Document Detail

Left ventricular early myocardial dysfunction after chronic misuse of anabolic androgenic steroids: a Doppler myocardial and strain imaging analysis.
MedLine Citation:
PMID:  17178777     Owner:  NLM     Status:  MEDLINE    
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 (beta coefficient = -0.32, p<0.01), the number of weeks of AAS use per year (beta = -0.42, p<0.001) and the weekly dosage of AAS (beta = -0.48, 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.
Antonello D'Andrea; Pio Caso; Gemma Salerno; Raffaella Scarafile; Giuseppe De Corato; Claudia Mita; Giovanni Di Salvo; Sergio Severino; Sergio Cuomo; Biagio Liccardo; Nicolino Esposito; Raffaele Calabrò
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-12-18
Journal Detail:
Title:  British journal of sports medicine     Volume:  41     ISSN:  1473-0480     ISO Abbreviation:  Br J Sports Med     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-05     Completed Date:  2007-11-05     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  0432520     Medline TA:  Br J Sports Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  149-55     Citation Subset:  IM    
Second University of Naples, Naples, Italy.
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MeSH Terms
Anabolic Agents / adverse effects*
Case-Control Studies
Diastole / drug effects
Doping in Sports*
Echocardiography, Doppler
Risk Factors
Time Factors
Ventricular Dysfunction, Left / chemically induced*,  ultrasonography
Reg. No./Substance:
0/Anabolic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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