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Computed Tomography Cardiac Angiography Findings in Patients With Sheehan Syndrome
Aqib Mohammad1, Majid Jehangir1, Shahnaz Ahmad Mir2
1Department of Radiology, Superspeciality Hospital Government Medical College Srinagar, Srinagar, Jammu and Kashmir, India.
Insights
Sheehan Syndrome (SS) patients show a high prevalence of coronary artery plaques, indicating increased cardiovascular disease risk. This study used computed tomography cardiac angiography to assess atherosclerotic cardiovascular disease in women with SS.
Area of Science:
- Endocrinology
- Cardiology
- Radiology
Background:
- Sheehan Syndrome (SS), or postpartum pituitary necrosis, is linked to higher risks of atherosclerotic cardiovascular diseases due to factors like dyslipidemia and hormonal deficiencies.
- Understanding the specific cardiovascular risks in SS patients is crucial for effective management and prevention strategies.
Purpose of the Study:
- To evaluate the prevalence and characteristics of coronary artery atherosclerotic disease in women with Sheehan Syndrome.
- To utilize computed tomography cardiac angiography for noninvasive assessment of coronary arteries in this patient group.
Main Methods:
- An observational, cross-sectional study was conducted on 30 women diagnosed with Sheehan Syndrome.
- Participants were undergoing standard hormone replacement therapy.
- Computed tomography cardiac angiography was performed to detect and analyze coronary artery plaques.
Main Results:
- Coronary artery plaques were identified in 23.3% of the 30 Sheehan Syndrome patients studied.
- Coronary artery calcium (CAC) scoring indicated varying levels of coronary artery disease risk among participants.
- A significant positive correlation (r = 0.96, P = .01) was found between CAC scores and the percentage of arterial stenosis.
Conclusions:
- Atherosclerotic plaques are present in a notable proportion of patients with Sheehan Syndrome, underscoring their heightened susceptibility.
- These findings highlight the increased risk of cardiovascular morbidity and mortality in individuals with SS.
- Noninvasive imaging like CT angiography is valuable for assessing cardiovascular risk in Sheehan Syndrome patients.
Objective:
Sheehan Syndrome (SS), or postpartum pituitary necrosis, is associated with an elevated risk of atherosclerotic cardiovascular (CV) diseases, driven by factors such as dyslipidemia, chronic inflammation, and growth hormone deficiency. To better understand the prevalence and characteristics of atherosclerotic CV disease in this population, we conducted a noninvasive evaluation of the coronary arteries using computed tomography cardiac angiography.
Methods:
This observational cross-sectional study included women diagnosed with SS who were receiving standard replacement therapy including thyroxine and glucocorticoids. All participants underwent computed tomography cardiac angiography to identify the presence of coronary artery plaques.
Results:
The study included 30 patients with SS, with a mean age of 54.20 ± 8.27 years and a mean duration of pituitary disease of 22.67 ± 6.27 years. Coronary artery calcium (CAC) scoring revealed the following risk stratification for coronary artery disease: minimal risk (CAC 1-10) in 6.7% (n = 2), mild risk (CAC 11-100) in 16.7% (n = 5), and moderate risk (CAC 101-400) in 3.3% (n = 1). Coronary artery plaques were identified in 23.3% (n = 7) of patients. Among these, 4 patients had noncalcified plaques, 2 had calcified plaques, and 1 patient had both calcified and noncalcified plaques. A strong positive correlation was observed between CAC scores and percentage stenosis (r = 0.96, P = .01).
Conclusion:
Approximately one-fourth of patients with SS were found to have atherosclerotic plaques in their coronary arteries, highlighting their increased susceptibility to CV morbidity and mortality.
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