{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T03:49:33Z","timestamp":1752551373866,"version":"3.40.5"},"reference-count":9,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:00:00Z","timestamp":1712793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In patients with primary hyperaldosteronism (PA), adrenal vein sampling (AVS) can identify patients suitable for unilateral adrenalectomy. However, in AVS with an indeterminate aldosterone\u2010to\u2010cortisol lateralization (ACL) ratio of 3.0\u20134.0, clinical guidance is unclear. The authors screened all patients undergoing AVS at the Cleveland Clinic from October 2010 to January 2021 and identified 18 patients with indeterminate ACL results. Ten underwent adrenalectomy and eight continued medical management. The surgical group was younger (58.5 vs. 68 years, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.17), and more likely to have a unilateral imaging adrenal abnormality (90% vs. 38%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.043) and a lower contralateral suppression index (0.63 vs. 1.1, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.14). Post\u2010treatment, the surgical group had a significant reduction in diastolic blood pressure (\u20135.5\u00a0mmHg, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.043) and aldosterone (4.40 vs. 35.80\u00a0ng\/mL, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.035) and required fewer anti\u2010hypertensive medications (2 vs. 3, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.015). These findings may support the benefit of adrenalectomy in a select group of patients with indeterminate ACL.<\/jats:p>","DOI":"10.1111\/jch.14810","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T06:08:47Z","timestamp":1712902127000},"page":"584-587","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgical versus medical management of patients with primary hyperaldosteronism and indeterminate adrenal vein sampling: A 10\u2010year experience of the Cleveland Clinic"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3183-8266","authenticated-orcid":false,"given":"Chineme","family":"Onwubueke","sequence":"first","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University EC\u201010 Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saif M","family":"Borgan","sequence":"additional","affiliation":[{"name":"South Georgia Medical Center  Valdosta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huijun","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keren","family":"Zhou","sequence":"additional","affiliation":[{"name":"Metabolism and Endocrinology Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.033597"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-14-0537"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4061"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-02089"},{"issue":"3","key":"e_1_2_8_6_1","first-page":"384","article-title":"Consequences of adrenal venous sampling in primary hyperaldosteronism and predictors of unilateral adrenal disease","volume":"211","author":"Mathur A","year":"2010","journal-title":"JACS"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2004.06.051"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-011-2121-5"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.113.02097"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e3282f9e66a"}],"container-title":["The Journal of Clinical Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jch.14810","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T16:00:47Z","timestamp":1715443247000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jch.14810"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,11]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/jch.14810"],"URL":"https:\/\/doi.org\/10.1111\/jch.14810","archive":["Portico"],"relation":{},"ISSN":["1524-6175","1751-7176"],"issn-type":[{"type":"print","value":"1524-6175"},{"type":"electronic","value":"1751-7176"}],"subject":[],"published":{"date-parts":[[2024,4,11]]},"assertion":[{"value":"2023-12-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}