The effect of high-dose steroid treatment used for the treatment of acute demyelinating diseases on endothelial and cardiac functionsMehmet Vedat Çaldır1, Güner Koyuncu Çelik3, Özgür Çiftçi4, İbrahim Haldun Müderrisoğlu2
1Department of Cardiology, Faculty of Medicine, Başkent University, Konya-Turkey
2Department of Cardiology, Faculty of Medicine, Başkent University, Ankara-Turkey
3Department of Norology, Beyhekim State Hospital; Konya-Turkey
4Department of Cardiology, Koru Private Hospital; Ankara-Turkey
Objective: The cardiovascular effects of short-term high-dose steroid treatment (pulse steroid treatment) have not yet been clarified. We examined the short- and long-term effects of pulse steroid treatment in demyelinating diseases on endothelial and cardiac functions.Keywords: demyelinating diseases, diastolic function, endothelial dysfunction, pulse steroid
Methods: In this prospective study, we included 35 patients (20 females and 15 males; mean age, 32.8±9.3 years) who were not treated with steroids and who were previously diagnosed with multiple sclerosis or neuromyelitis optica. Patients were evaluated before, 1 week after, and 3 months after the steroid treatment. Brachial artery flow-mediated relaxation and cardiac systolic/diastolic function were evaluated using echocardiography to assess physical examination results, carotid intimamedia thickness, and endothelial function.
Results: There was no difference between biochemical values, systolic function, left ventricular dimensions, and carotid intimamedia thicknesses in the three evaluation periods. There were significant increases in the body mass index, body weight, and systolic/diastolic blood pressure measurements at 1 week and 3 months after treatment (p<0.001). There was a significant decrease in brachial artery flow-mediated relaxation at 1 week and 3 months (1 versus 2, p=0.042; 1 versus 3, p=0.003). In Doppler measurements at 1 week and 3 months, there was an increase in mitral A velocity, IVRT, and EDT values and a decrease in the E/A ratio in line with diastolic dysfunction.
Conclusion: Pulse steroid therapy used for demyelinating diseases deteriorated endothelial and left ventricular diastolic functions in the early and late periods. Future studies are needed to evaluate the development of cardiovascular mortality and morbidity in patients receiving this type of treatment. (Anatol J Cardiol 2016; 16: 000-00)
Corresponding Author: Mehmet Vedat Çaldır, Türkiye