening-appropriate-for-everyone
#15
Konstantinos Stavropoulos, Konstantinos P Imprialos, Niki Katsiki, Konstantinos Petidis, Apostolos Kamparoudis, Panagiotis Petras, Vasiliki Georgopoulou, Stefanos Finitsis, Christodoulos Papadopoulos, Vasilios G Athyros, Michael Doumas, Asterios Karagiannis
Primary aldosteronism (PA) is a common form of secondary hypertension. Several guidelines recommend that patients with adrenal incidentaloma have a high probability of suffering from PA. We conducted a prospective study of 269 consecutive adults with adrenal incidentaloma to investigate the prevalence and clinical characteristics of PA. In total, 9 participants were detected with PA, suggesting a prevalence of 3.35% among the study population. PA participants had a higher blood pressure level by 14/20.8 mm Hg and a lower serum potassium level by 0...
May 2, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29715313/circulating-pentraxin-3-is-positively-associated-with-chronic-hyperglycemia-but-negatively-associated-with-plasma-aldosterone-concentration
#16
Yuichi Takashi, Minae Koga, Yoko Matsuzawa, Jun Saito, Masao Omura, Tetsuo Nishikawa
Pentraxin 3 (PTX3) is reported to be a vascular inflammation marker providing prognostic information of vasculopathy. Until today, however, the effect of aldosterone or oxidative stress on the regulation of PTX3 is unknown. In present study, we investigated to find regulative factors, especially aldosterone and oxidative stress, on PTX3. Serum PTX3 levels were measured in 75 patients (45 male and 30 women, aged 55.1±13.4 year-old (mean±SD)) with various endocrine disorders including 47 with diabetes, 24 with primary aldosteronism (PA)...
2018: PloS One
https://www.readbyqxmd.com/read/29709936/clinical-investigation-of-adrenal-incidentalomas-in-japanese-patients-of-the-fukuoka-region-with-updated-diagnostic-criteria-for-sub-clinical-cushing-s-syndrome
#17
Ichiro Abe, Kaoru Sugimoto, Tetsumasa Miyajima, Tomoko Ide, Midori Minezaki, Kaori Takeshita, Saori Takahara, Midori Nakagawa, Yuki Fujimura, Tadachika Kudo, Shigero Miyajima, Hiroshi Taira, Kenji Ohe, Tatsu Ishii, Toshihiko Yanase, Kunihisa Kobayashi
Objectives We retrospectively investigated the clinical and endocrinological characteristics of adrenal incidentalomas. Methods We studied 61 patients who had been diagnosed with adrenal incidentalomas and had undergone detailed clinical and endocrinological evaluations while hospitalized. We used common criteria to diagnose the functional tumors, but for sub-clinical Cushing's syndrome, we used an updated set of diagnosis criteria: serum cortisol ≥1.8 μg/dL after a positive response to a 1-mg dexamethasone suppression test if the patient has a low morning ACTH level (<10 pg/mL) and a loss of the diurnal serum cortisol rhythm...
April 27, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29709927/effect-of-eplerenone-on-the-glomerular-filtration-rate-gfr-in-primary-aldosteronism-sequential-changes-in-the-gfr-during-preoperative-eplerenone-treatment-to-subsequent-adrenalectomy
#18
Yujiro Nakano, Takanobu Yoshimoto, Tatsuya Fukuda, Masanori Murakami, Ryotaro Bouchi, Isao Minami, Koshi Hashimoto, Yasuhisa Fujii, Kazunori Kihara, Yoshihiro Ogawa
Objective Eplerenone (EPL) is a mineralo-corticoid receptor antagonist that is highly selective and has few side effects. This study was conducted to examine whether or not EPL treatment was able to reverse glomerular hyperfiltration, as an indicator of aldosterone renal action, in primary aldosteronism (PA) patients. Methods Changes in the estimated glomerular filtration rate (ΔGFR) were examined in 102 PA patients with EPL treatment. Furthermore, the sequential ΔGFR in 40 patients initially treated with EPL followed by adrenalectomy was examined in order to evaluate the extent of the remaining glomerular hyperfiltration in the patients treated with EPL...
April 27, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29701173/cyclical-cardiorenal-syndrome-in-late-stage-kidney-disease
#19
Benson Ku, Steven Fishbane
INTRODUCTION: In patients with late-stage chronic kidney disease (LS-CKD, estimated glomerular filtration rate (eGFR) < 30 mL/min) there is a high prevalence of congestive heart failure (CHF). We have observed a cyclical nature in the "cardiorenal syndrome" in LS-CKD, not previously described. The purpose of this article is to describe the syndrome and review its characteristics. MATERIALS AND METHODS: Patients enrolled in the Northwell Health Healthy Transitions in Late Stage Kidney Disease Program (HT) were followed, all with eGFR 0 - 30 mL/min...
April 27, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29701105/a-prospective-study-of-the-impact-of-agtr1-a1166c-on-the-effects-of-candesartan-in-patients-with-heart-failure
#20
Simon de Denus, Marie-Pierre Dubé, René Fouodjio, Thao Huynh, Marie-Hélène LeBlanc, Serge Lepage, Richard Sheppard, Nadia Giannetti, Joël Lavoie, Asmaa Mansour, Sylvie Provost, Valérie Normand, Ian Mongrain, Mathieu Langlois, Eileen O'Meara, Anique Ducharme, Normand Racine, Marie-Claude Guertin, Jacques Turgeon, Michael S Phillips, Jean-Lucien Rouleau, Jean-Claude Tardif, Michel White
AIM: To evaluate the impact of AGTR1 A1166C (rs5186) on the response to candesartan in patients with heart failure. MATERIALS & METHODS: Prospective, multicentre, open-label study. We studied 299 symptomatic patients with heart failure presenting a left ventricular ejection fraction ≤40%. RESULTS: Reductions in the primary end points of natriuretic peptides were not significantly associated with AGTR1 A1166C. Nevertheless, carrying the 1166C allele was associated with a greater compensatory increase in renin activity (p = 0...
April 27, 2018: Pharmacogenomics
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