Smit Diederik L, Voogel A J, den Heijer Martin, de Ronde Willem
Department of Internal Medicine, Spaarne Gasthuis, Haarlem, Netherlands.
Department of Cardiology, Spaarne Gasthuis, Haarlem, Netherlands.
Front Reprod Health. 2021 Sep 1;3:732318. doi: 10.3389/frph.2021.732318. eCollection 2021.
The use of anabolic androgenic steroids (AAS) is not uncommon among strength athletes. Several cross-sectional studies have linked AAS use to heart disease, but a causal role for AAS is not certain and it is unknown whether cardiac changes are reversible. Men of at least 18 years old intending to start an AAS cycle on short notice were included for comprehensive 3D echocardiographic examination before (T), at the end of the cycle (T), and 1 year after inclusion (T) after a recovery period. Details of the AAS cycle performed and the use of other performance and image-enhancing drugs (PIEDs) as well as illicit drug use were recorded. Trend analysis and multivariable regression analysis were performed with mixed effects linear models. Thirty-one subjects were included. Between start (T) and end of the cycle (T), after a median AAS cycle duration of 16 weeks, 3D left ventricular ejection fraction declined with 4.9% (CI -7.2 to -2.5, < 0.001), E/A-ratio declined with-0.45 (CI -0.69 to -0.21, < 0.001), and 3D left atrial volume increased with 9.2 ml (CI 2.9-15.4, = 0.004). Left ventricular mass increased with 28.3 g (CI 14.2-42.4, < 0.001) and was positively correlated with AAS average weekly dose. After a median recovery time of 8 months (T), all parameters returned to baseline. AAS induce left ventricular hypertrophy and impaired systolic and diastolic function in amateur strength athletes. The structural cardiac changes are positively associated with AAS dose and complete recovery occurred after AAS were discontinued.
合成代谢雄激素类固醇（AAS）在力量型运动员中使用并不罕见。多项横断面研究将AAS的使用与心脏病联系起来，但AAS是否起因果作用尚不确定，心脏变化是否可逆也不清楚。纳入至少18岁且打算在短时间内开始AAS周期的男性，在开始前（T0）、周期结束时（T1）以及纳入后1年的恢复期后（T2）进行全面的三维超声心动图检查。记录所进行的AAS周期细节以及其他性能和形象增强药物（PIEDs）的使用情况以及非法药物使用情况。采用混合效应线性模型进行趋势分析和多变量回归分析。共纳入31名受试者。在周期开始（T0）至结束（T1）之间，AAS周期的中位持续时间为16周，三维左心室射血分数下降了4.9%（CI -7.2至-2.5，P<0.001），E/A比值下降了-0.45（CI -0.69至-0.21，P<0.001），三维左心房容积增加了9.2 ml（CI 2.9 - 15.4，P = 0.004）。左心室质量增加了28.3 g（CI 14.2 - 42.4，P<0.001），且与AAS平均每周剂量呈正相关。在中位恢复时间8个月（T2）后，所有参数均恢复至基线水平。AAS可导致业余力量型运动员左心室肥厚以及收缩和舒张功能受损。心脏结构变化与AAS剂量呈正相关，停用AAS后心脏结构完全恢复。
