{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:03:37Z","timestamp":1781766217019,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,1,6]],"date-time":"2015-01-06T00:00:00Z","timestamp":1420502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Unilateral primary aldosteronism (<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>) should have a contralaterally normal and therefore suppressed adrenal zona glomerulosa. However, there is no validated definition of adrenal suppression. We created two biochemical hypotheses of adrenal suppression based upon measurements taken during adrenal vein sampling (<jats:styled-content style=\"fixed-case\">AVS<\/jats:styled-content>) to determine whether either proved useful for interpretation of <jats:styled-content style=\"fixed-case\">AVS<\/jats:styled-content> or prediction of hypertension outcome in operated cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective database analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Ninety\u2010nine cases of <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> from a tertiary hypertension unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Hypothesis 1 was the proportional suppression of the uninvolved\/lowest adrenal<jats:sub>aldo\/cortisol<\/jats:sub> to <jats:styled-content style=\"fixed-case\">IVC<\/jats:styled-content><jats:sub>aldo\/cortisol<\/jats:sub> ratio pre\u2010 and post cosyntropin. Hypothesis 2 was the absolute decrease in the uninvolved adrenal<jats:sub>aldo\/cortisol<\/jats:sub> ratio after cortrosyn injection. <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> analysis performed using lateralization and hypertension resolution as the outcomes of interest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hypothesis 1 proved highly predictive of lateralization with a <jats:styled-content style=\"fixed-case\">ROC AUC<\/jats:styled-content> of 0\u00b7958, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b70001, giving adrenal<jats:sub>aldo\/cortisol<\/jats:sub>:<jats:styled-content style=\"fixed-case\">IVC<\/jats:styled-content><jats:sub>aldo\/cortisol<\/jats:sub> &lt;1\u00b74 as the optimized criterion (sensitivity 90%, specificity 94%). For blood pressure outcomes in the surgical subgroup (<jats:italic>n<\/jats:italic>\u00a0=\u00a052), hypertension resolution was most commonly seen among subjects with adrenal suppression by both definitions although there was significant overlap with subjects requiring ongoing medication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Post cosyntropin suppression of the uninvolved adrenal\u2010to\u2010<jats:styled-content style=\"fixed-case\">IVC<\/jats:styled-content> ratio is a highly useful definition of adrenal suppression that accurately predicts unilateral <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>. This may be particularly useful in a case where <jats:styled-content style=\"fixed-case\">AVS<\/jats:styled-content> fails to catheterize one of the adrenal veins but suppression is seen on the other side. Adrenal suppression may also predict blood pressure outcome, however, a much larger <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> database is likely necessary to determine the relative contribution of this predictor.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12669","type":"journal-article","created":{"date-parts":[[2014,11,14]],"date-time":"2014-11-14T19:32:38Z","timestamp":1415993558000},"page":"20-27","source":"Crossref","is-referenced-by-count":42,"title":["Defining contralateral adrenal suppression in primary aldosteronism: implications for diagnosis and outcome"],"prefix":"10.1111","volume":"83","author":[{"given":"G.A.","family":"Kline","sequence":"first","affiliation":[{"name":"Division of Endocrinology Department of Medicine University of Calgary Calgary AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Chin","sequence":"additional","affiliation":[{"name":"Section of Clinical Biochemistry Calgary Laboratory Services Department of Pathology and Laboratory Medicine University of Calgary Calgary AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"So","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Calgary Calgary AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Calgary Calgary AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.L.","family":"Pasieka","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Calgary Calgary AB 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