Anabolic androgenic steroids and cardiomyopathy: an update

Fadah, Kahtan; Gopi, Gokul; Lingireddy, Ajay; Blumer, Vanessa; DeWald, Tracy A.; Mentz, Robert J

doi:10.3389/fcvm.2023.1214374

Cited by 13 publications

(3 citation statements)

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“…Furthermore, the heart, as a central cardiac pump, triggers the systolic ejection of oxygen-rich blood into the arteries, leading to the perfusion of organs and tissues to maintain life, whether in physiological or altered conditions, such as during physical exercise, diabetes, and obesity [30][31][32][33]. Furthermore, hemodynamic homeostasis involves the precise regulation of blood pressure, coordinated by the autonomic nervous system and renal mechanisms, while blood composition is maintained by the processes of hematopoiesis and hormonal control [33][34][35][36].…”

Section: The Association Of the Use Of Aass With Cardiovascular And M...mentioning

confidence: 99%

“…Direct myocardial injury caused by AASs promotes the marked hypertrophy of myocardial cells, extensive regional fibrosis, and necrosis. Unlike physiological hypertrophy, pathological hypertrophy decreases the strength of the heart [32,33,36]. High doses of AASs cause a significant increase in the concentration of erythrocytes and hemoglobin, which can lead to thromboembolism, intracardiac thrombosis, and stroke.…”

Section: The Association Of the Use Of Aass With Cardiovascular And M...mentioning

confidence: 99%

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The Use of Anabolic Steroids by Bodybuilders in the State of Sergipe, Brazil

dos Santos,

Souza,

Meneses-Santos

et al. 2024

EJIHPE

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Bodybuilding, as a high-performance sport, requires regular strength and resistance exercises with the principal objective of increasing muscle hypertrophy. However, many bodybuilders resort to the use of anabolic-androgenic steroids (AASs) to improve their performance in a short period of time. This study employs a survey-type, cross-sectional, descriptive–analytical method to evaluate the profile of bodybuilding athletes in the State of Sergipe, Brazil, and verify the level of knowledge/awareness about the health risks and impacts resulting from the use of such substances. Finite- and convenience-type populations are assessed, including individuals of both sexes, aged older than 18 years, self-declared bodybuilding athletes residing in the State of Sergipe, Brazil, and participating in regional and/or state competitions. As a result, no significant relationships were determined between sex (p = 0.492), age (p = 0.460), family income (p = 0.141), and medical follow-up sessions. For the variables level of education and medical follow-up vs. no follow-up sessions, a significant result was achieved (p = 0.01), with 74.3% of individuals reporting having follow-up treatment and 25.7% responding that they had no follow-up treatment, a percentage representing the group that completed their higher education. The substances most used by the athletes were Sustanon 250 or Durateston, Nandrolone Decanoate (Deca or Deca-Durabolin), and Testosterone. The most-reported acute side effects were acne at 33.8% (n = 20), irritability at 32.1% (n = 19), alopecia (hair loss), and nervousness at 23.7% (n = 14). The most-reported chronic side effects were arterial hypertension at 36.0% (n = 9), liver disease at 28.0% (n = 7), and cancer (non-specific) at 8.0% (n = 2). We concluded that, regardless of the athletes’ socioeconomic profiles, the use of AASs was high, with two or more substances being used in combination and for a prolonged period. Thus, it is necessary to promote awareness campaigns regarding the use of AASs and their effects on high-performance and recreational athletes.

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Section: The Association Of the Use Of Aass With Cardiovascular And M...mentioning

confidence: 99%

Section: The Association Of the Use Of Aass With Cardiovascular And M...mentioning

confidence: 99%

The Use of Anabolic Steroids by Bodybuilders in the State of Sergipe, Brazil

dos Santos,

Souza,

Meneses-Santos

et al. 2024

EJIHPE

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“…Além disso, há evidências de que, mesmo após a interrupção da administração dos anabolizantes, o aumento da massa ventricular esquerda pode persistir por muitos anos (Fadah et al, 2023). Esses achados reforçam a importância de compreender e monitorar os impactos cardiovasculares a longo prazo associados ao uso de esteroides anabolizantes.…”

Section: Introductionunclassified

A testosterona, em doses suprafisiológicas, e suas implicações cardíacas

Ramos,

Cedro Neto,

Lobão

et al. 2024

Braz. J. Hea. Rev.

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A testosterona, principal hormônio sexual masculino, desempenha papéis cruciais tanto no desenvolvimento sexual quanto em processos anabólicos, incluindo a regulação da massa muscular e densidade óssea. No entanto, seu uso em doses suprafisiológicas, como em esteroides anabolizantes, tem sido associado a uma série de efeitos adversos no sistema cardiovascular. Esta revisão aborda a relação entre os níveis elevados de testosterona e seus efeitos no sistema cardiovascular, examinando estudos experimentais, observacionais e revisões sistemáticas publicados nos últimos 15 anos. Os estudos indicam que, em níveis fisiológicos, a testosterona pode ter efeitos protetores no sistema cardiovascular, induzindo relaxamento vascular e reduzindo a formação de placa aterosclerótica. No entanto, quando administrada em doses suprafisiológicas, os esteroides anabolizantes podem desencadear uma série de complicações cardiovasculares, incluindo hipertrofia cardíaca, disfunção endotelial e eventos cardíacos adversos. Esses efeitos podem persistir mesmo após a interrupção do uso, destacando a importância da conscientização sobre os riscos associados ao abuso de esteroides anabolizantes. Medidas preventivas e educacionais são essenciais para mitigar os danos à saúde cardiovascular e proteger a saúde pública contra os efeitos adversos do uso indevido de esteroides anabolizantes.

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Coronary Microvascular Dysfunction Years After Cessation of Anabolic Androgenic Steroid Use

Bulut,

Rasmussen,

Brandt-Jacobsen

et al. 2024

JAMA Netw Open

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ImportanceLong-term use of anabolic androgenic steroids (AASs) is associated with a high risk of left ventricular hypertrophy, heart failure with reduced systolic function, and early sudden death, with the mechanism of progression being understudied. Early and persistent impaired myocardial microcirculation could be of clinical importance and a potential underlying mechanism of frequent and early cardiac disease among individuals with AAS use and a future potential target for intervention.ObjectiveTo investigate coronary microcirculation by measuring myocardial flow reserve (MFR) in men with current and former AAS use compared with controls with no prior AAS use, using cardiac rubidium 82 (82Rb) positron emission tomography/computed tomography (PET/CT).Design, Setting, and ParticipantsThis cross-sectional study included men involved in recreational strength training without established cardiovascular disease grouped according to their history of AAS use. The study was conducted November 24, 2021, to August 16, 2023.ExposureCardiac PET/CT with 82Rb was performed at rest and after adenosine-induced stress.Main Outcome and MeasureThe primary outcome of this study was the MFR among the study groups; a secondary outcome was the coronary calcium score. By definition, impaired myocardial microcirculation was determined using a cutoff of MFR less than 2, and subclinically impaired microcirculation was determined using a cutoff of MFR less than 2.5.ResultsA total of 90 men (32 with current AAS use, 31 with former AAS use, and 27 controls) were included. Mean (SD) age was 35.1 (8.7) years. Elapsed duration since AAS cessation was a geometric mean of 1.5 (95% CI, 0.9-2.5) years. Eighteen men (58.1%) with former use discontinued AAS use more than 1 year before enrollment. Impaired MFR was present in those with current (6 [18.8%]) and former (1 [3.2%]) use, whereas no impairment was observed among the controls (P = .02). Subclinically impaired MFR was higher among men with current (9 [28.1%]) and former (8 [25.8%]) AAS use than the controls (1 [3.7%]) (P = .02). In a multivariable logistic regression model among men with former AAS use, every doubling of the accumulated weekly duration of AAS use (log2) was independently associated with a factor 2 increase in the risk of impaired MFR less than 2.5 (odds ratio, 2.1; 95% CI, 1.03-4.35; P = .04).Conclusions and RelevanceIn this study, men with former AAS use displayed impaired MFR years after AAS cessation, suggesting impaired coronary microcirculation persists beyond active use.

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Anabolic androgenic steroids and cardiomyopathy: an update

Cited by 13 publications

References 99 publications

The Use of Anabolic Steroids by Bodybuilders in the State of Sergipe, Brazil

The Use of Anabolic Steroids by Bodybuilders in the State of Sergipe, Brazil

A testosterona, em doses suprafisiológicas, e suas implicações cardíacas

Coronary Microvascular Dysfunction Years After Cessation of Anabolic Androgenic Steroid Use

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