Abstract 3048: Chronic Anabolic Androgenic Steroid Use is Associated With Left Ventricular Systolic and Diastolic Dysfunction
Background: It is estimated that more than 1 million US males have used anabolic androgenic steroids (AAS). Anecdotal reports of cardiac death among young AAS users suggest an association between AAS use and cardiovascular disease. In addition, previous studies have documented left ventricular (LV) diastolic abnormalities in AAS users but many of these users had relatively short-term AAS exposure. To date, the cardiac effects of long-term chronic AAS use have not been well characterized.
Methods: Cardiac parameters in long-term AAS using weightlifters (n=12) were compared to those in weightlifting AAS non-user controls (n=7). LV structure and function were characterized using 2-dimensional, tissue-Doppler, and speckle-tracking strain echocardiography.
Results: AAS users and non-users had similar age (39.3±4.5 vs. 40.7±4.8 years, p=NS), years of regular weightlifting (17.3±7.0 vs. 17.4±6.4 years, p=NS) and body mass index (30.4±2.8 vs. 28.9±3.2 kg/m2, p=NS). The AAS users reported using a mean weekly dose of 750±280 mg of testosterone equivalent for a mean of 420±240 lifetime weeks. There were no differences in LV structure as measured by LV end-diastolic internal diameter (AAS users=50±3 mm vs. AAS non-users=48±4 mm, p=NS), posterior wall thickness ( AAS users=11±1 mm vs. AAS non-users=10±1 mm, p=NS) and LV mass (AAS users=236±48 g vs. AAS non-users=237±33 g, p=NS). However, there were important differences in LV function. Systolic function, as measured by LV ejection fraction, longitudinal strain, and radial strain, was significantly lower in AAS users (Table⇓). Further, 10/12 AAS users had an LV ejection fraction below the accepted limit of normal (55%). In addition, AAS users had significantly reduced diastolic function (Table⇓).
Conclusions: Chronic long-term AAS use appears to be associated with significant sub-clinical LV systolic and diastolic dysfunction. Further investigation is warranted to determine the clinical implications of these findings.