title: The effect of high-dose steroid treatment used for the treatment of acute demyelinating diseases on endothelial and cardiac functions.
abstract: 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.
  
  
  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 intima-media thickness, and endothelial function.
  
  
  RESULTS
  There was no difference between biochemical values, systolic function, left ventricular dimensions, and carotid intima-media 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Başkent University, Konya-Turkey. vcaldir@hotmail.com.
authors.forename: Mehmet Vedat
authors.initials: MV
authors.lastname: Çaldır
authors.affiliation: Department of Norology, Beyhekim State Hospital; Konya-Turkey.
authors.forename: Güner Koyuncu
authors.initials: GK
authors.lastname: Çelik
authors.affiliation: Department of Cardiology, Koru Private Hospital; Ankara-Turkey.
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Çiftçi
authors.affiliation: Department of Cardiology, Faculty of Medicine, Başkent University, Ankara-Turkey.
authors.forename: İbrahim Haldun
authors.initials: İH
authors.lastname: Müderrisoğlu
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy*; D009471:Neuromyelitis Optica / Q000188:drug therapy*; D011446:Prospective Studies; D011673:Pulsatile Flow; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D013256:Steroids