{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:15:37Z","timestamp":1791249337651,"version":"4.1.0"},"reference-count":27,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T00:00:00Z","timestamp":1629417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["413657723"],"award-info":[{"award-number":["413657723"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Adrenal: Central Relay in Health and Disease","award":["314061271"],"award-info":[{"award-number":["314061271"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Adrenal vein sampling (AVS) represents the current diagnostic gold standard for differentiation between unilateral and bilateral primary aldosteronism (PA). Postural stimulation testing (PST) has been used to provide additional diagnostic information.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This work aimed to evaluate the diagnostic utility of PST in the differential diagnosis of PA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This cohort study was conducted at a single tertiary reference center. We analyzed 106 PST performed between 2008 and 2020. Diagnosis of PA and cause of PA were determined according to the Endocrine Society Clinical Practice Guideline, taking into account results of saline infusion testing, AVS, preoperative imaging, and outcome after medical or surgical treatment. The suggested cutoffs for the diagnosis of unilateral PA were revisited and optimized for high specificity using receiver operating characteristics (ROC) analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 106 patients had confirmed PA (unilateral PA: n\u2005=\u200555, bilateral PA: n\u2005=\u200529, AVS unsuccessful\/declined by patients: n\u2005=\u200522). Based on decreased aldosterone plasma concentration of 28% or more after 4 hours in the upright position, the PST showed a sensitivity of 36.4% at a specificity of 100% to identify unilateral disease (area under the curve [AUC]\u2005=\u20050.72; 95% CI, 0.62-0.83; P\u2005=\u2005.001). In patients with valid testing (drop of cortisol of 10% or more after 4 hours, n\u2005=\u200553) the sensitivity of PST rose to 51.4% at a specificity of 100% (AUC\u2005=\u20050.77; 95% CI, 0.65-0.90; P\u2005=\u2005.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The high specificity of 100% for the detection of unilateral PA in patients with decreased aldosterone by at least 28% after 4 hours makes PST a simple, noninvasive contribution to subtype differentiation in PA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgab611","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T16:42:15Z","timestamp":1629477735000},"page":"e865-e873","source":"Crossref","is-referenced-by-count":18,"title":["Reassessment of Postural Stimulation Testing as a Simple Tool to Identify a Subgroup of Patients With Unilateral Primary Aldosteronism"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1466-5287","authenticated-orcid":false,"given":"Carmina","family":"Teresa Fuss","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Brohm","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6170-6398","authenticated-orcid":false,"given":"Martin","family":"Fassnacht","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of W\u00fcrzburg, W\u00fcrzburg, Germany"},{"name":"Central Laboratory, Core Unit Clinical Mass Spectrometry, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7628-3161","authenticated-orcid":false,"given":"Matthias","family":"Kroiss","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of W\u00fcrzburg, W\u00fcrzburg, Germany"},{"name":"Central Laboratory, Core Unit Clinical Mass Spectrometry, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"},{"name":"LMU Klinikum, Department of Internal Medicine IV, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Hahner","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2021,8,20]]},"reference":[{"issue":"3","key":"2022011805244264400_CIT0001","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1161\/HYPERTENSIONAHA.119.12935","article-title":"Primary aldosteronism","volume":"74","author":"Funder","year":"2019","journal-title":"Hypertension."},{"issue":"5","key":"2022011805244264400_CIT0002","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1210\/jc.2015-4061","article-title":"The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society clinical practice guideline","volume":"101","author":"Funder","year":"2016","journal-title":"J Clin Endocrinol Metab."},{"issue":"2","key":"2022011805244264400_CIT0003","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1161\/HYPERTENSIONAHA.117.09975","article-title":"Targeting CXCR4 (CXC chemokine receptor type 4) for molecular imaging of aldosterone-producing adenoma","volume":"71","author":"Heinze","year":"2018","journal-title":"Hypertension"},{"issue":"3","key":"2022011805244264400_CIT0004","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1210\/jc.2015-3431","article-title":"A novel CYP11B2-specific imaging agent for detection of unilateral subtypes of primary aldosteronism","volume":"101","author":"Abe","year":"2016","journal-title":"J Clin Endocrinol Metab."},{"issue":"5","key":"2022011805244264400_CIT0005","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1111\/cen.13942","article-title":"11C-metomidate PET\/CT is a useful adjunct for lateralization of primary aldosteronism in routine clinical practice","volume":"90","author":"O\u2019Shea","year":"2019","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"11","key":"2022011805244264400_CIT0006","doi-asserted-by":"crossref","first-page":"2656","DOI":"10.1007\/s00259-020-04722-0","article-title":"Imaging CXCR4 expression in patients with suspected primary hyperaldosteronism","volume":"47","author":"Ding","year":"2020","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"9","key":"2022011805244264400_CIT0007","doi-asserted-by":"crossref","first-page":"e2016209","DOI":"10.1001\/jamanetworkopen.2020.16209","article-title":"Use of steroid profiling combined with machine learning for identification and subtype classification in primary aldosteronism","volume":"3","author":"Eisenhofer","year":"2020","journal-title":"JAMA Netw Open."},{"issue":"4","key":"2022011805244264400_CIT0008","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1210\/clinem\/dgaa952","article-title":"Approach to the patient with primary aldosteronism: utility and limitations of adrenal vein sampling","volume":"106","author":"Turcu","year":"2021","journal-title":"J Clin Endocrinol Metab."},{"issue":"6","key":"2022011805244264400_CIT0009","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1055\/a-1141-3526","article-title":"Developments in primary aldosteronism subtyping using steroid profiling","volume":"52","author":"Wannachalee","year":"2020","journal-title":"Horm Metab Res."},{"issue":"4","key":"2022011805244264400_CIT0010","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1530\/EJE-18-0328","article-title":"Radiation exposure of adrenal vein sampling\u2014a German multicenter study","volume":"179","author":"Fuss","year":"2018","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2022011805244264400_CIT0011","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1161\/HYPERTENSIONAHA.119.13463","article-title":"Clinical outcomes of 1625 patients with primary aldosteronism subtyped with adrenal vein 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