Fyksen Tea Sætereng, Gravning Jørgen, Rossebø Anne, Vanberg Paul, Grøtta Ole Jørgen, Atar Dan, Halvorsen Sigrun
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Department of Cardiology, Oslo University Hospital Ullevål, Oslo University Hospital, Oslo, Oslo, Norway.
Open Heart. 2025 Aug 4;12(2):e003376. doi: 10.1136/openhrt-2025-003376.
Long-term data on cardiac changes in anabolic-androgenic steroid (AAS) users are lacking. The aim of this study was to explore the effects of AAS on cardiac structure and function during long-term follow-up.
In this prospective cohort study, AAS users and strength-trained non-users were included and examined at two time points with echocardiography and coronary CT angiography. AAS use and non-use were verified by blood and urine analyses.
A cohort of 32 AAS users (median age 33 years) and 13 non-users (median age 34 years) were followed for a median of 16 (IQR, 15-17) and 13 (7-15) years, respectively. At baseline, AAS users had been taking AAS for a median of 5-10 years. At follow-up, 15 had discontinued AAS, while 17 remained continued users. At baseline, AAS users presented with larger left ventricular mass (LVM) (266 g (213-319) vs 215 g (196-217), p<0.01), and lower left ventricular ejection fraction (LVEF) (49% (44-53) vs 53% (51-56), p=0.05), compared with non-users. At follow-up, LVM in discontinued users was reduced and similar to the non-users, while continued users still had larger LVM. LVEF remained significantly impaired in continued users versus non-users (p<0.01). In discontinued users, LVEF seemed to improve over time. The median change in LVEF over time differed significantly between continued and discontinued AAS users (-2 (-6 to 2) vs 3 (1 to 8), p<0.01). Despite higher cardiac troponin T levels in AAS users, coronary artery disease prevalence did not differ between groups.
Long-term AAS use was associated with myocardial remodelling and left ventricular dysfunction. In AAS users who discontinued use during follow-up, left ventricular remodelling and systolic function seemed to improve, even after more than a decade of AAS use.
缺乏关于合成代谢雄激素类固醇（AAS）使用者心脏变化的长期数据。本研究的目的是在长期随访期间探讨AAS对心脏结构和功能的影响。
在这项前瞻性队列研究中，纳入了AAS使用者和进行力量训练的非使用者，并在两个时间点通过超声心动图和冠状动脉CT血管造影进行检查。通过血液和尿液分析验证AAS的使用和未使用情况。
32名AAS使用者（中位年龄33岁）和13名非使用者（中位年龄34岁）的队列分别随访了中位时间16（四分位间距，15 - 17）年和13（7 - 15）年。在基线时，AAS使用者服用AAS的中位时间为5 - 10年。在随访时，15人停止使用AAS，而17人仍继续使用。在基线时，与非使用者相比，AAS使用者的左心室质量（LVM）更大（266 g（213 - 319）对215 g（196 - 217），p<0.01），左心室射血分数（LVEF）更低（49%（44 - 53）对53%（51 - 56），p = 0.05）。在随访时，停止使用者的LVM降低且与非使用者相似，而继续使用者的LVM仍然更大。与非使用者相比，继续使用者的LVEF仍然显著受损（p<0.01）。在停止使用者中，LVEF似乎随时间改善。继续和停止使用AAS的使用者随时间LVEF的中位变化有显著差异（-2（-6至2）对3（1至8），p<0.01）。尽管AAS使用者的心肌肌钙蛋白T水平较高，但两组之间冠状动脉疾病患病率没有差异。
长期使用AAS与心肌重塑和左心室功能障碍有关。在随访期间停止使用的AAS使用者中，即使在使用AAS十多年后，左心室重塑和收缩功能似乎也有所改善。
