Hemodynamic effects of steroids in cardiac disease

• Published in: The American heart journal Vol. 92; no. 2; pp. 133 - 138
• Main Authors: Gould, Lawrence, Reddy, C.V. Ramana, Swamy, C.R. Narayana, Chua, Windell, Dorismond, Jean-Claude
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.08.1976
• Subjects: Adult; Aged; Blood Pressure - drug effects; Cardiac Catheterization; Cardiac Output - drug effects; Clinical Trials as Topic; Female; Hemodynamics - drug effects; Humans; Male; Methylprednisolone - therapeutic use; Middle Aged; Myocardial Infarction - drug therapy; Myocardial Infarction - metabolism; Oxygen Consumption
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(76)80246-3

The hemodynamic effects of intravenous methylprednisolone were documented by right heart catheterization in seven patients with an acute uncomplicated transmural myocardial infarction 1 to 9 days after the onset of symptoms. Intracardiac pressures, brachial artery pressure, and cardiac output were determined before and 1 hour after the termination of the methylprednisolone infusion. Two grams of methylprednisolone were infused over a 20 minute period. The brachial pressure rose from a mean of 82 to 90 mm. Hg (N.S.). The brachial artery mean pressure fell in the one patient with a 1-day-old infarction, and it rose in the six patients with an older infarction, from 83 to 94 mm. Hg (p<0.01). As the brachial artery pressure rose in one patient, chest pain and marked ST-segment elevation occurred which were relieved by nitroglycerin. This experience promoted us to terminate the steroid study. There was a nonsignificant increase in the cardiac index and wedge pressure. The raise in the brachial artery pressure with an infarction older than 1 day was an unexpected finding, since steroids are presumed to be vasodilating agents.