オオツキ　ミチオ   Michio Otsuki   大月　道夫    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Historical changes and between-facility differences in adrenal venous sampling for primary aldosteronism in Japan
掲載誌名	正式名：Journal of human hypertension 略　 称：J Hum Hypertens ISSNコード：09509240/14765527
掲載区分	国外
巻・号・頁	34(1),pp.34-42
著者・共著者	Fujii, Y. Takeda, Y. Kurihara, I. Itoh, H. Katabami, T. Ichijo, T. Wada, N. Shibayama, Y. Yoshimoto, T. Ogawa, Y. Kawashima, J. Sone, M. Inagaki, N. Takahashi, K. Watanabe, M. Matsuda, Y. Kobayashi, H. Shibata, H. Kamemura, K. Otsuki, M. Yamamto, K. Ogo, A. Yanase, T. Okamura, S. Miyauchi, S. Fujita, M. Suzuki, T. Umakoshi, H. Ogasawara, T. Tsuiki, M. Naruse, M. Jpas Study Group
発行年月	2019
概要	Primary aldosteronism (PA) is a common curable cause of hypertension. Adrenal venous sampling (AVS) is recommended for subtype diagnosis but is a difficultprocedure. Recently, an increased prevalence of PA was reported, creating a greater demand for treatment of the condition in clinical facilities. The aim of the present study was to identify the historical changes over time and the differences between facilities in the success rate and subtype diagnosis of PA. The database of the PA registry developed by the Japan PA Study (JPAS) was used. A total of 2599 patients with PA who underwent AVS were evaluated. The overall success rate of AVS was 88%. The bilateral subtype was the dominant subtype, comprising 69% of cases. During the period 2004-2011 to 2011-2017, there were significant changes in the total number of AVS procedures (from 562 to 1732), ratio of ACTH administration with AVS (75 to 97%), success rate (79 to 90%), and proportion with bilateral subtype diagnosis (53 to 72%). There were also significant inter-facility differences in the number of AVS procedures (6 to 322), success rate (59 to 97%), and proportion with the bilateral subtype (44 to 86%). The principal enrolled department was Endocrinology (86%), and the ratio of unilateral PA was significantly higher in this department than in others (32% vs. 25%). In conclusion, the number of AVS procedures performed, the success rate, and the proportion with the bilateral subtype increased over time after normalizing the centre difference. Significant differences were observed between the centres.
DOI	10.1038/s41371-019-0229-4
文献番号	31462725