Cardiac systolic dysfunction in past illicit users of anabolic androgenic steroids - 06/09/18
, Morten Schou, MD, PhD b, c, Per L. Madsen, MD, DMSc c, Christian Selmer, MD, PhD a, Marie L. Johansen, MD a, b, Peter S. Ulriksen, MD d, Tina Dreyer, BSc a, Thomas Kümler, MD, PhD c, Louis L. Plesner, MD c, Jens Faber, MD, DMSc a, b, Finn Gustafsson, MD, PhD, DMSc b, e, Caroline Kistorp, MD, PhD a, bAbstract |
Background |
Illicit use of anabolic androgenic steroids (AAS) is associated with left ventricle (LV) systolic dysfunction and increased LV mass (LVM), but whether these findings persist in former AAS users has yet to be elucidated. The objective was to assess LV systolic function, LVM and myocardial fibrosis in current and former illicit AAS users compared with non-users.
Methods |
Community-based cross-sectional study among men, aged 18–50 years, involved in recreational resistance training. We included 37 current and 33 former illicit AAS users, geometric mean (95%CI), 30 (21; 44) months since AAS cessation, and 30 non-users as controls. We assessed myocardial function and structure using advanced echocardiography and cardiac MRI with late-gadolinium enhancement.
Results |
Mean (SE) LV global longitudinal strain (GLS) was impaired in former AAS users compared with non-users, −16.7 (0.5) versus −18.2 (0.4) %, P < .05. Mean (SE) LV ejection fraction (EF) was decreased, 51 (1) versus 58 (1) %, P < .001 and LV GLS impaired, −14.5 (0.4)%, P < .001, in current AAS users compared with non-users. Measures of LVM were increased in current AAS users compared with the other two groups, P < .001. Plasma total testosterone was independently associated with reduced LVEF (P = .049) and increased LVM/body surface area (P = .005) in multivariate linear regressions. Focal myocardial fibrosis was not detected in any participants and diffuse myocardial fibrosis, assessed using post-contrast T1-mapping time, did not differ among the three groups.
Conclusions |
Past illicit AAS use is associated with impaired LV GLS, suggesting subclinical cardiac systolic dysfunction years after AAS cessation.
Le texte complet de cet article est disponible en PDF.Abbreviations : 2D, 3D, AAS, BP, BSA, CVD, DXA, ECV, GLS, HOMA2-IR, LBM, LGE, LV, LVEF, MRI, MR-proANP, RV, RVEF, SHBG
Plan
| Declarations of interest: JJR and CK received unrestricted research grants from AntiDoping Denmark. MS, PLM, CS, MLJ, PSU, TK, TD, LLP, JF and FG have no conflicts of interest in relation to the present topic. |
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| Funding: This work was supported by AntiDoping Denmark (grant number: N/A), Research Foundation of Herlev Hospital (grant number: N/A), Danish Heart Foundation (grant number: 15-R99-A5797–22952), Faculty Scholarship from University of Copenhagen to JJR (grant number: N/A). |
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| Role of the funding source: The financial sources had no role in study design, conduction of study, statistical analyses, writing of manuscript or decision to publish the final version of manuscript. |
Vol 203
P. 49-56 - septembre 2018 Retour au numéro
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