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Purpose: To compare left adrenal venous sampling (AVS) in two locations: the central adrenal vein and the common trunk.
Materials and Methods: A total of 22 patients (12 men and 10 women; mean age, 50 y; range, 26–65 y) who were suspected of
having primary aldosteronism (PA) and underwent successful AVS with cortisol concentration measurement and/or venography
between November 2010 and August 2011 were retrospectively analyzed. In regard to the left adrenal vein, collections were done at
two locations: at the common trunk below the confluence of the inferior phrenic vein and at the central adrenal vein, which was above
the confluence. The effects of the inflow from the inferior phrenic vein on plasma aldosterone and cortisol levels were analyzed.
Results: Eight patients had bilateral hypersecreting lesions and 13 had a unilateral lesion. One was diagnosed as having secondary
hypertension other than PA. The median cortisol levels below and above the confluence were 129 mg/dL (range, 21–400 mg/dL) and
215 mg/dL (range, 21–690 mg/dL), respectively. The median aldosterone levels were 2,120 pg/mL (range, 164–42,700 pg/mL) and
4,275 pg/mL (range, 119–59,000 pg/mL), respectively. The median aldosterone/cortisol (A/C) ratios were 244 (range, 34–2,401)
and 278 (range, 25–2,251), respectively. Cortisol and aldosterone levels were significantly higher above the confluence (P 1⁄4 .0050
and P 1⁄4 .0003, respectively), whereas the A/C ratio showed no significant difference (P 1⁄4 .12).
Conclusions: Although higher levels of cortisol and aldosterone were obtained upstream, A/C ratio was not significantly different
between the central adrenal vein and the common trunk.