Computed Tomography Cardiac Angiography Findings in Patients With Sheehan Syndrome.

Abstract

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.