Effects of testosterone and nandrolone on cardiac function: a randomized, placebo-controlled study.
BACKGROUND
Androgens have striking effects on skeletal muscle, but the effects on human cardiac muscle function are not well defined, neither has the role of metabolic activation (aromatization, 5alpha reduction) of testosterone on cardiac muscle been directly studied.


OBJECTIVE
To assess the effects of testosterone and nandrolone, a non-amplifiable and non-aromatizable pure androgen, on cardiac muscle function in healthy young men.


METHODS
Double-blind, randomized, placebo-controlled, three-arm parallel group clinical trial.


METHODS
Ambulatory care research centre.


METHODS
Healthy young men randomized into three groups of 10 men.


METHODS
Weekly intramuscular injections of testosterone (200 mg mixed esters), nandrolone (200 mg nandrolone decanoate) or matching (2 ml arachis oil vehicle) placebo for 4 weeks.


METHODS
Comprehensive measures of cardiac muscle function involving transthoracic cardiac echocardiography measuring myocardial tissue velocity, peak systolic strain and strain rates, and bioimpedance measurement of cardiac output and systematic vascular resistance.


RESULTS
Left ventricular (LV) function (LV ejection fraction, LV modified TEI index), right ventricular (RV) function (ejection area, tricuspid annular systolic planar motion, RV modified TEI index) as well as cardiac afterload (mean arterial pressure, systemic vascular resistance) and overall cardiac contractility (stroke volume, cardiac output) were within age- and gender-specific reference ranges and were not significantly (P < 0.05) altered by either androgen or placebo over 4 weeks of treatment. Minor changes remaining within normal range were observed solely within the testosterone group for: increased LV end-systolic diameter (30 +/- 7 vs. 33 +/- 5 mm, P = 0.04) and RV end-systolic area (12.8 +/- 1.3 vs. 14.6 +/- 3.3 cm(2), P = 0.04), reduced LV diastolic septal velocity (Em, 9.5 +/- 2.6 vs. 8.7 +/- 2.0 cm/s, P = 0.006), increased LV filling pressure (E/Em ratio, 7.1 +/- 1.6 vs. 8.3 +/- 1.8, P = 0.02) and shortened PR interval on the electrocardiogram (167 +/- 13 vs. 154 +/- 12, P = 0.03).


CONCLUSIONS
Four weeks of treatment with testosterone or nandrolone had no beneficial or adverse effects compared with placebo on cardiac function in healthy young men.
Chung
T
T
Department of Cardiology, Concord Hospital and ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia.
Kelleher
S
S
Liu
P Y
PY
Conway
A J
AJ
Kritharides
L
L
Handelsman
D J
DJ
D000328:Adult; D045930:Anabolic Agents / Q000494:pharmacology*; D000704:Analysis of Variance; D002302:Cardiac Output / Q000187:drug effects; D004311:Double-Blind Method; D004562:Electrocardiography / Q000187:drug effects; D006801:Humans; D007273:Injections, Intramuscular; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects*; D009277:Nandrolone / Q000494:pharmacology*; D013314:Stress, Mechanical; D013599:Systole; D013739:Testosterone / Q000097:blood / Q000494:pharmacology*; D014655:Vascular Resistance / Q000187:drug effects
D045930:Anabolic Agents; D013739:Testosterone; D009277:Nandrolone; D007986:Luteinizing Hormone