title: CARDIAC STRUCTURAL AND FUNCTIONAL ABNORMALITIES IN FEMALES WITH UNTREATED HYPOPITUITARISM DUE TO SHEEHAN SYNDROME: RESPONSE TO HORMONE REPLACEMENT THERAPY.
abstract: OBJECTIVE
  Data on cardiac abnormalities in females with untreated hypopituitarism are limited. We investigated echocardiographic abnormalities in females with untreated hypopituitarism and their response to treatment.
  
  
  METHODS
  Twenty-three females with treatment-naïve hypopituitarism and 30 matched healthy controls were evaluated for cardiac structure and function. Echocardiographic evaluation was done at presentation and after achieving a euthyroid and eucortisol state.
  
  
  RESULTS
  Fourteen (61%) patients had mitral regurgitation, and 11 (48%) had pericardial effusion as against none among controls. Indices of left ventricular (LV) size like LV end diastolic dimension (LVEDD; 44.5 ± 3.5 mm in cases vs. 47.6 ± 3.8 mm in controls, P = .004), and LV diastolic volume (LVEDV; 91.8 ± 18.0 mL versus 106.5 ± 20.4 mL, P = .009) were significantly lower in the SS group compared with controls. LV mass (LVM) was 70.8 ± 19.2 g in cases and 108.0 ± 33.2 g in controls (P = .02). Similarly, indices of LV systolic function like stroke volume (SV; 59.1 ± 12.0 mL in cases and 74.4 ± 15.8 mL in controls; P = .000), ejection fraction (EF; 64.3 ± 6.2 % in cases against 69.9 ± 9.2 % in controls; P = .03), and fractional shortening (FS; 34.9 ± 4.7% versus 40.1 ± 4.4%, P = .000) were significantly decreased in patients compared with controls. Cardiac abnormalities normalized with restoration of a euthyroid and eucortisol state.
  
  
  CONCLUSIONS
  Pericardial effusion, mitral regurgitation, and diminished LVM are common in females with untreated hypopituitarism.
  
  
  BACKGROUND
  ACTH = adrenocorticotrophic hormone BMI = body mass index DT = deceleration time EDV = end-diastolic volume EF = ejection fraction FS = fractional shortening GH = growth hormone IGF-1 = insulin growth factor-1 ITT = insulin tolerance test IVSd = interventricular septal diameter LH = luteinizing hormone LV = left ventricular LVEDD = LV end diastolic dimension LVEDV = LV end diastolic volume LVM = LV mass MRI = magnetic resonance imaging MVP = mitral value prolapse PPH = postpartum hemorrhage PWd = posterior wall diameter SS = Sheehan syndrome SV = stroke volume T3 = triiodothyronine T4 = thyroxine TSH = thyroid-stimulating hormone.
authors.forename: Bashir Ahmad
authors.initials: BA
authors.lastname: Laway
authors.forename: Mahroosa
authors.initials: M
authors.lastname: Ramzan
authors.forename: Mohd Sultan
authors.initials: MS
authors.lastname: Allai
authors.forename: Arshad Iqbal
authors.initials: AI
authors.lastname: Wani
authors.forename: Raiz Ahmad
authors.initials: RA
authors.lastname: Misgar
mesh_terms: D000328:Adult; D009202:Cardiomyopathies / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology*; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000453:epidemiology; D009206:Myocardium / Q000473:pathology*; D010490:Pericardial Effusion / Q000453:epidemiology; D013318:Stroke Volume; D016277:Ventricular Function, Left