Sports Medicine Laboratory, Department of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece.
Int J Environ Res Public Health. 2021 Jun 29;18(13):6974. doi: 10.3390/ijerph18136974.
The effects of androgen anabolic steroids (AAS) use on athletes' cardiac autonomic activity in terms of baroreflex sensitivity (BRS), and heart rate variability (HRV) have not yet been adequately studied. Furthermore, there is no information to describe the possible relationship between the structural and functional cardiac remodeling and the cardiac autonomic nervous system changes caused by AAS abuse. Thus, we aimed to study the effects of long-term AAS abuse on cardiac autonomic efficacy and cardiac adaptations in strength-trained athletes. In total, 80 strength-trained athletes (weightlifters and bodybuilders) participated in the study. Notably, 40 of them using AAS according to their state formed group A, 40 nonuser strength-trained athletes comprised group B, and 40 healthy nonathletes (group C) were used as controls. All subjects underwent a head-up tilt test using the 30 min protocol to evaluate the baroreflex sensitivity and short HRV modulation. Furthermore, all athletes undertook standard echocardiography, a cardiac tissue Doppler imaging (TDI) study, and a maximal spiroergometric test on a treadmill to estimate their maximum oxygen consumption (VOmax). The tilt test results showed that group A presented a significantly lower BRS and baroreflex effectiveness index than group B by 13.8% and 10.7%, respectively ( < 0.05). Regarding short-term HRV analysis, a significant increase was observed in sympathetic activity in AAS users. Moreover, athletes of group A showed increased left ventricular (LV) mass index (LVMI) by 8.9% ( < 0.05), compared to group B. However, no difference was found in LV ejection fraction between the groups. TDI measurements indicated that AAS users had decreased septal and lateral peak E' by 38.0% ( < 0.05) and 32.1% ( < 0.05), respectively, and increased E/E' by 32.0% ( < 0.05), compared to group B. This LV diastolic function alteration was correlated with the year of AAS abuse. A significant correlation was established between BRS depression and LV diastolic impairment in AAS users. Cardiopulmonary test results showed that AAS users had significantly higher time to exhaustion by 11.0 % ( < 0.05) and VOmax by 15.1% ( < 0.05), compared to controls. A significant correlation was found between VOmax and LVMI in AAS users. The results of the present study indicated that long-term AAS use in strength-trained athletes led to altered cardiovascular autonomic modulations, which were associated with indices of early LV diastolic dysfunction.
长期使用雄激素合成代谢类固醇（AAS）对运动员心脏自主活动的影响，包括压力反射敏感性（BRS）和心率变异性（HRV），尚未得到充分研究。此外，目前尚无信息描述 AAS 滥用引起的心脏结构和功能重构与心脏自主神经系统变化之间的可能关系。因此，我们旨在研究长期 AAS 滥用对力量训练运动员心脏自主效能和心脏适应性的影响。共有 80 名力量训练运动员（举重运动员和健美运动员）参加了这项研究。值得注意的是，其中 40 名根据自身情况使用 AAS 的运动员组成了 A 组，40 名非使用者力量训练运动员组成了 B 组，40 名健康非运动员（C 组）作为对照组。所有受试者均接受了 30 分钟的倾斜测试，以评估压力反射敏感性和短程 HRV 调节。此外，所有运动员均接受了标准超声心动图、心脏组织多普勒成像（TDI）研究和跑步机上的最大心肺功能测试，以估计其最大耗氧量（VOmax）。倾斜试验结果显示，A 组的 BRS 和压力反射有效指数分别比 B 组低 13.8%和 10.7%（<0.05）。关于短期 HRV 分析，AAS 使用者的交感神经活性明显增加。此外，A 组运动员的左心室（LV）质量指数（LVMI）增加了 8.9%（<0.05），与 B 组相比。然而，两组之间的 LV 射血分数没有差异。TDI 测量表明，AAS 使用者的室间隔和侧壁峰值 E'分别下降了 38.0%（<0.05）和 32.1%（<0.05），E/E'增加了 32.0%（<0.05），与 B 组相比。这种 LV 舒张功能改变与 AAS 滥用的年限有关。AAS 使用者的 BRS 抑制与 LV 舒张功能障碍呈显著相关。心肺测试结果显示，AAS 使用者的运动时间延长了 11.0%（<0.05），VOmax 增加了 15.1%（<0.05），与对照组相比。AAS 使用者的 VOmax 与 LVMI 呈显著相关。本研究结果表明，长期使用 AAS 会改变力量训练运动员的心血管自主调节，这与早期 LV 舒张功能障碍的指标有关。
