Long-term anabolic-androgenic steroid use is associated with left ventricular dysfunction.
Long-term anabolic-androgenic steroid use is associated with left ventricular dysfunction.
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DOI：
10.1161/circheartfailure.109.931063
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发表时间：
2010-07
期刊：
影响因子：
--
通讯作者：
Pope HG Jr
中科院分区：
文献类型：
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作者：
Baggish AL;Weiner RB;Kanayama G;Hudson JI;Picard MH;Hutter AM Jr;Pope HG Jr
尽管非法合成代谢雄激素类固醇（AAS）的使用很普遍，但长期使用AAS对心脏的影响仍不充分。我们比较了长期使用AAS的举重运动员的心脏参数和其他方面相似但没有使用AAS的举重运动员。我们使用二维、组织多普勒和斑点跟踪超声心动图来评估长期AAS使用者（n=12）和其他类似的AAS非使用者（n=7）的左室（LV）射血分数、左室收缩应变和舒张功能的常规指标。AAS使用者（中位数[Q1，Q3]累积终生AAS暴露468[169-520]周）在年龄、既往举重持续时间和当前重量训练强度方面与非使用者非常相似。两组间左室结构参数相似。然而，AAS使用者的左室射血分数显著降低（50.6%[48.4,53.6]对59.1%[58.0,61.7]，双尾Wilcoxon秩和检验p = 0.003）；纵向应变（16.9%[14.0,19.0]对21.0% [20.2,22.9],p = 0.004）和径向应变（38.3[28.5,43.7]对50.1 [44.3,61.8],p = 0.02）。12例AAS患者中有10例左室射血分数低于正常值（≥55%）。与非AAS使用者相比，AAS使用者的舒张功能也有所下降，这可以从E ' velocity （7.4 [6.8, 7.9] vs . 9.9 [8.3, 10.5]; p = 0.005）和E/ a ratio （0.93 [0.88, 1.39] vs . 1.80 [1.48, 2.00]; p = 0.003）得到证明。长期AAS使用者的心功能障碍似乎比以前报道的更严重，并且可能足以增加心力衰竭的风险。
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. 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). Cardiac dysfunction in long-term AAS users appears more severe than previously reported, and may be sufficient to increase the risk of heart failure.