Institute of Legal Medicine, Medical Faculty, University of Cologne, Cologne, Germany.
Institute of Biochemistry, German Sport University Cologne, Cologne, Germany.
Forensic Sci Int. 2019 Oct;303:109925. doi: 10.1016/j.forsciint.2019.109925. Epub 2019 Aug 8.
A 34-year old male was found breathless and panting at home by his girlfriend three hours after a gym workout. Minutes later, he collapsed and died. Autopsy, histological and chemical analyses were conducted. The examination of the heart showed left ventricular hypertrophy, while the right coronary artery showed only a small vascular lumen (3 mm in diameter), due to its anatomical structure. In femoral blood concentrations of approx. 1 μg/L clenbuterol, approx. 56 μg/L stanozolol and approx. 8 μg/L metandienone, with trenbolone (<limit of quantification (LOQ)) were detected. Additionally, there were positive results in urine for boldenone, clomiphene, trenbolone, metandienone, stanozolol, clenbuterol and drostanolone, along with indications of testosterone and/or testosterone prohormones having been taken. In consideration of all aspects of this case, in can be assumed that the long-term consumption of anabolic androgen steroids (AAS) caused apparently pathological changes of the heart. Over and above, the combination of anatomical (small lumed coronary artery, ventricular hypertrophy) and substance-induced risk factors led to the fatal cardiovascular failure.
一名 34 岁男性在健身房锻炼三小时后被女友发现呼吸困难、喘粗气，几分钟后倒地身亡。进行了尸检、组织学和化学分析。心脏检查显示左心室肥大，而右冠状动脉由于解剖结构仅显示出小的血管腔（直径 3 毫米）。在股动脉血液中检测到约 1μg/L 的克仑特罗、约 56μg/L 的司坦唑醇和约 8μg/L 的美睾酮，而 trenbolone（<定量限 (LOQ)）。此外，尿液中还检测到 Boldenone、Clomiphene、Trenbolone、Metandienone、Stanozolol、Clenbuterol 和 Drostanolone，以及睾酮和/或睾酮前体的存在迹象。考虑到此案的各个方面，可以假设长期使用合成代谢雄激素类固醇 (AAS) 导致了明显的心脏病变。此外，解剖学（小腔冠状动脉、心室肥大）和物质诱导的风险因素的结合导致了致命的心血管衰竭。
