Long term steroid exposure, as in Cushing's disease, causes myocardial dysfunction, hypertrophy and fibrosis in addition to causing obesity, hypertension and glucose intolerance. The aim of our study was to verify if short-term high-dose exogenous steroid therapy adversely effects the heart.

Patients eligible for high dose steroid therapy due to inflammatory diseases were offered to participate in this study. The minimal total intravenous dose was 375 mg prednisone, and the daily steroids were divided into 2-3 doses. To determine the steroids' effect on myocardial function the echocardiographic studies included estimation of global and segmental longitudinal strain. Each patient had a baseline echocardiographic study performed before high-dose steroid therapy was initiated and again immediately after it. A follow-up echo study was performed after completion of a 3-month low-dose steroid therapy period. The paired 2-tailed t-test was used to compare group means

Inclusion Criteria:

• Age above 18
• Patient with rheumatic disease that need high dose steroids due to exacerbation
• Patient whom echocardiographic study can be performed with a good quality

Exclusion Criteria:

• age below 18

patient with inflammatory disease who needs high dose steroids according to there disease severity and welling to participate in observation study to see the effect od steroids taken on the myocaridal functions duering hospital stay