The Indiscriminate Use Of Androgenic Anabolic Steroids: The Contribution of Cardiovascular Imaging

Abstract

Anabolic androgenic steroids (AAS) are natural or synthetic compounds similar to the male hormone testosterone. The literature also describes cases of AAS abuse, such as in bodybuilding, cosmetics, recreational use, and aesthetic enhancement. It was discovered that AAS alone directly induce myocardial injury, with the main pathological finding in autopsied hearts being left ventricle (LV) hypertrophy in frequent association with myocyte hypertrophy, increased collagen deposition in the matrix, increased activity of the cardiac angiotensin, and myocardial fibrosis.Patients who used illicit AAS present decreased LV systolic function. In athletes who self-administer AAS, LV hypertrophy and elevated sympathetic modulation were observed, as well as elevated blood pressure (BP). High doses of AAS can cause the user to have ventricular arrhythmias and sudden death. Furthermore, AAS users demonstrated greater coronary artery plaque volume than non-users. The objective of this review is to revisit the main effects of the use of AAS on cardiac changes through cardiovascular imaging as well as to establish a difference in relation to athletic heart syndrome.