Clinical InvestigationCardiac systolic dysfunction in past illicit users of anabolic androgenic steroids
Section snippets
Study design and participation criteria
Men, aged 18 to 50 years, involved in recreational resistance training, volunteered from the community to participate in this cross-sectional study from November 2014 to December 2015. We have previously described the study design, inclusion of participants and several procedures.14., 15., 16., 17. To minimize risk of selection bias, we did not use specific criteria regarding weekly hours of resistance training or duration nor extent of AAS abuse. Participants were allocated into three
Characteristics of participants
The study cohort comprised 37 ongoing AAS users, 33 former AAS users, and 30 non-users. Geometric mean (95%CI) number of weeks of accumulated duration of illicit AAS use did not differ between current users, 142 (100; 203) and former users, 112 (81; 154) (Table I). AAS dose ranges used by current and former AAS users are described elsewhere for each AAS compound.14 Mean (95%CI) elapsed duration since AAS discontinuation was 30 (21; 44) months among former users and in this group none reported
Discussion
The primary findings in this study were that both former and current illicit AAS users featured indices of decreased LV systolic function; manifested as impaired LV GLS in both former and current AAS users and lower LVEF in current AAS users. Only current use of AAS was associated with LV myocardial hypertrophy and diastolic dysfunction. We noted independent associations between increased plasma total testosterone and decreased LVEF and LV myocardial hypertrophy, but we did not detect
Conclusions
In conclusion, both current and former illicit AAS users displayed lower LV systolic function than non-users. LV mass was only increased in current AAS users. We noted independent associations between increased plasma testosterone and decreased LVEF and LV myocardial hypertrophy, but myocardial fibrosis was not detected in any participants using MRI-LGE. Longitudinal studies are warranted to further elucidate the clinical relevance of our findings.
Acknowledgements
The authors are grateful to all participants for their contribution to this study. Furthermore, we are thankful to the personnel in the endocrine research lab of Herlev Hospital for highly qualified technical assistance.
Contributors
Conception and design: JJR, CK, FG, MS. Acquisition of data: JJR, CK, MS, MLJ. Analysis of data: JJR, TK, PLM, LLP, TD. Interpretation of data: JJR, CK, FG, MS, CS, PLM, JF, PSU, MLJ, TK, LLP and TD. Drafting of manuscript: JJR. Revising manuscript of critically important intellectual content: JJR, CK, FG, MS, CS, PLM, JF, PSU, MLJ, TK, LLP and TD. Final approval of manuscript: JJR, CK, FG, MS, CS, PLM, JF, PSU, MLJ, TK, LLP and TD. All authors had full access to the data and agree to take
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Declarations of interest: JJR and CK received unrestricted research grants from AntiDoping Denmark. MS, PLM, CS, MLJ, PSU, TK, TD, LLP, JF and FG have no conflicts of interest in relation to the present topic.
Funding: This work was supported by AntiDoping Denmark (grant number: N/A), Research Foundation of Herlev Hospital (grant number: N/A), Danish Heart Foundation (grant number: 15-R99-A5797–22952), Faculty Scholarship from University of Copenhagen to JJR (grant number: N/A).
Role of the funding source: The financial sources had no role in study design, conduction of study, statistical analyses, writing of manuscript or decision to publish the final version of manuscript.