The Bland–Altmann plot (A) shows the correlation between A/M LI and A/C LI for unstimulated AVS (n = 88). The y-axis reports the ratio between A/M LI and A/C LI, while the x-axis reports the mean value of A/M LI and A/C LI. The plot highlights that patients with asymmetrical cortisol secretion (black dots) show greater dissimilarity between A/M LI or A/C LI than patients with symmetrical cortisol secretion (gray dots). The panel (B) shows C/M LI with and without cosyntropin stimulation in patients who had both procedures and showed asymmetrical cortisol secretion with unstimulated procedure (n = 11); Asterisk indicates an AVS where the dominant side of C/M LI changed after cosyntropin stimulation. The pie charts show the prevalence of asymmetrical cortisol secretion defined as C/M LI ≥4 (C) and the distribution of C/M LI compared to the subtype diagnosis (D). Abbreviations: A/C LI, aldosterone to cortisol lateralization index; A/M LI, aldosterone to metanephrine lateralization index; AVS, adrenal venous sampling; BiPA, bilateral primary aldosteronism; C/M LI: cortisol to metanephrine lateralization index; UPA; unilateral primary aldosteronism.