TY - JOUR

T1 - Cardiac systolic dysfunction in past illicit users of anabolic androgenic steroids

AU - Rasmussen, Jon J.

AU - Schou, Morten

AU - Madsen, Per L.

AU - Selmer, Christian

AU - Johansen, Marie L.

AU - Ulriksen, Peter S.

AU - Dreyer, Tina

AU - Kümler, Thomas

AU - Plesner, Louis L.

AU - Faber, Jens

AU - Gustafsson, Finn

AU - Kistorp, Caroline

PY - 2018

Y1 - 2018

N2 - Background: Illicit use of anabolic androgenic steroids (AAS) is associated with left ventricle (LV) systolic dysfunction and increased LV mass (LVM), but whether these findings persist in former AAS users has yet to be elucidated. The objective was to assess LV systolic function, LVM and myocardial fibrosis in current and former illicit AAS users compared with non-users. Methods: Community-based cross-sectional study among men, aged 18–50 years, involved in recreational resistance training. We included 37 current and 33 former illicit AAS users, geometric mean (95%CI), 30 (21; 44) months since AAS cessation, and 30 non-users as controls. We assessed myocardial function and structure using advanced echocardiography and cardiac MRI with late-gadolinium enhancement. Results: Mean (SE) LV global longitudinal strain (GLS) was impaired in former AAS users compared with non-users, −16.7 (0.5) versus −18.2 (0.4) %, P <.05. Mean (SE) LV ejection fraction (EF) was decreased, 51 (1) versus 58 (1) %, P <.001 and LV GLS impaired, −14.5 (0.4)%, P <.001, in current AAS users compared with non-users. Measures of LVM were increased in current AAS users compared with the other two groups, P <.001. Plasma total testosterone was independently associated with reduced LVEF (P =.049) and increased LVM/body surface area (P =.005) in multivariate linear regressions. Focal myocardial fibrosis was not detected in any participants and diffuse myocardial fibrosis, assessed using post-contrast T1-mapping time, did not differ among the three groups. Conclusions: Past illicit AAS use is associated with impaired LV GLS, suggesting subclinical cardiac systolic dysfunction years after AAS cessation.

AB - Background: Illicit use of anabolic androgenic steroids (AAS) is associated with left ventricle (LV) systolic dysfunction and increased LV mass (LVM), but whether these findings persist in former AAS users has yet to be elucidated. The objective was to assess LV systolic function, LVM and myocardial fibrosis in current and former illicit AAS users compared with non-users. Methods: Community-based cross-sectional study among men, aged 18–50 years, involved in recreational resistance training. We included 37 current and 33 former illicit AAS users, geometric mean (95%CI), 30 (21; 44) months since AAS cessation, and 30 non-users as controls. We assessed myocardial function and structure using advanced echocardiography and cardiac MRI with late-gadolinium enhancement. Results: Mean (SE) LV global longitudinal strain (GLS) was impaired in former AAS users compared with non-users, −16.7 (0.5) versus −18.2 (0.4) %, P <.05. Mean (SE) LV ejection fraction (EF) was decreased, 51 (1) versus 58 (1) %, P <.001 and LV GLS impaired, −14.5 (0.4)%, P <.001, in current AAS users compared with non-users. Measures of LVM were increased in current AAS users compared with the other two groups, P <.001. Plasma total testosterone was independently associated with reduced LVEF (P =.049) and increased LVM/body surface area (P =.005) in multivariate linear regressions. Focal myocardial fibrosis was not detected in any participants and diffuse myocardial fibrosis, assessed using post-contrast T1-mapping time, did not differ among the three groups. Conclusions: Past illicit AAS use is associated with impaired LV GLS, suggesting subclinical cardiac systolic dysfunction years after AAS cessation.

U2 - 10.1016/j.ahj.2018.06.010

DO - 10.1016/j.ahj.2018.06.010

M3 - Journal article

C2 - 30015068

AN - SCOPUS:85049754467

VL - 203

SP - 49

EP - 56

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

ER -