Aaron L. Baggish, Rory B. Weiner, Gen Kanayama, James I. Hudson, Michael H. Picard, Adolph M. Hutter, Jr., and Harrison G. Pope, Jr.
Circ Heart Fail. Author manuscript; available in PMC 2011 January 1.
Published in final edited form as:
Circ Heart Fail. 2010 July 1; 3(4): 472–476.
Published online 2010 April 27. doi: 10.1161/CIRCHEARTFAILURE.109.931063
Background
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.
Methods & Results
We performed 2-dimensional, 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 non-users (n=7). AAS users (median [Q1,Q3] cumulative lifetime AAS exposure 468 [169–520] weeks) closely resembled non-users 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 Wilcoxon rank sum test, two-tailed); longitudinal strain (16.9% [14.0, 19.0] versus 21.0% [20.2, 22.9]; p = 0.004), and radial strain (38.3 [28.5, 43.7] versus 50.1 [44.3, 61.8]; p = 0.02). Ten of the 12 AAS users showed LV ejection fractions below the accepted limit of normal (≥55%). AAS users also demonstrated decreased diastolic function compared to non-users, as evidenced by a markedly lower E′ velocity (7.4 [6.8, 7.9] versus 9.9 [8.3, 10.5]; p = 0.005) and E/A ratio (0.93 [0.88, 1.39] versus 1.80 [1.48, 2.00]; p = 0.003).
Conclusions
Cardiac dysfunction in long-term AAS users appears more severe than previously reported, and may be sufficient to increase the risk of heart failure.
