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February 6, 2026European Heart Journal

Cardiac structure and function in anabolic-androgenic steroid users: a 16-year follow-up study

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Key result

Long-term anabolic steroid use is linked to lower LVEF, with partial recovery after discontinuation.

  • P<0.01
  • n=45

Why the study?

Does discontinuation of anabolic-androgenic steroids improve myocardial structure and function in long-term users compared to continued use?

Population

45 males, comprising 32 anabolic-androgenic steroid users and 13 strength-trained non-users.

Comparison

Anabolic-androgenic steroid use. vs Strength-trained male non-users (controls).

Design

Cohort

Follow-up

median 16 years for AAS users, 13 years for controls

Authors

TFTea Sætereng FyksenOslo University HospitalJGJørgen GravningHeart Failure & TransplantARA B RosseboOslo University Hospital

Discussion

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Implication

Discontinuation of long-term anabolic-androgenic steroid use is associated with partial recovery of left ventricular systolic dysfunction over a decade.

Key Points

  • The aim is to evaluate myocardial changes in anabolic-androgenic steroid users over a long-term follow-up compared to non-users.
  • Conducted a prospective cohort study with male AAS users and strength-trained male non-users.
  • AAS use verification through blood and urine tests.
  • Performed transthoracic echocardiography and laboratory tests at two time points.
  • Followed up with participants over a median of 16 to 13 years.
  • Baseline AAS users exhibited concentric left ventricular hypertrophy and impaired LV systolic function.
  • At follow-up, LV mass index reduced in both continuing and discontinued AAS users, with more significant changes in those who stopped.
  • The improvement in LVEF and GLS was noted in users who discontinued AAS compared to those who continued.

Study Design

Type

Cohort (n=45)

Structured PICO

Does discontinuation of anabolic-androgenic steroids improve myocardial structure and function in long-term users compared to continued use?

P
Population
45 male participants (32 AAS users and 13 strength-trained controls) followed for a median of 13 to 16 years to assess myocardial changes.
E
Exposure
Anabolic-androgenic steroid (AAS) use (with 15 discontinuing use and 17 continuing use during follow-up).
C
Comparator
Strength-trained male non-users (controls).
O
Outcome
Myocardial structural and functional changes (including left ventricular ejection fraction, global longitudinal strain, and left ventricular mass index) measured by transthoracic echocardiography.surrogate

Main Result

Absolute Event Rate: 50% vs 54%

p-value: p=<0.01

Discontinuation of long-term anabolic-androgenic steroid use is associated with partial recovery of left ventricular systolic dysfunction over a decade.

Cite This Study

Fyksen et al. (2025) conducted a cohort in Anabolic-androgenic steroid use (n=45). Anabolic-androgenic steroids (AAS) vs. Strength-trained non-using athletes was evaluated on Left ventricular ejection fraction (LVEF) at follow-up (p=<0.01). Long-term anabolic-androgenic steroid use was associated with impaired left ventricular ejection fraction compared to controls (50% vs 54%, p<0.01), with partial recovery upon discontinuation.

synapsesocial.com/papers/698585fe8f7c464f23009c44https://doi.org/10.1093/eurheartj/ehaf784.3963
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiac structure and function in anabolic-androgenic steroid users: a 16-year follow-up study2025 · 8 citations
  2. 2Anabolic Androgenic Steroids Induce Reversible Left Ventricular Hypertrophy and Cardiac Dysfunction. Echocardiography Results of the HAARLEM Study2021 · 58 citations
  3. 3Early Left Ventricular Diastolic Dysfunction, Reduced Baroreflex Sensitivity, and Cardiac Autonomic Imbalance in Anabolic–Androgenic Steroid Users2021 · 16 citations
  4. 4Anabolic Steroids Use Is Associated with Impairments in Atrial and Ventricular Cardiac Structure and Performance in Athletes2021 · 18 citations
  5. 5Prospective Echocardiographic Assessment of Androgenic-Anabolic Steroids Effects on Cardiac Structure and Function in Strength Athletes2003 · 71 citations