{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:10:54Z","timestamp":1783681854169,"version":"3.55.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Hypertension"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:p>\n            Adrenal venous sampling is considered to be the most reliable diagnostic procedure to lateralize aldosterone excess in primary aldosteronism (PA). However, normative criteria have not been established partially because of a lack of data in non-PA hypertensive patients. The aim of the study was to investigate aldosterone concentration and its gradient in the adrenal vein of non-PA hypertensive patients. We retrospectively studied the results of cosyntropin-stimulated adrenal venous sampling in 40 hypertensive patients who showed positive screening testing but negative results in 2 confirmatory tests\/captopril challenge test and saline infusion test. Plasma aldosterone concentration, aldosterone\/cortisol ratio, its higher\/lower ratio (lateralization index) in the adrenal vein with cosyntropin stimulation were measured. Median plasma aldosterone concentration in the adrenal vein was 25 819 pg\/mL (range, 5154\u201369 920) in the higher side and 12 953 (range, 1866\u201336 190) pg\/mL in the lower side (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001). There was a significant gradient in aldosterone\/cortisol ratio between the higher and the lower sides (27.2 [5.4\u201366.0] versus 17.3 [4.0\u201359.0] pg\/mL per \u03bcg\/dL;\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001) with lateralization index ranging from 1.01 to 3.87. The aldosterone lateralization gradient was between 1 to 2 in 32 patients and 2 to 4 in 8 patients. None of the patients showed lateralization index \u22654. The present study demonstrated that plasma aldosterone concentration in the adrenal veins showed significant variation and lateralization gradient even in non-PA hypertensive patients. Adrenal venous sampling aldosterone lateralization gradients between 2 and 4 should be interpreted with caution in patients with PA because these gradients can be found even in patients with negative confirmatory testing for PA.\n          <\/jats:p>","DOI":"10.1161\/hypertensionaha.115.06607","type":"journal-article","created":{"date-parts":[[2016,3,15]],"date-time":"2016-03-15T03:28:24Z","timestamp":1458012504000},"page":"1014-1019","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Adrenal Venous Sampling in Patients With Positive Screening but Negative Confirmatory Testing for Primary Aldosteronism"],"prefix":"10.1161","volume":"67","author":[{"given":"Hironobu","family":"Umakoshi","sequence":"first","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhide","family":"Naruse","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norio","family":"Wada","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takamasa","family":"Ichijo","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Kamemura","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Matsuda","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Fujii","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Kai","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomikazu","family":"Fukuoka","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichi","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Ogo","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Suzuki","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutaka","family":"Nanba","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Tsuiki","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (H.U., M.N., K.N., M.T.); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan (N.W.); Department of Diabetes and Endocrinology, Saiseikai Yokohama City Toubu Hospital, Yokohama City, Japan (T.I.); Department of Cardiology, Akashi Medical Center, Akashi, Japan (K.K.); Department of Cardiology, Sanda City..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031337"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.07.059"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-2116"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ13-0353"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-5-200909010-00007"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3663"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.114.04812"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-09-0869"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2009.03714.x"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2008.03450.x"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(14)70069-5"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.113.02097"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2830"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1291\/hypres.30.1083"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12761"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1677\/ERC-08-0094"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0104"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2014.20"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ11-0133"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.091827"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0078"},{"key":"e_1_3_3_23_2","first-page":"1157","article-title":"Screening tests and diagnostic examinations of hypertensives for primary aldosteronism.","volume":"54","author":"Omura M","year":"2006","unstructured":"Omura M, Nishikawa T. 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