Gebze Fatih State Hospital, Gebze, Kocaeli, Turkey.
Kocaeli State Hospital, Kocaeli, Turkey.
J Electrocardiol. 2024 May-Jun;84:95-99. doi: 10.1016/j.jelectrocard.2024.03.015. Epub 2024 Apr 1.
The control of the cardiovascular system depends on the autonomic nerve system. Chronic anabolic andorogenic steroids (AAS) use causes sympathovagal imbalance and increases sympathetic nerve activity.
The reduction in heart rate from the peak exercise rate following the end of the exercise stress test is known as the heart rate recovery index (HRRI). Several methods have been utilized to assess myocardial repolarization, such as QT interval (QT), corrected QT interval (QTc), and T-wave peak-to-end interval (Tp-e interval). Based on a growing number of data a higher Tp-e/QT ratio is linked to malignant ventricular arrhythmias, and an increased Tp-e interval may correlate with the transmural dispersion of repolarization. Our hypothesis is that the use of chronic AAS was decrease HRRI during maximal exercise and increased risk of cardiac arrhythmias and sudden cardiac death.
This study included 44 male bodybuilders, with an average age of 29.7 ± 8.14 years, divided into AAS abuse [AAS users (n = 21) and AAS nonuser (n = 23)].
The first (p = 0.001) and second minute (p = 0.001) HRRI of the subjects with AAS users were significantly lower than those of the control group. Additionally, HRRI after the third (p = 0.004) and fifth minutes (p = 0.007) of the recovery period were significantly lower in AAS group compared with the control group. Who used AAS had significantly higher QT, QTc, Tp-e, Tp-e/QT, and Tp-e/QTc values than non-users (all p = 0.001).
Chronic AAS use has been shown to cause sympathetic dominance, which may be a pro arrhythmic state.
心血管系统的控制依赖于自主神经系统。慢性合成代谢和雄激素类固醇(AAS)的使用会导致交感神经和副交感神经失衡,增加交感神经活动。
运动应激试验结束后,从峰值运动心率下降的心率恢复指数(HRRI)。已经使用了几种方法来评估心肌复极,例如 QT 间期(QT)、校正 QT 间期(QTc)和 T 波峰至末段间期(Tp-e 间期)。基于越来越多的数据,较高的 Tp-e/QT 比值与恶性室性心律失常有关,而 Tp-e 间期的增加可能与复极的跨壁离散相关。我们的假设是,慢性 AAS 的使用会降低最大运动时的 HRRI,并增加心律失常和心脏性猝死的风险。
本研究纳入了 44 名男性健美运动员,平均年龄 29.7±8.14 岁,分为 AAS 滥用组(AAS 使用者(n=21)和 AAS 非使用者(n=23))。
AAS 使用者的第 1 分钟(p=0.001)和第 2 分钟(p=0.001)HRRI 显著低于对照组。此外,在恢复期的第 3 分钟(p=0.004)和第 5 分钟(p=0.007),AAS 组的 HRRI 明显低于对照组。与非使用者相比,AAS 使用者的 QT、QTc、Tp-e、Tp-e/QT 和 Tp-e/QTc 值明显更高(均 p=0.001)。
慢性 AAS 的使用已被证明会导致交感神经优势,这可能是一种致心律失常状态。