The Effect of Long-term Steroid Therapy on Cardiac Function in Nephrotic Syndrome

ABSTRACT

PURPOSE: The aim of this study is to assess the cardiac effect of long-term steroid therapy in nephrotic syndrome and the validity of LV functional parameters as an early predictor of subclinical cardiac dysfunction. METHODS: The study group was composed of 21 patients diagnosed as minimal change nephrotic syndrome(NS), being managed with prednisone over 6 months or within 6 weeks after stopping medication. The control group was composed of 23 healthy children without cardiopulmonary dysfunction. The functional parameters of the left ventricle, including systolic and diastolic indices were measured using 2D-doppler echocardiography. RESULTS: There was a significant increase of left ventricular mass index in the study group(P value<0.05). Isovolumetric relaxation time of the left ventricle was prolonged significantly in the study group(P value<0.05). The systolic phase area and the ratio of systolic and diastolic phase area of pulmonary vein flow profile were increased significantly in the study group(P value<0.05). CONCLUSION: In NS patients managed with long-term steroid therapy, left ventricular diastolic functional abnormality may be present even though functional limitation is not yet evident. In the future, the longitudinal study will be needed conderning the cardiac effect of long-term steroid treatment.