Table 3.
Details of patients with partial or absent biochemical or clinical responses
| No. | PASO Outcomes | Imaging Findings | Pathology Findings | Notes | |
|---|---|---|---|---|---|
| Bioch. | Clin. | ||||
| 1 | Complete | Partial | Negative | Hyperplasia | 70 yo male seen in follow-up at 136.7 months. Residual hypertension felt to be due to obesity, OSA, and CKD, and was on a beta blocker for heart failure and ventricular tachycardia. |
| 2 | Complete | Partial | Left-sided 0.8-cm nodule | Multiple left-sided adenomas with surrounding hyperplasia | 55 yo male seen in follow-up at 86.2 months. Residual hypertension felt to be due to obesity. |
| 3 | Absent | Partial | Bilateral bulkiness | Right-sided 0.5-cm adenoma | 59 yo male with clinical follow-up at 49.3 mo and biochemical follow-up at 46.5 mo. Residual hypertension felt to be due to obesity and bilateral aldosterone-producing adenomas. There was a reduction of the ARR from 3490 pmol/L per ng/mL/hr preoperatively to 2910 pmol/L per ng/mL/hr (ie, PAC 291 pmol/L and PRA 0.1 ng/mL/hr) after surgery. AVS SI was >3 bilaterally postcosyntropin and LI was 38.3. |
| 4 | Complete | Partial | Negative | Hyperplasia | 52 yo male seen in follow-up at 6.5 mo. Residual hypertension felt to be due to obesity and OSA. |
| 5 | Complete | Absent | Negative | Hyperplasia | 47 yo male seen in follow-up at 21.2 mo. Residual hypertension felt to be due to obesity and an anxiety disorder, and was on a calcium channel blocker for atrial fibrillation. AVS SI was >2 bilaterally at baseline and >3 bilaterally postcosyntropin and LI was 17.3. |
| 6 | Partial | Partial | Right-sided 0.9-cm nodule | Right-sided 1.2-cm adenoma | 65 yo male with a history of obesity and OSA, with clinical follow-up at 2.7 mo and biochemical follow-up at 2.3 mo. There was a reduction of the ARR from 447 pmol/L per mIU/L preoperatively to 71 pmol/L per mIU/L (ie, PAC 135 pmol/L and DRC 1.9 mIU/L) after surgery. Lost to further follow-up. |
| 7 | Complete | Partial | Right-sided 0.9-cm nodule | Right-sided 1.3-cm adenoma with surrounding hyperplasia | 42 yo female with a history of migraine (on metoprolol) and white coat syndrome, seen in follow-up at 1.9 mo. Lost to further follow-up. |
| 8 | Complete | Absent | Left-sided 0.6-cm nodule | Left-sided 1.1-cm adenoma | 77 yo male seen in follow-up at 2.5 mo. At that time, 24-hr ambulatory blood pressure monitor showed an average BP of 149/80 mm Hg off treatment. He declined further postoperative pharmacological treatment. AVS SI was >3 bilaterally postcosyntropin and LI was 8.4. |
| 9 | Complete | Partial | Left-sided 0.9-cm nodule | Left-sided 0.8-cm adenoma with surrounding hyperplasia | 67 yo male seen in follow-up at 60.3 mo. Residual hypertension felt to be due to cyclosporine use after kidney transplant, progressive CKD, and obesity. |
| 10 | Complete | Partial | Negative | Left-sided 1.5-cm adenoma with surrounding hyperplasia | 48 yo male with a history of obesity, OSA, and diuretic use for chronic edema, seen in follow-up at 1.8 mo. Lost to further follow-up. |
| 11 | Complete | Partial | Right-sided 0.7-cm nodule | Right-sided 0.7-cm adenoma | 49 yo male seen in follow-up at 58.3 mo. Residual hypertension felt to be due to CKD and obesity. |
| 12 | Complete | Partial | Left-sided 0.8-cm nodule | Left-sided hyperplasia | 45 yo male seen in follow-up at 12.1 mo. Residual hypertension felt to be due to obesity and an anxiety disorder. |
| 13 | Complete | Partial | Negative | Right-sided 1.3-cm adenoma | 54 yo male seen in follow-up at 23 mo. Residual hypertension felt to be due to obesity. |
| 14 | ND | Partial | Left-sided 0.9-cm nodule | Left-sided 1.0-cm adenoma | 42 yo female seen in follow-up at 43.9 mo. Residual hypertension felt to be due to essential hypertension, and was on a beta blocker for atrial fibrillation. |
| 15 | Complete | Partial | Negative | Right-sided 1.1-cm adenoma | 69 yo male seen in follow-up at 57.2 mo. Residual hypertension felt to be due to CKD, and was on a beta blocker for ischemic heart disease. |
| 16 | Complete | Partial | Negative | Left-sided 1.0-cm adenoma with surrounding hyperplasia | 65 yo male seen in follow-up at 51.6 mo. Residual hypertension felt to be due to obesity. |
| 17 | ND | Partial | Left-sided 0.8-cm nodule | Left-sided 1.8-cm adenoma | 50 yo male seen in follow-up at 94.9 months. Residual hypertension felt to be due to obesity and daily nonsteroidal anti-inflammatory use for osteoarthritis. |
| 18 | Complete | Partial | Right-sided 0.9-cm nodule | Right-sided 1.1-cm adenoma with surrounding hyperplasia | 52 yo male with a history of obesity and white coat hypertension seen in follow-up at 0.3 mo. Lost to further follow-up. |
| 19 | ND | Partial | Right-sided nodule <1.0 cm | Right-sided 1.7-cm adenoma | 62 yo male seen in follow-up at 114.1 mo. Residual hypertension felt to be due to CKD. |
| 20 | Complete | Partial | Left-sided nodule <1.0-cm | Left-sided hyperplasia | 56 yo male seen in follow-up at 72.1 mo. Residual hypertension felt to be due to obesity, OSA, and was on a calcium channel blocker for atrial fibrillation. |
| 21 | Absent | Partial | Left-sided 0.7-cm nodule | Left-sided 0.6-cm adenoma | 60 yo male with clinical follow-up at 13.1 mo and biochemical follow-up at 13.1 mo. Residual hypertension felt to be due to bilateral aldosterone-producing adenomas. There was an increase in the ARR from 104 pmol/L per mIU/L preoperatively to 293 pmol/L per mIU/L (ie, PAC 293 pmol/L and DRC 1.0 mIU/L) after surgery. AVS SI was >3 bilaterally postcosyntropin and LI was 3.8. |
| 22 | Complete | Partial | Negative | Left-sided 0.9-cm adenoma | 40 yo male seen in follow-up at 13.8 mo. Residual hypertension felt to be due to obesity. |
| 23 | Complete | Absent | Left-sided bulkiness | Right-sided 0.8-cm adenoma with surrounding hyperplasia | 59 yo male seen in follow-up at 28.4 mo. Residual hypertension felt to be due to obesity. AVS SI was >3 bilaterally postcosyntropin and LI was 16.8. |
| 24 | Absent | Absent | Negative | Hyperplasia | 42 yo male with clinical follow-up at 0.7 mo and biochemical follow-up at 6.8 mo. Residual hypertension felt to be due to bilateral adrenal hyperplasia or unilateral adrenal hyperplasia with concurrent obesity. There was an increase in the ARR from 757 pmol/L per ng/mL/hr (approximately equivalent to 53 pmol/L per ng/mL/hr) preoperatively to 215 pmol/L per mIU/L (ie, PAC 862 pmol/L and DRC 4.0 mIU/L) after surgery. Lost to further follow-up. AVS SI was >2 bilaterally at baseline and >3 bilaterally postcosyntropin and LI was 20.9. |
| 25 | Absent | Absent | Right-sided 0.9-cm nodule and left-sided bulkiness | Left-sided hyperplasia | 52 yo male seen in clinical follow-up at 1.2 mo and biochemical follow-up at 0.8 mo. Residual hypertension felt to be due to bilateral adrenal hyperplasia. There was a reduction of the ARR from 4589 pmol/L per ng/mL/hr preoperatively to 4194 pmol/L per ng/mL/hr (ie, PAC 1057 pmol/L and PRA 0.25 ng/mL/hr) after surgery. Lost to further follow-up. AVS SI was >3 bilaterally postcosyntropin and LI was 23.2. |
| 26 | Partial | Partial | Left-sided 0.8-cm nodule with surrounding bulkiness | Left-sided 0.9-cm adenoma | 45 yo male seen in clinical follow-up at 0.7 mo and biochemical follow-up at 11.9 mo. Residual hypertension felt to be due to obesity. There was a reduction of the ARR from 10680 pmol/L per ng/mL/hr preoperatively to 690 pmol/L per ng/mL/hr (ie, PAC 283 pmol/L and PRA 0.41 ng/mL/hr) after surgery. Lost to further follow-up. |
| 27 | Complete | Partial | Negative | Left-sided 0.9-cm adenoma | 50 yo male seen in follow-up at 6.3 mo. Unknown cause of residual hypertension. |
| 28 | Absent | Partial | Left-sided bulkiness | Right-sided 0.5-cm adenoma with surrounding hyperplasia | 54 yo male seen in clinical follow-up at 22.2 mo and biochemical follow-up at 9.0 mo. Residual hypertension felt to be due to obesity, OSA, and CKD, and was on a diuretic for chronic edema. There was a reduction of the ARR from 422 pmol/L per mIU/L preoperatively to 134 pmol/L per mIU/L (ie, PAC 470 pmol/L and DRC 3.5 mIU/L) after surgery. AVS SI was >2 bilaterally at baseline and >3 bilaterally postcosyntropin, and LI was 3.3. |
| 29 | Complete | Partial | Left-sided bulkiness | Hyperplasia | 54 yo male with a history of obesity and type 2 diabetes mellitus seen in follow-up at 0.2 mo. Lost to further follow-up. |
Abbreviations: AVS, adrenal vein sampling; Bioch., Biochemical; BP, blood pressure; CKD, chronic kidney disease; Clin., Clinical; DRC, direct renin concentration; hr, hours; LI, lateralization index; mo, months; ND, no data; SI, selectivity index; OSA, obstructive sleep apnea; PAC, plasma aldosterone concentration; PRA, plasma renin activity; yo, year-old.