Acute changes in indices of cardiac filling and function induced by high-dose intravenous methylprednisolone pulse therapy: a single-center prospective study.

Abstract

The current study investigated acute circulatory dynamics changes induced by high-dose intravenous methylprednisolone pulse therapy (steroid pulse therapy). Eight patients who underwent steroid pulse therapy were included in the study. After steroid pulse therapy, plasma levels of brain and atrial natriuretic peptides were significantly increased compared with those before steroid pulse therapy (both p < 0.001). Echocardiography revealed that left ventricular end-diastolic diameter (LVDd) tended to increase after steroid pulse therapy (p = 0.055). Left atrial volume index (LAVI) also increased after steroid pulse therapy (p < 0.05). Peak early diastolic transmitral flow velocity (E wave) increased significantly (p < 0.05), and early diastolic mitral annular velocity tended to increase (p = 0.09). These findings indicate that steroid pulse therapy may increase cardiac preload, as suggested by the observed increases in LVDd, LAVI, and E wave velocity. Clinicians should remain mindful of this potential effect when administering steroid pulse therapy.