(04-04-07) Athletes Using Anabolic Steroids Have Subclinical Impairment of Cardiac Function

By Sarah Pressman Lovinger

Misuse of anabolic androgenic steroids by athletes can lead to subclinical impairment of systolic and diastolic myocardial function in a dose-dependent and duration-dependent fashion, results of an Italian study suggest.
?The extent to which increased left ventricular muscle mass caused by AAS [anabolic androgenic steroid] misuse represents a long-term risk for cardiac complications is controversial,? the study investigators wrote in the March issue of the British Journal of Sports Medicine.
The study shows for the first time that two noninvasive techniques--Doppler myocardial imaging and strain rate imaging--can detect subclinical left ventricular (LV) myocardial dysfunction after AAS misuse, wrote Dr. Antonello D?Andrea of the Second University of Naples, Italy, and his associates.
The authors evaluated 20 athletes who were using anabolic androgenic steroids for least 5 years, 25 athletes who were not using AAS, and 25 age-matched healthy sedentary controls. All participants were men, aged 33-34. The athletes engaged in 3 hours of weight lifting per day and 2 hours of low-intensity endurance training per day.
The AAS users and nonusers had significantly higher body surface areas (2.2 m2and 2.1 m2, respectively) than did the controls (1.9m2). The users also had significantly higher baseline systolic blood pressure levels than the controls (140 mm Hg vs. 126 mm Hg).
All participants underwent standard Doppler echocardiography with Doppler myocardial imaging and strain rate imaging.
There was a significant increase in wall thickness in the two athlete groups, compared with the control group. Colour Doppler myocardial imaging studies revealed significantly lower myocardial early: myocardial atrial diastolic wave ratios in athletes using AAS at the basal interventricular septum and LV lateral wall, compared with athletes who did not use AAS (Br. J. Sports Med. 2007;41:149-155 [doi: 10.1136/bjsm.2006.030171]).
AAS users also had lower peak systolic LV strain rates in the middle interventricular septum and left ventricular lateral free wall, compared with the other two groups. In the group using AAS, impairment of LV strain was associated with significantly lower physical performance with effort.
Calculations involving the LV wall thickness and the number of weeks per year of AAS use together with the dosage of AAS were the only independent predictors of middle interventricular septum strain rate.
There were no significant differences in left ventricular ejection fraction, LV end-diastolic diameter, and transmittal Doppler indexes amongst all three groups. There also were no significant differences in LV mass index between the two groups of athletes.

Source: Elsevier Global Medical News

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