Key result
Long-term anabolic steroid use is linked to ~10-point lower LVEF compared with non-using weightlifters.
Why the study?
The cardiovascular effects of long-term anabolic-androgenic steroid (AAS) use in current and former weightlifters, the occurrence of severely reduced myocardial function, and the impact of AAS duration and amount needed exploration.
Does long-term anabolic-androgenic steroid use cause biventricular cardiomyopathy and severely reduced myocardial function in current and former weightlifting users compared to non-using weightlifting controls?
Cross-Sectional (n=172)
Blinded offline echocardiographic analysis
No
Does long-term anabolic-androgenic steroid use cause biventricular cardiomyopathy and severely reduced myocardial function in current and former weightlifting users compared to non-using weightlifting controls?
Long-term anabolic-androgenic steroid use is independently associated with severe biventricular cardiomyopathy and reduced systolic function that persists even years after cessation of use.
May warrant cardiac evaluation in long-term AAS users; leaves open causality and reversibility after cessation.
AIMS: This study aims to explore the cardiovascular effects of long-term anabolic-androgenic steroid (AAS) use in both current and former weightlifting AAS users and estimate the occurrence of severe reduced myocardial function and the impact of duration and amount of AAS. METHODS AND RESULTS: In this cross-sectional study, 101 weightlifting AAS users with at least 1 year cumulative AAS use (mean 11 ± 7 accumulated years of AAS use) were compared with 71 non-using weightlifting controls (WLC) using clinical data and echocardiography. Sixty-nine were current, 30 former (>1 year since quitted), and 2 AAS users were not available for this classification. Anabolic-androgenic users had higher left ventricular mass index (LVMI) (106 ± 26 vs. 80 ± 15 g/m2, P < 0.001), worse left ventricular ejection fraction (LVEF) (49 ±7 vs. 59 ± 5%, P < 0.001) and right ventricular global longitudinal strain (-17.3 ± 3.5 vs. -22.8 ± 2.0%, P < 0.001), and higher systolic blood pressure (141 ± 17 vs. 133 ± 11 mmHg, P < 0.001) compared with WLC. In current users, accumulated duration of AAS use was 12 ± 7 years and in former 9 ± 6 years (quitted 6 ± 6 years earlier). Compared with WLC, LVMI and LVEF were pathological in current and former users (P < 0.05) with equal distribution of severely reduced myocardial function (LVEF ≤40%) (11 vs. 10%, not significant (NS)). In current users, estimated lifetime AAS dose correlated with reduced LVEF and LVGLS, P < 0.05, but not with LVMI, P = 0.12. Regression analyses of the total population showed that the strongest determinant of reduced LVEF was not coexisting strength training or hypertension but history of AAS use (β -0.53, P < 0.001). CONCLUSION: Long-term AAS users showed severely biventricular cardiomyopathy. The reduced systolic function was also found upon discontinued use.
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Abdullah et al. (2023) conducted a cross-sectional in Long-term anabolic-androgenic steroid (AAS) use and biventricular cardiomyopathy (n=172). Long-term anabolic-androgenic steroid (AAS) use vs. Non-using weightlifting controls (WLC) was evaluated on Left ventricular ejection fraction (LVEF) (β -0.53, p=<0.001). Long-term anabolic-androgenic steroid use was associated with lower LVEF (49±7% vs 59±5%, P<0.001) and higher LVMI (106±26 vs 80±15 g/m2, P<0.001) compared to non-using weightlifting controls.
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