The impact of anabolic androgenic steroids abuse and type of training on left ventricular remodeling and function in competitive athletes (original) (raw)
Related papers
International Journal of Cardiology, 2013
Background: Uncertainty remains about possible cardiac adaptation to resistance training. Androgenic anabolic steroids (AAS) use plays a potential role and may have adverse cardiovascular effects. Objective: To elucidate the effect of resistance training and of AAS-use on cardiac dimensions and function. Participants: Cardiac magnetic resonance (CMR) were performed in 156 male subjects aged 18-40 years: 52 nonathletes (maximum of 3 exercise hours/week), 52 strength-endurance (high dynamic-high static, HD-HS) athletes and 52 strength (low dynamic-high static, LD-HS) trained athletes (athletes ≥6 exercise hours/week). 28 LD-HS athletes denied and 24 admitted to AAS use for an average duration of 5 years (range 3 months-20 years). Results: No significant differences were found between non-athletes and non-AAS-using LD-HS athletes. AASusing LD-HS athletes had significantly larger LV and RV volumes and LV wall mass than non-AAS-using LD-HS athletes, but lower than HD-HS athletes. In comparison to all other groups AAS-using LD-HS athletes showed lower ejection fractions of both ventricles (LV/RV EF 51/48% versus 55-57/51-52%) and lower E/A ratios (LV/RV 1.5/1.2 versus 1.9-2.0/1.4-1.5) as an indirect measure of diastolic function. Linear regression models demonstrated a significant effect of AAS-use on LV EDV, LV EDM, systolic function and mitral valve E/A ratio (all ANOVA-tests p b 0.05). Conclusions: Strength athletes who use AAS show significantly different cardiac dimensions and biventricular systolic dysfunction and impaired ventricular inflow as compared to non-athletes and non-AAS-using strength athletes. Increased ventricular volume and mass did not exceed that of strength-endurance athletes. These findings may help raise awareness of the consequences of AAS use.
Echocardiographic Findings in Power Athletes Abusing Anabolic Androgenic Steroids
Asian Journal of Sports Medicine, 2013
Purpose Anabolic androgenic steroids (AAS) abuse for improving physical appearance and performance in body builders is common and has been considered responsible for serious cardiovascular effects. Due to disagreement about cardiovascular side effects of these drugs in published articles, this case control study was designed to evaluate the echocardiographic findings in body builder athletes who are current and chronic abusers of these drugs. Methods Body builder athletes with continuous practice for the preceding two years and were training at least twice weekly were selected and divided into AAS abuser and non user and compared with age and BMI matched non athletic healthy volunteers (15 cases in each group). Results There was no significant difference in left ventricular size or function either systolic or diastolic in comparison to cases and control groups. The only difference was in diastolic size of septum and free wall but observed differences were only significant (P = 0.05)...
Androgenic anabolic steroids also impair right ventricular function
International Journal of Cardiology, 2009
Chronic anabolic steroid use suppresses left ventricular functions. However, there is no information regarding the chronic effects of anabolic steroids on right ventricular function which also plays a key role in global cardiac function. The main objective of the present study was to investigate the effects of androgenic anabolic steroids usage among athletes on remodeling the right part of the heart. Androgenic-anabolic steroids-using bodybuilders had smaller diastolic velocities of both ventricles than drug-free bodybuilders and sedentary counterparts. This study shows that androgenic anabolic steroids-using bodybuilders exhibited depressed diastolic functions of both ventricles.
Long-term anabolic-androgenic steroid use is associated with left ventricular dysfunction
Circulation. Heart failure, 2010
Although illicit anabolic-androgenic steroid (AAS) use is widespread, the cardiac effects of long-term AAS use remain inadequately characterized. We compared cardiac parameters in weightlifters reporting long-term AAS use to those in otherwise similar weightlifters without prior AAS exposure. We performed 2D tissue-Doppler and speckle-tracking echocardiography to assess left ventricular (LV) ejection fraction, LV systolic strain, and conventional indices of diastolic function in long-term AAS users (n=12) and otherwise similar AAS nonusers (n=7). AAS users (median [quartile 1, quartile 3] cumulative lifetime AAS exposure, 468 [169, 520] weeks) closely resembled nonusers in age, prior duration of weightlifting, and current intensity of weight training. LV structural parameters were similar between the two groups; however, AAS users had significantly lower LV ejection fraction (50.6% [48.4, 53.6] versus 59.1% [58.0%, 61.7%]; P=0.003 by two-tailed Wilcoxon rank sum test), longitudinal ...
2015
Background: The most common drug abuse among athletes is anabolic steroids which lead to the development of cardiovascular diseases and sudden death. Thus, the aim of this study was to evaluate cardiovascular outcomes of anabolic consumption in body building athletes. Materials and Methods: Totally, 267 male athletes at the range of 20-45 years old with the regular consumption of anabolic steroids for >2 months with at least once weekly. High-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), and hematocrit (Hct) levels were measured after 10 h of fasting. Data analysis was performed using K2, t-test, ANOVA and correlation coefficient through SPSS 17. Results: There was a nonsignificant difference between groups regarding HDL, TG, and total cholesterol. There was a significant decrease in the total and categorized LDL and Hct levels in consumers of anabolic steroid versus nonusers (P = 0.01 and P = 0.041, respectively). Results showed a significant incre...
British Journal of Sports Medicine, 2007
Background: Anabolic androgenic steroids (AAS) are sometimes used by power athletes to improve performance by increasing muscle mass and strength. Recent bioptical data have shown that in athletes under the pharmacological effects of AAS, a focal increase in myocardial collagen content might occur as a repair mechanism against myocardial damage. Objective: To investigate the potential underlying left ventricular myocardial dysfunction after chronic misuse of AAS in athletes by use of Doppler myocardial imaging (DMI) and strain rate imaging (SRI). Methods: Standard Doppler echocardiography, DMI, SRI and ECG treadmill test were undertaken by 45 bodybuilders, including 20 athletes misusing AAS for at least 5 years (users), by 25 anabolic-free bodybuilders (non-users) and by 25 age-matched healthy sedentary controls, all men. The mean (SD) number of weeks of AAS use per year was 31.3 (6.4) in users, compared with 8.9 (3.8) years in non-users, and the mean weekly dosage of AAS was 525.4 (90.7) mg. Results: The groups were matched for age. Systolic blood pressure was higher in athletes (145 (9) vs 130 (5) mm Hg) than in controls. Left ventricular mass index did not significantly differ between the two groups of athletes. In particular, both users and non-users showed increased wall thickness and relative wall thickness compared with controls, whereas left ventricular ejection fraction, left ventricular end-diastolic diameter and transmitral Doppler indexes were comparable for the three groups. Colour DMI analysis showed significantly lower myocardial early: myocardial atrial diastolic wave ratios in users at the level of the basal interventricular septum (IVS) and left ventricular lateral wall (p,0.01), in comparison with both non-users and controls. In addition, in users, peak systolic left ventricular strain rate and strain were both reduced in the middle IVS (both p,0.001) and in the left ventricular lateral free wall (both p,0.01). By stepwise forward multivariate analyses, the sum of the left ventricular wall thickness (b coefficient = 20.32, p,0.01), the number of weeks of AAS use per year (b = 20.42, p,0.001) and the weekly dosage of AAS (b = 20.48, p,0.001) were the only independent determinants of middle IVS strain rate. In addition, impaired left ventricular strain in users was associated with a reduced performance during physical effort (p,0.001). Conclusions: Several years after chronic misuse of AAS, power athletes show a subclinical impairment of both systolic and diastolic myocardial function, strongly associated with mean dosage and duration of AAS use. The combined use of DMI and SRI may therefore be useful for the early identification of patients with more diffused cardiac involvement, and eventually for investigation of the reversibility of such myocardial effects after discontinuation of the drug.
Ventricular structure, function, and focal fibrosis in anabolic steroid users: a CMR study
European Journal of Applied Physiology, 2014
Results AS users had higher absolute left ventricular (lV) mass (220 ± 45 g) compared to nAS (163 ± 27 g; p < 0.05) but this difference was removed when indexed to fat-free mass. AS had a reduced right ventricular (rV) ejection fraction (AS 51 ± 4 % vs. nAS 59 ± 5 %; p < 0.05) and a significantly lower left ventricular E':A' myocardial tissue velocity ratio [AS 0.99(0.54) vs. nAS 1.78(0.46) p < 0.05] predominantly due to greater tissue velocities with atrial contraction. Peak lV longitudinal strain was lower in AS users (AS −14.2 ± 2.7 % vs. nAS −16.6 ± 1.9 %; p < 0.05). there was no evidence of focal fibrosis in any participant. Conclusions AS use was associated with significant lV hypertrophy, albeit in-line with greater fat-free mass, reduced lV strain, diastolic function, and reduced rV ejection fraction in male bodybuilders. there was, however, no evidence of focal fibrosis in any AS user.
The Indiscriminate Use Of Androgenic Anabolic Steroids: The Contribution of Cardiovascular Imaging
ABC Imagem Cardiovascular, 2024
Anabolic androgenic steroids (AAS) are natural or synthetic compounds similar to the male hormone testosterone. The literature also describes cases of AAS abuse, such as in bodybuilding, cosmetics, recreational use, and aesthetic enhancement. It was discovered that AAS alone directly induce myocardial injury, with the main pathological finding in autopsied hearts being left ventricle (LV) hypertrophy in frequent association with myocyte hypertrophy, increased collagen deposition in the matrix, increased activity of the cardiac angiotensin, and myocardial fibrosis. Patients who used illicit AAS present decreased LV systolic function. In athletes who self-administer AAS, LV hypertrophy and elevated sympathetic modulation were observed, as well as elevated blood pressure (BP). High doses of AAS can cause the user to have ventricular arrhythmias and sudden death. Furthermore, AAS users demonstrated greater coronary artery plaque volume than non-users. The objective of this review is to revisit the main effects of the use of AAS on cardiac changes through cardiovascular imaging as well as to establish a difference in relation to athletic heart syndrome.